Measurement Heretics: Being, Meaning & Measuring Well

3.30–5PM
A fluid history of measurement: the drop in the metric revolution

Armel Cornu and Sarah Hijmans

Chair: Coreen McGuire

Non-standard measures exist at every level of measuring practice, from the local to the global, the everyday to the scientific, across different historical periods. Familiar to most, the drop is one such measurement unit, ubiquitous in numerous fields from cooking to pharmaceutical research. Because of its variability in shape and size depending on the liquid and container, it is non-standard by its very nature. Why then does it still persist alongside the metric and other standardised measurement systems? In this talk, we explore the history of the drop in order to reflect on the persistence of non-standard units.

Our focus is on the wet sciences, chemistry and medicine, at a time of great emphasis on standardisation and quantification in France. During the late eighteenth and early nineteenth centuries, these fields underwent successive waves of reform. The introduction of the newly developed metric system came with the call to abandon pre-existing measures and body-based units. And yet, while many units were abandoned during this transition, the drop escaped relatively unscathed and continues to be used alongside or even within the metric system.

The drop was not only incredibly versatile and flexible, but also easy to produce, which encouraged practitioners to pay attention to their patients and instruments. In those cases, it was precisely the non-standard drop which made for an ultimately more accurate measurement result. By retracing the tumultuous path of the drop throughout the standardisation waves of the epoch, we show how, and reflect on why non-standard units survive, both at the margins, and at the heart of powerful systems of measurement.

Armel Cornu is a postdoctoral researcher in Department of History of Science and Ideas at Uppsala University, where her research centres on the interactions between science, environments, and the political and economic realities of early modern societies. She specialises in the histories of chemistry, medicine, and extraction, and explores how these knowledge traditions have interacted with the social and economic forces of the period. In addition to research on the history of liquids and the technologies of their containment, her current postdoctoral project investigates the relation between Swedish copper, the chemistry of metals, and the French Atlantic trade, revealing the critical role of raw material supply chains in a time of colonial expansion, climate change, and revolution.

Sarah Hijmans is assistant professor in history and philosophy of science at Université Paris Cité in Paris, France. Her research focuses on chemistry during the nineteenth century, specifically laboratory practices and how they relate to conceptualisation and analogical reasoning. Sarah defended her PhD on the identification of chemical elements in 2023 at the same university and has since been affiliated with the Royal Institution of Great Britain, the Science History Institute and the Technische Universität Berlin before returning to Paris.

10.30–11.25AM
From zodiacs to cyclones: A short history of medical meteorology and its measurements 

Maximilian Hepach

Chair: Rebecca Jackson

Tracing changes in health and well-being back to changes in weather has a long history, back to the inception of Hippocratic medicine itself. This early humoral medicine rested on the idea that health can be restored through a balancing of the four humours, which served as a scaffolding for relating changes on the scale of the body and mind to those of the atmosphere, with its changing winds and seasons, and even to those of the celestial sphere. In their various and sometimes incommensurable forms, these theories sought to establish a predictable order over capricious minds, bodies, peoples, and weathers.

With the success of the germ theory of disease in the late 19th century, key explanatory models of how weather, body, and mind are intertwined fell out of favour, relinquishing early medical meteorology to the epidemiological collection of mortality and disease incidence statistics, correlated with either the simple passing of time (seasons) or with individual meteorological variables, like temperature. Medical meteorology matured into a field in the early 20th century with the help of the Bergen school, which introduced into meteorology proper concepts such as weather fronts and air masses. This allowed medical meteorologists to explore weather’s impact on health and well-being across new spatial and temporal scales: human (and animal) bodies and minds were no longer thought to be affected by changes in a single meteorological property, but by the complex combination of many in synchrony with cyclonal weather.

This paper explores this emergence of medical meteorology as a field in the first half of the twentieth century, tracing its maturation under the auspices of the German Weather Service in the 1970s and 80s. It focuses on difficulties of and suspicions around medical meteorological measurement: What changes in weather, bodies, and minds are being measured, and to what end? What would a world look like in which these sometimes radical results were taken seriously? And why has this scientific tradition been considered and called a ‘borderline science’, a Grenzwissenschaft, operating not just at the border between meteorology and medicine, but at the border/edge between science and superstition?

Maximilian Hepach is an Assistant Professor (Research) in the Department of Geography at Durham University and a historical and cultural geographer of climate change. His current research focuses on the physiological and psychological impacts of unprecedented weather. His project “Under pressure: A historical and cultural geography of meteorosensitivity”, supported by the Wellcome Trust, examines our evolving understanding of the effects of weather on health and well-being.

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11.25AM–12.20AM
Patient Health Questionnaire (PHQ-9) in Historical Perspective

Coreen McGuire 

Chair: Mark Fabian

The PHQ-9 questionnaire is a psychometric tool primarily used to measure levels of depression. Its development was funded through Pfizer, and it aligns closely with the Diagnostic and Statistical Manual of Mental Disorders (DSM) Criteria for major depressive episode. Intended to function as a screening tool, it is nonetheless widely used for diagnostic purposes. This talk will discuss the data involved in its historical development to (1) question its validity and (2) criticize its current use in the UK context.

Coreen McGuire is Assistant Professor in Twentieth-Century British History at Durham University, and the author of Measuring Difference, Numbering Normal: Setting the standards for disability in the interwar period. Her current research focuses on the development and impact of the categories used to organize data to measure disability, and she leads ‘The Measurement Lab’ at Durham University’s Institute for Medical Humanities alongside Louise Creechan. She is co-editor of The British Journal for the History of Science book reviews section and co-editor of the Disability History series for Manchester University Press.

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2.00–2.55PM
Does a coherent approach to measurement require ‘common’ measures? Opportunities, challenges, and reflections on advancing a common measures agenda in mental health

Sophie Chung and Catherine Smith 

Chair: Michele Luchetti

Coherent measurement in mental health is often seen as important for enabling comparison across studies, supporting evidence synthesis, and helping the field build a clearer understanding of what works, for whom, and in what contexts.  Despite this, what “coherence” means in practice – and how best to achieve it – remains contested.

Drawing on our work advancing an explicit common measures agenda within a large mental health funding portfolio, we reflect on both the opportunities and the frictions this approach creates. Although potentially offering benefits such as improved comparability or reduced fragmentation, it also raises questions about relevance, cultural fit, burden, and the extent to which widely used tools capture the experiences researchers and participants consider most important.

Rather than asking whether common measures are the answer, we ask what kind of coherence the field needs. How can measurement systems remain flexible enough to capture diverse lived experiences while still enabling greater comparison and accumulation of knowledge? How can we empower the research field to interrogate the evidence underlying measures to make context and population appropriate measurement decisions, and what type of evidence do we need to surface?

We use these questions to argue for a thoughtful understanding of coherence that values alignment, without assuming uniformity, and that treats measurement as a collaborative, interdisciplinary endeavour.

Sophie Chung is a Research Lead in the Mental Health team at Wellcome. As part of this role, she oversees a portfolio of activities focused on advancing outcome measurement in mental health. She has a background in Human Sciences and Public Health. Prior to Wellcome, she worked as a health service manager in the United Kingdom, as well as part of consensus-building initiatives at the International Consortium for Health Outcome Measures (ICHOM) and Outcomes Based Healthcare.

Catherine Smith is a Research Manager in the Mental Health team at Wellcome. In this role, she oversees activities focused on outcome measurement in mental health and projects to advance innovation in mental health interventions. Prior to Wellcome, she worked as a programme manager in charities supporting children and young people, with a specialist focus on neurodevelopmental disorders. She holds an MSc in Clinical Mental Health Sciences.

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2.55–3.50PM
Why Meaningful Measurement requires Validation-in-action in Mental Health Care

Femke L. Truijens

Chair: Michele Luchetti

Measurement is widely regarded as a cornerstone of evidence-based mental health research and practice. Validated self-report measures require respondents to translate lived experience into standardized numerical scores assumed to be valid and comparable. But what do people mean when they score, and can researchers and clinicians interpret and use these scores as validly as they assume?

The Meaningful Measurement (MEANS) Lab builds on two premises: (1) self-report measurement necessarily involves individual meaning-making, as respondents translate lived experience into standardized numbers; and (2) those who administer and use such measures must secure the accuracy of their interpretations in relation to respondents’ intended meaning through active, local, and context-sensitive validation-in-action. 

Based on discussion of the “I feel 4 out of 5 depressed” study, I invite the audience into a reflexive examination of what makes measurement meaningful in practice. We approach measurement not as a neutral instrument, but as a situated practice that inevitably intervenes in the contexts it seeks to assess. I argue that reliance on measurement entails epistemic responsibility: it is not enough to use instruments deemed‘validated’: each user is responsible to actively validate their interpretation and use of scores in context. The rhetorical force of classical validity theory may obstruct responsible practice by suggesting that once validity is established at the level of instruments or models, measures can be applied without further ado. Drawing on a hermeneutic perspective, I argue for the need to move beyond classical validity theory toward validity-in-action, understanding validity as an ongoing, situated, and ethically accountable practice. 

Femke L. Truijens is Assistant Professor of Clinical Psychology, (Qualitative) Methodology, and Philosophy of Science at the Erasmus University Rotterdam, The Netherlands. She is the founder of the Meaningful Measurement (MEANS) Lab, where her research approaches measurement as an interpretative practice, examining how meaning is constituted in self-report measurement and how numerical scores can be validly interpreted and used in clinical contexts. Building on a hermeneutic approach, her work develops a framework of meaningful measurement and validity-in-action for (recovery-oriented) mental health care. She is the founder and chair of the Qualitative Research Collective in Mental Health Care (KOG) and the owner of PsyHB, a psychotherapy practice for gifted adolescents and adults.

9.50–10.45AM
Values and Validity: The Interpretation of Measurement Scores in Youth Mental Health 

Sebastian Rodriguez Duque

Chair: Sarah Wieten

Psychometric validation can appear very specific and context sensitive. For the case of patient-reported outcome measures (PROMs), I argue that validation practice is both overly rigid and it falls short of securing the rigorous interpretation of scores in part due to the different values of respondents and administrators in a new clinical context. I argue that validation practice is overly rigid. The lack of robust theories of constructs and response behaviour makes the standardized interpretation of scores unwarranted. Instead, attention to user values requires that a validation practice remain dynamic, where the interpretation of scores must be collaborative. While some theories of psychometric validation attend to the ethics of measurement and the role of values, these are often addressed as bias. I discuss how values are an essential ingredient of validity evidence to secure the clinical interpretation of scores in the case of mental health. I substantiate my claims through my ongoing collaboration with a youth mental health service in British Columbia. There, the requirements of measurement-based care (MBC) and values like patient-centredness, are in tension with the need to build and evaluate a learning health system and values like standardization. If the interpretation of scores can only be fixed in a clinical situation, it is not clear how such data can be collected and aggregated to support system level inferences. Different values must be traded off in a measurement practice, which in turn affects the quality of the inferences that different measurements may support for different purposes.

Sebastian Rodriquez Duque  is a Quebec Research Fund – Society and Culture Research Fellow (Fonds de Recherche du Québec – Société et Culture (FRQSC)) at the Department of History and Philosophy of Science, University of Cambridge. His work is about the joint epistemic and ethical issues that arise in the practice of science, especially in the formation of concepts and in the collection and management of data. He is interested in the design and use of measures in the human sciences, with a focus on how epistemic and ethical issues are linked in healthcare, and especially in mental health.

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10.45–11.40AM
Validity: Best Before – Validity as an intrinsically temporal measurement property

Michele Luchetti 

Chair: Sarah Wieten

(partly based on joint work with Prof. Dr. Lara Keuck, Bielefeld University) 

This talk defends a conception of validity as a measurement property which is not merely historical contingent, but intrinsically temporal. In the biomedical and psychosocial sciences, measurands are not only evaluated differently as ethical values and epistemic aims change; the phenomena themselves may undergo ontological change over time. Once this is acknowledged, validity can no longer be understood as a stable achievement. On this view, validating a measure is more like validating a train ticket than calibrating a thermometer: the validity of a diagnostic measurement is temporally limited, though the relevant time span is not fixed in advance but shaped by historically evolving forces. 

I first outline several diachronic challenges to measurement validity in biomedicine, illustrated through the case of aneurysm measurement. I then revisit recent accounts of epistemic and ethical iteration by distinguishing two interconnected iterative loops: a familiar coherentist loop governing the justification of a measurement’s validity, and a second-order loop concerning how validity itself, such as the validity of a diagnostic category, is assessed and revised. This yields a central insight: where continuous change in medical objects is the norm, the validity of diagnostic categories and associated measurements is always liable to become outdated. 

Finally, I will extend this analysis beyond the validity of measures in the biomedical domain, to show how the validity of certain measurement practices themselves should be understood as time-bounded. In particular, I will focus on the case of empathy measurement in medical education to claim that the very justification behind the developing validity criteria for a measure should be regarded as historically constituted. 

1.15–2.10PM
Measuring Moving Targets: The Case of Empathy

Riana Betzler

Chair: Mark Fabian

In 1949, the social psychologists Leonard S. Cottrell, Jr. and Rosalind Dymond wrote a paper calling for increased attention to the empathic responses in empirical social psychology. The empathic responses, they wrote, “occupy a crucial position in human interaction and adjustment” (1949, 357). Not only practically important for therapy and communication, the empathic responses were considered to be foundational for the very development of the self. Given their importance, why hadn’t the empathic responses received adequate attention? Cottrell and Dymond ventured a response: “One answer may be that the phenomena belong so much to the taken-for-granted that they have been overlooked as challenging objects of research effort. Another possibility is that the nature of the phenomena renders them extremely difficult to study with available techniques for objective observation and analysis” (1949, 357). In this paper, I focus on the second possibility—that there is something about the nature of the empathic responses that renders them difficult to study scientifically. That something, I suggest, is their interactivity. This interactivity makes empathy a “moving target,” which poses special challenges for measurement.  

I begin by developing the historical case which focuses on Dymond’s work in the 1940s to develop what is widely acknowledged to be one of the first measures of empathy. Borrowing from sociological theories, Dymond conceptualized empathy as interactional—that is, as existing in the dynamic relationship between people rather than individual heads. This posed methodological challenges that the new sub-discipline of social psychology would have to confront: How could the tools of psychology be adapted to the interactional view of the human? This part of the paper illuminates the negotiations that had to occur to develop a genuinely social psychology. It also highlights researchers’ attempts to square their commitments to scientific measurement and objectivity with their views of persons as dynamic, interactional beings.  

I then use this case to bring out challenges associated with measuring moving targets. If we conceptualize empathy as dynamic, as Dymond and her colleagues did, it should change over time as individuals get to know one another. But this dynamism undermines the possibility and desirability of test-retest reliability. I situate Dymond’s response to these issues in relation to wider conversations about the possibility of developing a science of the person ongoing at mid-century (e.g., Cronbach and Meehl 1955; Rogers 1963) as well as in relation to contemporary issues in the philosophy of measurement.  

Throughout the paper, I bring work on measurement into closer contact with debates about the challenges associated with studying interactive phenomena in the human and social sciences (e.g., Godman 2021; Hacking 1995).  

I then bring this case to bear on debates about the challenges associated with studying interactive phenomena, or “moving targets” in contemporary philosophy of science (e.g., Godman 2021; Hacking 1995).  

Riana Betzler is an Assistant Professor of Philosophy at San José State University (SJSU). Her main area of research concerns the history and philosophy of the psychological sciences. Prior to her position at SJSU, she held postdoctoral research fellowships in the Philosophy-Neuroscience-Psychology Program at Washington University in St. Louis and at the Konrad Lorenz Institute for Evolution and Cognition Research in Klosterneuburg, Austria. Her familiarity with the techniques and practices of the psychological sciences, alongside her training in history and philosophy of science, provides the foundation for her interdisciplinary approach to research.

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2.10–3.05PM
What is lost (and gained) between experience, concept, and clinical measurement in women’s health research reporting embodied experiences?

Hannah Loret

Chair: Fraser Riddell

Women’s health research within academic and health systems explores embodied experiences including (but not limited to) gynaecological pain, menopausal symptoms, and long-term mental health experiences. Lived/living experiences may be framed or channelled by clinical terms and measures, and the individuals holding power in complex systems of policy, research, and health and social care. 

Despite this channelling, women underserved by systems of power are more likely to be affected by health and social inequalities across their life course, often with profound consequences on quality of life and mortality. Using a capability-focused lens informed by the Amartya Sen’s concepts of equality and wellbeing, this presentation broadly explores the spaces between concepts, clinical measures and women’s embodied experiences of health, and how these are linked to the maintaining of persistent health inequalities.  

Women often know how to improve their health, and how to find solutions to challenges posed by health and care systems, yet systems which compound experiences of poor health remain. This presentation questions the role that measures have in shaping systems which are appropriate for women to express their capabilities, experiences and knowledge, challenging the gathering and measurement of knowledge which may do little to truly mend real-world health inequalities.

Hannah Loret is a lecturer and researcher in the Faculty of Health at the University of Dundee, Scotland. She has a background researching gendered health inequalities and as a clinical support worker in the NHS in England. She has a particular interest in the social determinants of health, strengths-based research practices, and how gender interacts with diagnostic categories and measures.