What Is the PRISM Visual Tool Measuring? Risk Affiliation?

Perhaps for the first time, researchers have attempted to formally measure the risk perceptions of travelers compared with expert providers regarding health risks using a psychometric measuring instrument.1 However in both the original article and the associated editorial,2 there was no discussion or referencing of the vast body of knowledge from the field of risk perception within the greater context of risk research.3 Some of the findings from Zimmermann and colleagues1 using the PRISM visual tool could easily be ascribed to established attributes of risk perception documented in the plethora of risk research falling outside of travel medicine. The purpose of this correspondence is to critique the lack of validation of this particular instrument for measuring attributes of risk perception. A coherent risk research agenda is also lacking within the International Society of Travel Medicine (ISTM)4 and the field of travel medicine in general.5Zimmermann and colleagues used a visual psychometric measuring instrument to record travelers' risk perceptions.1 This tool is called the “pictorial representation of illness and self measurement” or PRISM6 being successfully validated in the past,7 but solely in the context of subjective burden of suffering in patients with chronic diseases.8–10 The PRISM has never been formally validated in the context of evaluating risk perception in relatively healthy travelers.1 Therefore, it would have been useful for the researchers to have first validated this psychometric tool in the full context of travel medicine practice before conducting applied research and trying to draw conclusions from …