Biased measure, strong evidence?—An overview of common risk of bias in measurement

Abstract

Although nurses, whether researchers or clinicians, may use measuring instruments in their daily practice, instruments deemed credible sometimes present with several undisclosed biases. These biases can undermine the credibility of the results obtained from their use in research or practice. This article aims to synthesize the most frequent biases of instruments to allow nurse researchers and clinicians to recognize them when exposed to new instruments or undertake an original instrument's development. The types of biases and relevant management strategies are classified into four categories: conceptual, methodological, response and contextual. The strategies recommended by measurement experts address biases introduced in developing, testing, and validating instruments. This article provides an overview of recommended practices for their development and testing. It is expected that this article will contribute to raise awareness of nurse researchers and clinicians towards the possible limitations and biases in using instruments and refine their critical thinking about measurement in their respective fields.