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The argument-based approach to validity: theory, assumptions, evidence, and consequences.

Journal articles  - Journal Article
Hawkins, M; Sawatzky, R; Weinfurt, K; Cartner, S; Gill, S; Osborne, R; Mayo, N; Schick-Makaroff, K; Sprangers, M; Wirth, RJ; Elsworth, GR; Nolte, S
Published in: Qual Life Res
June 6, 2026

BACKGROUND: Concerns about measurement validation are often expressed as imperatives to use a "valid measure". However, validity is not a characteristic of a measure. Instead, validation and validity refer to score interpretation within a context of use. This is important because responses to health measures can be different in different contexts, influencing equitable consequences of measurement. In this paper, we aim to (1) outline the theory of the argument-based approach to validity, and (2) discuss assumptions and evidence in relation to equitable consequences of measurement. METHODS: The argument-based approach to validity asks us to first state how scores will be interpreted and used in context. Assumptions underpinning this statement guide validation planning. Existing and new evidence need to be examined and evaluated in relation to the assumptions and concept of interest, leading to a reasoned evidence-based argument about the degree to which score interpretation in a context of use is valid, with consideration of potential threats to validity and measurement consequences. RESULTS: Key assumptions are described, including why evidence is needed, what evidence tells us, and the importance of assumptions in relation to the equitable consequences of measurement. CONCLUSION: The argument-based approach to validity shifts the focus of validation to a score's interpretation and use in a context, in relation to the concept of interest. A validity argument is built from evidence about the plausibility of the score interpretation in the context of use with consideration of the degree to which measurement consequences will lead to the intended beneficial health consequences and not perpetuate existing inequities in health.

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Published In

Qual Life Res

DOI

EISSN

1573-2649

Publication Date

June 6, 2026

Volume

35

Issue

7

Location

Netherlands

Related Subject Headings

  • Surveys and Questionnaires
  • Self Report
  • Reproducibility of Results
  • Humans
  • Health Policy & Services
  • 44 Human society
  • 42 Health sciences
 

Citation

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Hawkins, M., Sawatzky, R., Weinfurt, K., Cartner, S., Gill, S., Osborne, R., … Nolte, S. (2026). The argument-based approach to validity: theory, assumptions, evidence, and consequences. Qual Life Res, 35(7). https://doi.org/10.1007/s11136-026-04194-z
Hawkins, Melanie, Richard Sawatzky, Kevin Weinfurt, Sharla Cartner, Scott Gill, Richard Osborne, Nancy Mayo, et al. “The argument-based approach to validity: theory, assumptions, evidence, and consequences.Qual Life Res 35, no. 7 (June 6, 2026). https://doi.org/10.1007/s11136-026-04194-z.
Hawkins M, Sawatzky R, Weinfurt K, Cartner S, Gill S, Osborne R, et al. The argument-based approach to validity: theory, assumptions, evidence, and consequences. Qual Life Res. 2026 Jun 6;35(7).
Hawkins, Melanie, et al. “The argument-based approach to validity: theory, assumptions, evidence, and consequences.Qual Life Res, vol. 35, no. 7, June 2026. Pubmed, doi:10.1007/s11136-026-04194-z.
Hawkins M, Sawatzky R, Weinfurt K, Cartner S, Gill S, Osborne R, Mayo N, Schick-Makaroff K, Sprangers M, Wirth RJ, Elsworth GR, Nolte S. The argument-based approach to validity: theory, assumptions, evidence, and consequences. Qual Life Res. 2026 Jun 6;35(7).
Journal cover image

Published In

Qual Life Res

DOI

EISSN

1573-2649

Publication Date

June 6, 2026

Volume

35

Issue

7

Location

Netherlands

Related Subject Headings

  • Surveys and Questionnaires
  • Self Report
  • Reproducibility of Results
  • Humans
  • Health Policy & Services
  • 44 Human society
  • 42 Health sciences