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Comment: Generalizability theory and assessment in medical training

Even though it is more than 50 years old,1 generalizability theory,2 or G theory, is not well known to the medical community. It combines aspects of classic test theory and analysis of variance in order to estimate reliability (“G-study”) of a measurement instrument as a function of design aspects (“facets” in G-theory literature), and to improve instrument design (“D-study”). G theory is unrelated to G estimation used in causal inference.