Is the coefficient of variation a valid measure for detecting sincerity of effort of grip strength?

The wide use of the coefficient of variation in detecting sincerity of effort is puzzling since existing research findings regarding its effectiveness are contradictory. The lack of empirical support in the literature raises the question of whether or not the coefficient of variation is a valid measure for detecting sincerity of effort. Many clinicians, especially those who use a computer software to calculate the coefficient of variation, may not understand how the coefficient of variation is derived and what it is based on. The coefficient of variation is a measure of relative variability and would be used correctly only if the average and the standard deviation of grip strength trials increased proportionally. This case study, however, demonstrated that the average and standard deviation of grip strength are independent. Thus, the coefficient of variation is not a valid measure of sincerity of effort. In addition, this study indicated that the coefficient of variation may be inflated in individuals after carpal tunnel release surgery. The author, therefore, cautions clinicians against the use of the coefficient of variation as a measure of sincerity of effort especially in injured individuals with compromised hand strength.

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