Why only 'high', 'middle' and 'low' importance?
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Why only 'high', 'middle' and 'low' importance?

These are judgements. In general, an attempt to be more precise would be misleading, and tempt users to add them up to get a single score. However there is no objection to using more precise levels of importance where they are material to the decision and where they can be justified by evidence. For example, if QoL Assessment is being used to compare two possible alternative sites for a development, it might be important and valid to compare how many people would experience how much loss of recreational access to the two sites.   

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