The Road to National Validation
The PCRES is on a structured path to full psychometric validation. Here is exactly where we are, what comes next, and how you can help.
What’s Happening Now
Content Validity
Expert panel review confirms items adequately represent the constructs they claim to measure. This is the single most important measurement property according to COSMIN.
What Comes Next
Pilot Testing
Instrument administered to a sample of the target population to assess feasibility, item performance, and preliminary psychometric properties.
Structural Validity
Statistical analysis confirms that items group into the domains claimed by the instrument.
Full Validation Timeline
Pre-CERS: Parallel Validation Track
Pre-Craniotomy Emotional Readiness Screen (Pre-CERS)
The Pre-CERS is a 15-item preoperative screening tool that captures baseline emotional state and flags risk factors before surgery. It uses flag-based interpretation rather than a total score.
When paired with postoperative PCRES data, the Pre-CERS enables predictive validation — testing whether preoperative emotional flags predict postoperative recovery trajectories. This longitudinal design strengthens the evidence base for both instruments.
Our Methodology
The PCRES validation follows standards defined by COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) and the FDA PRO Guidance for Patient-Reported Outcome measures.
Domain Generation
The seven PCRES domains were derived through: (1) systematic review of post-craniotomy patient qualitative research identifying themes not captured by existing instruments; (2) direct patient interviews conducted in the outpatient neurosurgical setting; and (3) iterative item review by the instrument author. Domain structure is being evaluated through confirmatory factor analysis in the Phase 3 validation study.
What makes this validation effort different:
Digital-First
All data collection happens online, reducing cost and geographic barriers. Every assessment completed on pcres.org contributes to the validation dataset.
AI-Assisted Analysis
Automated scoring, workflow support, and structured data analysis reduce the manual overhead of running the validation program. Public-facing clinical language, validation status, and major content revisions are reviewed by Dr. Eric Whitney, DO before publication.
Community-Driven
Clinicians and patients participate directly through the website. Every administration is a data point. Every expert review strengthens content validity.
Fully Transparent
Every step of the validation process is visible and documented publicly on this page. No black boxes.
Public-facing clinical language, validation status, and major content revisions are reviewed by Dr. Eric Whitney, DO before publication.
Following the PHQ-9 Playbook
The PHQ-9 became the standard depression screener because Pfizer funded its development, Spitzer and Kroenke validated it across nearly 10,000 patients between 1999 and 2009, and then they made it free and public domain. Over 560 publications followed.
We are following the same principles — free, brief, validated, actionable — but with advantages they did not have: digital-first data collection, AI-driven analysis, transparent validation, and community-driven participation. The process that took a decade can move faster with modern tools.
Help Us Get There
Every assessment, every expert review, and every research collaboration brings us closer to giving post-craniotomy patients the recovery measure they deserve.