The SPSS syntax procedures in Additional file 3, which has been revised referring to the previously published article [7], can help authors easily report Alpha intervals
in studies involving quality-of-life investigation and surveillance. Furthermore, the skewness coefficient and its 95% CI, referring to expected response scores, can be used to verify whether the assessed attitude is neutral (approaching a normal distribution), in absolute agreement
(with a negatively skewed distribution if higher scores represent agreement) or in disagreement (with a positively skewed distribution if lower scores represent disagreement). Use of this coefficient merits further study in other kinds of quality-of-life surveys. One major obstacle
is that users may need some training to interpret the visual representation of the skewness analysis.