Researchers may be tempted to conclude that available measures do not meet their needs and that they must develop their own instruments. They may view the measures they want to develop as being so straight- forward, such as a few questions mea- suring patient knowledge or a speci c item from a medical chart, that they do not need to conduct a pilot test to determine reliability and validity. Researchers may then go to consider- able effort collecting data only to nd at the end of the study that subjects do not vary much in their responses to the instrument