OBJECTIVES: To improve the evaluative-scale characteristics of the WHQ. Comparative clinical trials require evaluative scales that are sensitive and responsive as well as valid and reliable. The Women’s Health Questionnaire (WHQ), a 36-item, 4-point Likert self-administered rating scale, assesses subjective reports of emotional and physical well-being in mid-aged women using nine physical, emotional, and symptom-specific scales. We assessed the WHQ evaluative scale properties using both true score and Rasch measurement models to determine whether the scoring techniques proposed by the scale developer optimized the evaluative properties. METHODS: We analyzed WHQ baseline and six-week change score data from 651 mid-aged women treated with HRT in two US clinical trials. The Multitrait/Multi-item Analysis Program – Revised provided true score psychometric information. The BIGSTEPS program produced the Rasch analysis. RESULTS: The original nine-factor structure was not supported by confirmatory factor analysis. Rasch analysis identified scale-level category response problems for several scales in the revised six-factor structure. The problematic scales failed to detect differences between “known groups” formed by clinical criteria for menopausal symptoms, and were not responsive to change within groups that changed significantly on clinical criteria. Revised scale scoring based on Rasch conversion to standardized logits resulted in improved sensitivity and responsiveness. CONCLUSIONS: Rasch models provide important psychometric information for scale development and revision. They resolve interval data assumptions, are more sensitive to information contained in the tails of the response distributions, and yield useful response category analyses that guide scaling decisions independent of the sample characteristics. Based on the Rasch analysis, we made scoring and interpretation changes to the WHQ that increased its sensitivity and responsiveness.