Measurement of contextual factors in clinical practice and research: development of an expert-informed toolkit
Bent, Jennifer, Cook, Chad, Bailliard, Antoine, Bialosky, Joel, Bishop, Felicity, Carlino, Elisa, Colloca, Luana, Esteves, Jorge, Garcia, Alessandra, McDevitt, Amy, Napadow, Vitaly, Newell, Dave, Palese, Alvisa, Reed, William and Rossettini, Giacomo (2026) Measurement of contextual factors in clinical practice and research: development of an expert-informed toolkit. Scientific Reports. ISSN 2045-2322 (In Press)
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Text (Article in press)
Newell D SR 2026 Full Article in press OA.pdf - Published Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (2MB) | Preview |
Abstract
Contextual factors (CFs) can influence therapeutic encounters and clinical outcomes, yet their measurement remains fragmented, lacking a unified framework to guide tool selection. To identify, appraise, and synthesize CF measurement instruments into an expert-informed clinical toolkit and identify current measurement gaps. An international panel of 15 experts evaluated 227 instruments across five domains (patient/practitioner characteristics, relational dynamics, environment, and treatment) using a hybrid COSMIN-informed appraisal design. Instruments were screened for content validity and psychometric robustness. Twenty instruments were selected for inclusion in the toolkit. Despite identifying high-quality instruments for stable traits, our analysis revealed critical measurement gaps in dynamic, state-responsive processes. Specifically, there is an absence of validated, clinically feasible tools for capturing real-time clinician affective states, non-verbal synchrony, therapeutic touch, and moment-to-moment environmental or procedural interactions. This study provides the first expert-informed framework for assessing CFs. Future research should prioritize developing state-responsive instruments capable of capturing these dynamic elements as they unfold in real-world settings to better understand the contextual drivers of recovery.
| Item Type: | Article |
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| Additional Information: | This article has been shared early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply. |
| Schools: | AECC School of Chiropractic |
| Depositing User: | Jessica Tovey |
| Date Deposited: | 16 Oct 2026 14:35 |
| Last Modified: | 16 Oct 2026 14:35 |
| URI: | https://hsu.repository.guildhe.ac.uk/id/eprint/676 |
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