Ralph Siu proposed that to evaluate the intensity of suffering the first thing to do is ask the patient to do so using a dukkha scale from 1 to 9.

That’s the mistake, says Dr. Bartoshuk.TIMES reporter Goode reports Bartoshuk as suggesting that "[the problem] creeps in when researchers use a common measurement technique, the rating scale, to compare different people’s subjective experiences. Undetected, it can produce distorted or even backward results."

Goode writes that when Bartoshuk reviewed eight volumes of the JOURNAL OF PHYSIOLOGY AND BEHAVIOR, "she found the error in 17 of 68 human studies that used rating scales. In some cases, the mistake completely invalidated the studies’ findings..."

The problem is that terms or measures on a rating scale may reflect very different intensities depending upon the nature of the individuals asked to use them.

The TIMES article comments, for example: "A famine victim’s ‘very hungry’...probably indicates a level of hunger far higher than the ‘very hungry’ of a Fortune 500 C.E.O. questioned an hour before dinner. Similarly, ‘very depressed’ likely suggests an emotion far more extreme to a person suffering from manic depression than to someone whose emotional life is generally on an even keel."

The article cites an observation by Dr. Douglas Wedell at the University of Southern California. He said a 1940s study asked people from around the globe to place themselves on a "ladder of happiness."

TIMES reporter Goode goes on: " The researchers were startled to discover that the desperately poor residents of famine-torn regions of India rated their happiness at close to the same level as American suburbanites whose homes were stocked with modern conveniences and who always knew where the next meal was comng from."

In conclusion, the article quotes Dr. Bartoshuk: "This is all terribly obvious when you think about it. The question is, how did such mistakes get into the literature in the first place?"