4.2 Article

Does Response Format Matter? The Psychometric Effects of Filter Questions on Self-Reported Symptom Frequencies

Journal

ASSESSMENT
Volume 30, Issue 6, Pages 1998-2015

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/10731911221133310

Keywords

filter questions; response formats; symptom frequencies; item response theory; clinical assessment

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The presence-severity response format, which includes a filter question, has a substantial effect on people's responses and the psychometric properties of items. It results in a reduction in symptom reporting and loss of information about individual differences, particularly for people experiencing mild symptoms.
The presence-severity response format uses a filter question to ask about the presence of a symptom, followed by a question about the severity of that symptom. Only an affirmative response to the filter question triggers the follow-up question. Despite its widespread use, little research has compared the psychometric properties of the presence-severity response format to those of the traditional single-item response format. The purpose of this research was to understand how filter questions influence item responses and characteristics on several short health-related questionnaires. Using two different experimental designs, we find that depending on the construct being measured, the inclusion of a filter question can have a substantial effect on people's responses, and in turn, the psychometric properties of the items. Overall, the presence-severity response format results in a reduction in symptom reporting and loss of information about individual differences, particularly for people experiencing mild symptoms. Measurement recommendations are provided.

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