Assessment and quantification happen every day and enhance the capacity of making good decisions that can impact a patient’s survival, quality of life and quality of health care provided. The true score of any health assessment relies on the strength and verisimilitude of the instrument that measures it. The strongest and most reliable method to assess quantifiable measures, characteristics, or attributes is called the gold standard.1 Yet, gold standards are not immutable. They exist up to a point in which they are replaced by faster, more cost-effective, or more reliable methods, that will then be considered the gold standards until a better method arises.2

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