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Interpreting CARE questionnaire scores

Posted Date: 26 Feb 2018

For some time, there has been some concern about how to interpret the scores for the CARE patient satisfaction questionnaire.

Comments often reflect that a doctor is approachable and respected by patients, but the scores can appear contradictory and the results appear rather disappointing for appraisees.

For example it is not uncommon for an overall score to be between the 50th and 75th percentile, but a score for 'making you feel at ease' to be between the 25th and 50th percentile.

If we take as an example a numeric score of 4.6250, the average for doctors being 4.5980. i.e. the score is above the average doctor but is still in the 25th-50th percentile. Is this correct?

This was the issue one of our fellow appraisers raised with the research team responsible for CARE. I thought the answer received was illuminating and worth sharing with all appraisers.

Thank you for your question - it is a very sensible one! The answer lies in the fact that the average reported on the CARE site is a mean but the 50th percentile is defined by the median.

Consider the numbers 1,2,3,4,7 compared to 1,2,3,4,4. The median is 3 in both cases so a value of 2.9 is below the 50th percentile. However, the mean of the first set is 3.4 and the mean of the second set is 2.8 so in the second example, a score of 2.9 is above the mean but below the median (and so below the 50th percentile).

It is acknowledged the results should really report the median, not the mean as the average and we hope this may be changed in the near future.


Dr Niall Cameron
National Appraisal Adviser

This page was last updated on: 26/02/2018