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Open Access Correspondence

The new COSMIN guidelines confront traditional concepts of responsiveness

Felix Angst

Author Affiliations

Research Department, RehaClinic Zurzach, 5300 Bad Zurzach, Switzerland

Department for Upper Extremity and Hand Surgery, Schulthess Klinik, 8008 Zurich, Switzerland

BMC Medical Research Methodology 2011, 11:152  doi:10.1186/1471-2288-11-152

Published: 18 November 2011


The recently published "COSMIN" guidelines aim to rate properties of outcome instruments and state two issues with regard to responsiveness which is the instrument's ability to detect change over time. These issues are comparison of score changes with change of an external criterion using correlations and the judgement of traditional methods as inappropriate. The latter are the "transition" concept, a global rating of change, and parametric measures of responsiveness, for example, effect sizes. It can be shown that the methodology proposed by the guidelines has important weaknesses and that denunciation of traditional methods is not appropriate. Some claims of the guidelines about responsiveness do not match the demands of clinical reality and confront findings of numerous epidemiological studies.