The measurement of health status is sometimes perceived as being “soft” and subjective, and is unfavorably compared with the measurement of clinical parameters that are considered as having the desirable attributes of robustness associated with scientific observations obtained under controlled conditions in the laboratory. Such “hard” measurements are reliable, repeatable, accurate, sensitive and above all valid. A positive feast of desiderata! In an effort to achieve parity with its Big Brother, health status measures are often exposed to cruel and unnatural practices that include performing tests that might be regarded as unwarranted under other circumstances. Instrument developers are particularly prone to this tendency since they need to compete in a market that is overly impressed by the size of a P-value rather than by any more profound considerations. Hence the tyranny of Cronbach’s alpha.

Male sexual health is of increasing relevance and importance, so that new measures for use in evaluating therapeutic interventions in this area ought to be welcomed. One such measure is reported in this edition of Value in Health (Marquis and Marrel). In health care it is both a legal requirement and a moral necessity that products are adequately labeled and appropriately promoted—and not just for the protection of the patient. Health status measures need to be capable of withstanding close scrutiny too. Male sexual (dys)function is simply characterized in terms of four principal elements. Issues not addressed in the paper relate to the generalizability of these elements—specifically, whether the experience of sexual dysfunction in benign prostatic hyperplasia (BPH) is similar to that encountered as a result of other causation. Since the paper lacks any coherent account of the genesis of the MSF-4 (Male Sexual Function 4-item questionnaire), the reader is left to wonder how it is that pre-existing measures are so bad that a new measure is justified. No one would challenge the legitimacy of measuring health-related quality of life (HrQoL) in the treatment of BPH but there has to be a reasonable expectation that instrument developers have a solid case to make before we are asked to junk the old and pick up the new. To do otherwise is a disservice to the appropriate use of HrQoL measurement. Change for change’s sake is no rationale for scientists.