Welcome back. Week 5. This lecture we're going to talk about Measurement. Measuring things.

A critical idea to science and obviously critical to the social epidemiology. This first module we're going to talk about measurement in general, I want to introduce to you some basic ideas of reliability and validity. Give you some brief examples, but most importantly remind you that this is a very difficult area. There's volumes written about these concepts and ideas and sometimes it gets very mathematical or statistical quickly. So I want to give you some basics and then encourage you to either on our discussion site or on your own to explore these ideas further... There are two assigned readings for this week. the first is a chapter I wrote for an NIH online textbook and that's about measuring socioeconomic status and you'll read that and you'll be quizzed on that. And then the second reading is a chapter from a book I edited and it's on measuring race and racism. And let me just say thanks to my publisher Jossey-Bass WIley, and my editor, Andy Pasternack, for letting you have free access to this material. I also wanted to offer you some optional readings. These aren't required. You're not going to be quizzed on them. But I thought they might help you further your investigation further your learning into the importance of measurement of different kinds of ideas. measurements critical ironically or some delightfully perhaps the poet Yeats I thought really captured it well in his famous poem, with measurement began our might. In other words if we can't measure something well We can quickly get into trouble with understanding how the relationships are working. For example, if we don't measure morbidity or mortality well in epidemiology, we can really come to some wrong conclusions about the causes of morbidity and mortality. And just to remind you morbidity is illness and mortality is death or alive or not.

Well, the core ideas about measurement tend to come from a field from psychology and that field is called psychometrics measuring things in psychology. there's other aspects, but the core sort of approach to this comes from psychometrics, a subfield of psychology. And, in the classical sense, there's been some advances, but the idea is that there's some observed measure and that is made up of some true or underlying measure and some error. So this is an important idea and I just want to spend a minute with you walking through it. Let's just take for example the measure of socioeconomic status, an idea critical to social epidemiology. We'll be discussing it more in later on. So socioeconomic status we measure in someone's high or low in the -- position in the, social stratification system. We want to appreciate that what we see or what we measure is made up of two parts. First, there are true or underlying level of socioeconomic status or social class, if you wish, and some error and these two parts come in tandem. It's very rare that we measure anything without error. Even if we're measuring the length of this desk, we might measure it five times and if we had a very precise tool get five slightly different measurements of the width of the desk. and so the same thing is true but amplified when we measure social constructs like social economic status, social capital, and things like this. When it comes to measuring things such as morality, is someone alive or dead, we're usually pretty good at whether we get that measurement correct. Morbidity or illness is more difficult however. does someone have a cancer, yes or no? But the question can better be said, does someone have a cancer that's life-threatening? Many people will die with a certain cancer or mass in their body, not from it. And so that's where the idea of error comes in. And so, this whole thing about measuring something that whether it's a level of disease or some causal factor for the disease is two components, the true and the error. And there's a whole vast literature on

how these two things interplay. There's really two core ideas when we talk about how to assess whether how well we measure something, and the first is reliability and reliability is really about consistency. If we measure something one day and we expect it to be the same the next day, we want the measure to be the same the next day. Some things change. The weather changes every day. What we want though is a good measure that's reliable over time. So when we're measuring weather or heart disease or socioeconomic status, we're getting consistency. So, the core idea of reliability is consistency. If we have inconsistent measurement, our analyses, our investigations can get all jumbled up, we can get the wrong answer. There are three broad types of reliability. Inter-rater, test-retest, and something called split half. I don't have time to go into that with you today, but I encourage you to go to the discussion boards and we can exchange, and students, you guys yourselves, can work on figuring out the difference... Obviously the whole internet is available to you to understand the distinctions. For now let me remind you that reliability is about consistency and it can be measured in different ways. Validity is different from reliability. Validity is about measuring the thing that we want to measure. So if we're interested in measuring socioeconomic status, measuring someone's shoe size or hair color is probably not a valid measure of socioeconomic status. Measuring someone's income or educational attainment is probably a valid measure of socioeconomic status. So, validity is about measuring what we want to measure. And so we want to ask questions or use tools that give us that precise or valid measurement of a single instrument. again, health outcomes are pretty straightforward if we're interested in a certain kind of cancer, a certain kind of a body mass index, a certain kind of quality of life, we want to have measures that are tapping that measuring that. Like reliability, there are different ways to measure validity and different

kinds of validity is probably a better way to put it. Content, criterion, and construct are the most commonly, most commonly described types of validity. Again, not a lot of time in this module to talk about that, but I encourage you to go to our class discussion site and let's have some conversations about this tension between these subtle, but sometimes very important types of polity. What about the implications for mismeasurement as I said at the outset? If we mismeasure something, we usually get the wrong answer, but I want to walk you through some more subtleties here. First, it should be obvious. If we mismeasure our outcome variable alive, dead, sick or not sick, we're going to have problems in the analysis. So most people appreciate that a well-measured outcome variable is a key to a good analysis. Similarly, most people appreciate that a well-measured exposure or treatment variable. Were you in the obesity program or not? Were you exposed to the toxic chemical or not? We want a good measure of this. Otherwise, the analyses can become all jumbled or technically biased or incorrect. So, good outcome measures are key, good exposure measures are key. What a lot of people fail to realize though is we also want good measures or what might be called adjustment variables or confounders. And confoundings of big complicated topic, don't have time to go on to here. So let me just say that simply for those of you had an epidemiology, if we mismeasure our counfounders, this can lead to a further bias in our estimates. If we don't know what confounding is the short answer is t's another type of explanation for the relationships we're investigating. And you could Google this, or of course, get on the discussion boards and we can work through it together. Let me simply add that in epidemiology proper, This idea of measurement error or measurement bias is typically called misclassification bias. It's the same thing. So, in the epiliterature, if you see misclassification bias, misclassification error, we're talking about various kinds

of measurement error. It's just that the terms come from different disciplines. Finally, I'd like to talk with you about different levels of measurement. We can measure things at a person level or even subperson, organ systems cellular level, those kinds. So usually, in social epi, we measure things at the person level. What is your height? What is your health? Things like that. We also thought want to measure things at the group level. What is the measurement, the reliability of a measure, the validity of a measure of your group. Are you 40% African American? Are you 90% healthy? Have 60% of you been exposed to a food-borne bacteria. These kinds of measurements are at a group or community level and are key to advancing our multilevel understanding in social epidemology. [SOUND].