I recently took a survey and as for many surveys, there were a few questions for which none of the answer choices seemed to fit. In the case of this survey, I knew the author of the survey and emailed him my concern. His answer illuminated things.
The survey was about prostate cancer treatment by proton beam therapy (a form of radiation) and the question was: “How would you describe the quality of your life TODAY: better than, same as, or worse than before proton treatment?” The author was thinking that proton beam therapy side effects are minimal as compared to – for some – the life altering side effects of surgery. Moreover, the author had non prostate related health counseling that improved his life so for him, the choice was clear – his quality of life was better.
For most of us, prostate cancer has no symptoms – the only way we know we have it is an elevated PSA followed by a biopsy. Also for most of us, proton beam therapy side effects are minimal but there are still side effects; hence the only logical way to answer the question is that quality of life is worse than before proton treatment. Of course, the quality of life for some might be better – say if you hit the lottery, but this is unrelated to treatment.
One way of preventing these issues is to test the survey with a subset of the intended recipients. This should help but perhaps another thing to do is to add a response to every question that is something like: “this question cannot be answered with the above choices.”