International investigators who have been comparing health survey items with and without health attribution for more than 10 years teamed together and presented their findings at a special plenary session on Cutting Edge Research at the 21st Annual Conference of the International Society for Quality of Life Research (ISOQOL) in Berlin, Germany on October 16, 2014. This ISOQOL session highlighted high quality research from members of the ISOQOL community. The research team (Jakob Bjorner, Janine Devine, Barbara Gandek, Matthias Rose, Mark Kosinski, and John Ware) presented results from studies of a representative sample of US adults (N=900) who completed sets of questions about role functioning which differed in attribution (no attribution or attribution to health, physical health, or emotional health) but were otherwise identical in content. For example, some standard measures, such as the SF-36 Role Physical and Role Emotional subscales, use items with health attribution (e.g., “… have you had any of the following problems with your work or other regular daily activities as a result of your physical health?”). Other measures, such as the PROMIS Ability to Participate in Social Roles and Activities items, do not use health attribution (e.g., ‘I have trouble doing all of my usual work (include work at home)”). The team found that the prevalence of limitations in role participation was greater for items without health attribution. The practical implications of these differences, were apparent in tests of validity in discriminating between clinical groups, which favored items with health attribution over those without. Conclusions included recommendations for using role functioning measures with health attributions in health outcomes research. Dr. Ware is Chief Science Officer at JWRG and Dr. Gandek is Director of Research; both also are on the faculty of UMass Medical School. More information can be found here.