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Health Status Measurement, Floor and Ceiling Effects

Floor and ceiling effects refer to specific limitations encountered when measuring health status scores. Floor effects occur when data cannot take on a value lower than some particular number; ceiling effects occur when data cannot take on a value higher than an upper limit. Health status instruments or surveys that are used to assess domains or attributes of health status use a rating scale. This is commonly a Likert scale with rating scales between 1 and 10, for example. There are limitations to the use of such instruments when measuring health status for either evaluative or discriminative purposes. An awareness of these limitations is important because of the problems that can occur in the interpretation of the results obtained when measuring health status, regardless of ...

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