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. 1994 Dec;3(4):186–192. doi: 10.1136/qshc.3.4.186

SF 36 health survey questionnaire: II. Responsiveness to changes in health status in four common clinical conditions.

A M Garratt 1, D A Ruta 1, M I Abdalla 1, I T Russell 1
PMCID: PMC1055239  PMID: 10140232

Abstract

OBJECTIVE--To assess the responsiveness of the SF 36 health survey questionnaire to changes in health status over time for four common clinical conditions. DESIGN--Postal questionnaires at baseline and after one year's follow up, with two reminders at two week intervals if necessary. SETTING--Clinics and four training general practices in Grampian region in the north east of Scotland. PATIENTS--More than 1,700 patients aged 16 to 86 years with one of four conditions: low back pain, menorrhagia, suspected peptic ulcer, and varicose veins; and a random sample of 900 members of the local general population for comparison. MAIN MEASURES--A transition question measuring change in health and the eight scales of the SF 36 health survey questionnaire; standardised response means (mean change in score for a scale divided by the standard deviation of the change in scores) used to quantify the instrument's responsiveness to changes in perceived health status, and comparison of patient scores at baseline and follow up with those of the general population. RESULTS--The response rate exceeded 75% in a patient population. Changes across the SF 36 questionnaire were associated with self reported changes in health, as measured by the transition question. The questionnaire showed significant improvements in health status for all four clinical conditions, whether in referred or non-referred patients. For patients with suspected peptic ulcer and varicose veins the SF 36 profiles at one year approximate to the general population. CONCLUSIONS--These results provide the first evidence of the responsiveness of the SF 36 questionnaire to changes in perceived health status in a patient population in the United Kingdom.

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Selected References

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  1. Bergner M., Bobbitt R. A., Pollard W. E., Martin D. P., Gilson B. S. The sickness impact profile: validation of a health status measure. Med Care. 1976 Jan;14(1):57–67. doi: 10.1097/00005650-197601000-00006. [DOI] [PubMed] [Google Scholar]
  2. Bindman A. B., Keane D., Lurie N. Measuring health changes among severely ill patients. The floor phenomenon. Med Care. 1990 Dec;28(12):1142–1152. doi: 10.1097/00005650-199012000-00003. [DOI] [PubMed] [Google Scholar]
  3. Brazier J. E., Harper R., Jones N. M., O'Cathain A., Thomas K. J., Usherwood T., Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160–164. doi: 10.1136/bmj.305.6846.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Deyo R. A., Centor R. M. Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chronic Dis. 1986;39(11):897–906. doi: 10.1016/0021-9681(86)90038-x. [DOI] [PubMed] [Google Scholar]
  5. Deyo R. A., Inui T. S. Toward clinical applications of health status measures: sensitivity of scales to clinically important changes. Health Serv Res. 1984 Aug;19(3):275–289. [PMC free article] [PubMed] [Google Scholar]
  6. Fitzpatrick R., Ziebland S., Jenkinson C., Mowat A., Mowat A. Transition questions to assess outcomes in rheumatoid arthritis. Br J Rheumatol. 1993 Sep;32(9):807–811. doi: 10.1093/rheumatology/32.9.807. [DOI] [PubMed] [Google Scholar]
  7. Garratt A. M., Macdonald L. M., Ruta D. A., Russell I. T., Buckingham J. K., Krukowski Z. H. Towards measurement of outcome for patients with varicose veins. Qual Health Care. 1993 Mar;2(1):5–10. doi: 10.1136/qshc.2.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Garratt A. M., Ruta D. A., Abdalla M. I., Buckingham J. K., Russell I. T. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993 May 29;306(6890):1440–1444. doi: 10.1136/bmj.306.6890.1440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Guyatt G., Walter S., Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis. 1987;40(2):171–178. doi: 10.1016/0021-9681(87)90069-5. [DOI] [PubMed] [Google Scholar]
  10. Jenkinson C., Coulter A., Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993 May 29;306(6890):1437–1440. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Katz J. N., Larson M. G., Phillips C. B., Fossel A. H., Liang M. H. Comparative measurement sensitivity of short and longer health status instruments. Med Care. 1992 Oct;30(10):917–925. doi: 10.1097/00005650-199210000-00004. [DOI] [PubMed] [Google Scholar]
  12. Liang M. H., Fossel A. H., Larson M. G. Comparisons of five health status instruments for orthopedic evaluation. Med Care. 1990 Jul;28(7):632–642. doi: 10.1097/00005650-199007000-00008. [DOI] [PubMed] [Google Scholar]
  13. Liang M. H., Larson M. G., Cullen K. E., Schwartz J. A. Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. Arthritis Rheum. 1985 May;28(5):542–547. doi: 10.1002/art.1780280513. [DOI] [PubMed] [Google Scholar]
  14. MacKenzie C. R., Charlson M. E., DiGioia D., Kelley K. Can the Sickness Impact Profile measure change? An example of scale assessment. J Chronic Dis. 1986;39(6):429–438. doi: 10.1016/0021-9681(86)90110-4. [DOI] [PubMed] [Google Scholar]
  15. MacKenzie C. R., Charlson M. E., DiGioia D., Kelley K. Can the Sickness Impact Profile measure change? An example of scale assessment. J Chronic Dis. 1986;39(6):429–438. doi: 10.1016/0021-9681(86)90110-4. [DOI] [PubMed] [Google Scholar]
  16. McHorney C. A., Ware J. E., Jr, Raczek A. E. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993 Mar;31(3):247–263. doi: 10.1097/00005650-199303000-00006. [DOI] [PubMed] [Google Scholar]
  17. McHorney C. A., Ware J. E., Jr, Rogers W., Raczek A. E., Lu J. F. The validity and relative precision of MOS short- and long-form health status scales and Dartmouth COOP charts. Results from the Medical Outcomes Study. Med Care. 1992 May;30(5 Suppl):MS253–MS265. doi: 10.1097/00005650-199205001-00025. [DOI] [PubMed] [Google Scholar]
  18. Phillips R. C., Lansky D. J. Outcomes management in heart valve replacement surgery: early experience. J Heart Valve Dis. 1992 Sep;1(1):42–50. [PubMed] [Google Scholar]
  19. Ruta D. A., Abdalla M. I., Garratt A. M., Coutts A., Russell I. T. SF 36 health survey questionnaire: I. Reliability in two patient based studies. Qual Health Care. 1994 Dec;3(4):180–185. doi: 10.1136/qshc.3.4.180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Ruta D. A., Garratt A. M., Wardlaw D., Russell I. T. Developing a valid and reliable measure of health outcome for patients with low back pain. Spine (Phila Pa 1976) 1994 Sep 1;19(17):1887–1896. doi: 10.1097/00007632-199409000-00004. [DOI] [PubMed] [Google Scholar]
  21. Sheldon T. Measuring patients' views of their health. Reliability of SF 36 remains uncertain. BMJ. 1993 Jul 10;307(6896):125–126. doi: 10.1136/bmj.307.6896.125-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Stewart A. L., Greenfield S., Hays R. D., Wells K., Rogers W. H., Berry S. D., McGlynn E. A., Ware J. E., Jr Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):907–913. [PubMed] [Google Scholar]
  23. Tuley M. R., Mulrow C. D., McMahan C. A. Estimating and testing an index of responsiveness and the relationship of the index to power. J Clin Epidemiol. 1991;44(4-5):417–421. doi: 10.1016/0895-4356(91)90080-s. [DOI] [PubMed] [Google Scholar]
  24. Ware J. E., Jr, Sherbourne C. D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed] [Google Scholar]

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