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Table 2 Reasons for changing items during pre-testing (Adapted from [17])

From: Developing and pretesting a new patient reported outcome measure for paediatric Chronic Fatigue Syndrome/ Myalgic Encephalopathy (CFS/ME): cognitive interviews with children

Item Property

Reasons for change or deletion

Clarity of relevance

• Not relevant to a large number of the participants

• Large amounts of requests for clarification from participants

• Participants interpret items in a different way than intended by the conceptual framework

Response range

• High number of participants response at extreme ends of the scale

• Participants feedback that the none of the response options apply to them


• All participants give the same answer

• Participants do not give different responses even when important differences are known


• Item duplicates information collected from other items