Patient participation can be seen as an end in and of itself, and it can be seen as a way to foster further goals like quality and safety in healthcare, adherence and cost-effectiveness. Wide-scale implementation of interventions to increase patient participation without having confidence in its measures means being unable to determine if implementation was successful or the desired outcome was achieved. Therefore, we were pleased to see a review of measures assessing patient participation in healthcare. However, we have some major concerns about the conceptual approach, the method and the conclusions in the …