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December 2, 1988


Author Affiliations

Bethesda, Md

Bethesda, Md

JAMA. 1988;260(21):3202. doi:10.1001/jama.1988.03410210116052

Recognized methods for validating psychological and social science measures are generally quite different from those used to validate a laboratory procedure. Somewhere in between these, but methodologically more closely allied with social science approaches, are the methods used to establish and validate medical indices that are used to characterize the clinical status of patients. Grading of heart murmurs, the TNM classification for malignant tumors, and the functional classification of the New York Heart Association are all well-known examples of attempts to quantify clinical findings.

In this book, Dr Feinstein attempts to delineate the principles underlying the construction and utility of such clinical scales. His treatment of the diverse considerations that impact on these scales is detailed and exhausting and is replete with definitions of terms from the social science literature as well as those, such as "clinimetrics," that he has coined himself. Because clinical medicine deals with such a large