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. 1994 Dec;44(389):545–549.

Measuring functional health status in primary care using the COOP-WONCA charts: acceptability, range of scores, construct validity, reliability and sensitivity to change.

P Kinnersley 1, T Peters 1, N Stott 1
PMCID: PMC1239076  PMID: 7748664

Abstract

BACKGROUND. The COOP-WONCA charts comprise six scales designed to measure functional health status in primary care. AIM. A study was undertaken to describe the acceptability, distribution of chart scores, construct validity, test-retest reliability and sensitivity to change when these charts were used in the United Kingdom. METHOD. For acceptability, distribution of scores and construct validity, data were obtained from 100 consecutive consulting patients aged 16 years and over and 100 non-consulting age-sex matched individuals from one general practice. In order to examine reliability and sensitivity to change, both groups were followed up two weeks later. RESULTS. Regarding acceptability, four patients refused to complete the charts during the initial recruitment of the consulters; 74 out of 100 non-consulters returned the first postal questionnaire. The follow-up questionnaire was returned by 68 out of 100 consulters and 57 out of 74 non-consulters. Overall distributions of scores demonstrated reasonable variation. Regarding construct validity, differences between the consulters and non-consulters were all in the anticipated direction and reached statistical significance for three of the six charts. For reliability, the proportion of non-consulters whose scores were unchanged ranged from 56% to 73%. For those whose scores changed, the differences were small and evenly balanced. For sensitivity to change, the proportion of consulters whose scores altered ranged from 45% to 59% with mean changes all indicating improvements in health. There were larger changes for patients consulting about acute problems than for those with chronic problems. CONCLUSION. It appears that the charts were acceptable, with reasonable distributions of scores and evidence of construct validity. Moderate levels of reliability and sensitivity to change were demonstrated. This study suggests that the COOP-WONCA charts are suitable for measuring functional health status in primary care in the UK.

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Selected References

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  1. Bass M. J., Buck C., Turner L., Dickie G., Pratt G., Robinson H. C. The physician's actions and the outcome of illness in family practice. J Fam Pract. 1986 Jul;23(1):43–47. [PubMed] [Google Scholar]
  2. Bergner M., Rothman M. L. Health status measures: an overview and guide for selection. Annu Rev Public Health. 1987;8:191–210. doi: 10.1146/annurev.pu.08.050187.001203. [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. Measuring functional outcomes in therapeutic trials for chronic disease. Control Clin Trials. 1984 Sep;5(3):223–240. doi: 10.1016/0197-2456(84)90026-6. [DOI] [PubMed] [Google Scholar]
  6. Fitzpatrick R., Fletcher A., Gore S., Jones D., Spiegelhalter D., Cox D. Quality of life measures in health care. I: Applications and issues in assessment. BMJ. 1992 Oct 31;305(6861):1074–1077. doi: 10.1136/bmj.305.6861.1074. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fitzpatrick R., Ziebland S., Jenkinson C., Mowat A., Mowat A. Importance of sensitivity to change as a criterion for selecting health status measures. Qual Health Care. 1992 Jun;1(2):89–93. doi: 10.1136/qshc.1.2.89. [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. Henbest R. J., Stewart M. Patient-centredness in the consultation. 2: Does it really make a difference? Fam Pract. 1990 Mar;7(1):28–33. doi: 10.1093/fampra/7.1.28. [DOI] [PubMed] [Google Scholar]
  11. Horder J., Moore G. T. The consultation and health outcomes. Br J Gen Pract. 1990 Nov;40(340):442–443. [PMC free article] [PubMed] [Google Scholar]
  12. 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]
  13. Kazis L. E., Anderson J. J., Meenan R. F. Effect sizes for interpreting changes in health status. Med Care. 1989 Mar;27(3 Suppl):S178–S189. doi: 10.1097/00005650-198903001-00015. [DOI] [PubMed] [Google Scholar]
  14. Nelson E., Wasson J., Kirk J., Keller A., Clark D., Dietrich A., Stewart A., Zubkoff M. Assessment of function in routine clinical practice: description of the COOP Chart method and preliminary findings. J Chronic Dis. 1987;40 (Suppl 1):55S–69S. doi: 10.1016/s0021-9681(87)80033-4. [DOI] [PubMed] [Google Scholar]
  15. Ware J. E. Measuring patients' views: the optimum outcome measure. BMJ. 1993 May 29;306(6890):1429–1430. doi: 10.1136/bmj.306.6890.1429. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. van Weel C., Rosser W. W. Measuring functional status in family practice. Fam Pract. 1991 Dec;8(4):394–395. doi: 10.1093/fampra/8.4.394. [DOI] [PubMed] [Google Scholar]

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