The MOS 36-Item Short Form Health Survey: reliability, validity, and preliminary findings in schizophrenic outpatients. Using the SF-36 and Euroqol on an elderly population Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire Changes in quality of life in chronic psychiatric patients: A comparison between EuroQol (EQ-5D) and WHOQoL EQ-5D in a general population survey – A description of the most commonly reported EQ-5D health states using the SF-36 Development and validation of a patient-based health-related quality of life questionnaire in schizophrenia: the S-QoL Quality of Life and General Health After Elective Surgery for Cervical Spine Pathologies: Determining a Valid and Responsive Metric of Health State Utility. Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures Comparison of EQ-5D and SF-6D utilities in mental health patients. Mapping SF-36 onto the EQ-5D index: how reliable is the relationship? A single European currency for EQ-5D health states How do scores on the EuroQol relate to scores on the SF-36 after stroke? Effect of order of administration of health-related quality of life interview instruments on responses An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcome Questionnaire in patients with rheumatoid arthritis of the hand Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Self-reported functioning and well-being in patients with Parkinson's disease: comparison of the short-form health survey (SF-36) and the Parkinson's Disease Questionnaire (PDQ-39) Clinimetric properties of the EuroQol-5D in patients with chronic low back pain.
OBJECTIVES The authors test the reliability and validity of the Medical Outcomes Study Short Form 36-Item Health Survey ( SF-36 ) as a written , self-administered survey in out patients with chronic schizophrenia . METHODS Thirty-six schizophrenic out patients completed a written and oral form of the SF-36 . A psychiatrist rated the patients using the Brief Psychiatric Rating Scale to determine severity of psychopathology . Cognitive functioning and academic achievement were also assessed . Internal consistency , test-retest reliability , concurrent and discriminative validity of the oral and written versions were determined . RESULTS The SF-36 in both forms was shown to have good internal consistency , stability , and concurrent validity . The mental health SF-36 subscales had poor discriminant validity , compared with the physical functioning scale that demonstrated good discriminant validity . CONCLUSIONS The validity of using the written form of the SF-36 on a sample of patients with chronic mental illness was demonstrated . The SF-36 appears to be an appropriate outcome measure for changes in physical and role functioning in consumers of outpatient mental health programs An important method ological issue in measuring health-related quality of life is whether instruments such as SF-36 and EQ can be used on an elderly population . This paper aims to test the completion , reliability and validity of the SF-36 and Euroqol on an elderly female population , and to compare them with the OPCS Disability Survey .  Three hundred and eighty women aged 75 and over participated in a r and omized controlled trial of the use of clodronate provided the sample . As part of the trial , patients were asked to complete the  UK SF-36 and Euroqol  , and the OPCS disability survey instrument  administered by interview in a hospital clinic at baseline . A r and om sub sample of respondents were retested six months later . The SF-36 achieved poorer levels of completion by dimension ( 68.1%–88.9 % ) than the OPCS ( 99.2 % ) and Euroqol ( 84%–93.5 % ) instruments . There were no major floor effects in the distribution of scores , except for the role dimensions of SF-36 . Correlation between test-retest were significant for all instruments , but lower for the role dimensions and social functioning of SF-36 , and these dimensions also had 95 % Cls for the mean differences in excess of 10 points . There was substantial agreement between the three instruments , and evidence for their construct validity against age and recent use of health services . The sensitivities of the instruments were tested through hypothetical changes in health status . There was some evidence of greater sensitivity to lower levels of morbidity in the SF-36 . Where brevity is required and the health changes are expected to be substantial , then EQ may be sufficient . For greater sensitivity SF-36 seems to have an advantage , however lower completion rates and problems with consistency suggest it requires adaptation . One solution would be to use interviewer administration . Another would be to change the SF-36 to make it more suitable for use in elderly people , although this may reduce its usefulness as a generic instrument There is an interest in the consequences of deriving a single index measure of health for validity and sensitivity . This paper presents the results of testing a recent example of a general health measure design ed to derive a single index , the Euroqol ( EQ ) , and presents a comparison with a new , influential profile measure , the Short Form 36 ( SF-36 ) Health Survey Instrument . The EQ and an anglicised version of the SF-36 health survey , both design ed for self-completion , were included in a postal survey of a r and om sample of 1980 patients from two practice lists in Sheffield , UK . The response rate for the EQ question naire was 83 % , and the rate of completion over 95 % . Evidence was found for the construct validity of the EQ dimension responses and the derived total EQ health score in terms of distinguishing between groups with expected health differences . Considerable agreement was found between EQ responses and the total EQ score , and the UK SF-36 profile scores . There was substantial evidence of EQ being less sensitive at the ceiling ( i.e. low levels of perceived ill-health ) and throughout the range of health states . A recent restructuring of the EQ , may help overcome some of the problems with the physical dimensions by reducing their skewness It has often been postulated that simple , short question naires are unable to reflect complex changes in well-being of individuals with chronic psychiatric disorders . To investigate these assumptions we included two recently developed instruments to measure quality of life  ( the WHOQoL-Bref and the EuroQoL EQ-5D ) in a r and omised control trial ( RCT ) in which two treatment conditions were compared . Aims of the study were to assess the sensitivity and validity of these  quality of life (QoL)-instruments  , to establish their relationship and to examine the predictors of changes in QoL. Subjective changes in QoL were measured on three assessment s waves in a period of 18 months and compared to objective changes in psychopathology and social functioning in a sample of 76 chronic schizophrenic patients who participated in the RCT . Results indicated that both WHOQoL-Bref and EuroQoL EQ-5D are capable of detecting changes in QoL over time in physical and psychological well-being . The instruments partly measure the same aspects of QoL , indicated by 50 % common variance on total scores . Reduction of positive psychotic symptoms appeared to be the most important factor in improving QoL. The weighted TTO-score of EuroQoL-5D , which is often used as an index in economic evaluations of health care , did however not correspond with these changes , which indicates that it is less sensitive to changes in social and psychological well-being . It ’s use as the core measure in ( economic ) health evaluation in the field of psychiatry therefore seems less appropriate The importance of study ing health-related quality of life in the general population has increasingly been emphasized . From a public health perspective , this benefits the identification of population inequalities in health status . One of the currently most popular instruments is the EQ-5D . Evaluations of the EQ-5D generally focus on the overall preference-based index . As this index has a built-in value , exploration of the information from the underlying health states is also important . In this study , the ten most commonly reported EQ-5D health states are described using the SF-36 . Data collected in 1999 by question naires mailed to a r and om sample aged 20–74 in south-eastern Sweden were used ( n = 9489 ) . Almost 43 % reported the best possible EQ-5D health state and 78 % were accounted for by three EQ-5D health states . The EQ-5D health state classification was largely reflected by the SF-36 , with the EQ-5D items mobility , usual activities , pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning , role limitations due to physical health problems , bodily pain , and mental health , respectively . However , within the same level of EQ-5D ( i.e. , moderate problems ) there was a rather large variation of SF-36 scale scores , particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP We developed a self-administered instrument to assess  health-related quality of life ( HRQL ) among people with schizophrenia . The S-QoL , based on Calman 's approach to the subject 's point of view , is a multidimensional instrument that is sensitive to change . The scale is a 41-item question naire with eight subscales ( psychological well-being , self-esteem , family relationships , relationships with friends , resilience , physical well-being , autonomy and sentimental life ) and a total score . In-depth interviews with patients determined the pertinent issues for item development . The validation study , performed with 207 patients , showed high internal consistency reliability , reproducibility and responsiveness . Construct validity was confirmed using established clinical and HRQL measures . S-QoL covers domains that differ from areas tapped in other measures , with greater responsiveness . The S-QoL is an efficient instrument for the measurement of the impact of schizophrenia  on individuals ' lives BACKGROUND As part of the Affordable Care Act , health utility metrics are being investigated to define a cost-effective , value-based health care model . EuroQOL-5D ( EQ-5D ) and Short Form-6D ( SF-6D ) are commonly used quality -of-life instruments . Domains in the EQ-5D question naire are thought to be less responsive in measuring quality of life after cervical surgery . OBJECTIVE To evaluate the validity and responsiveness of SF-6D and EQ-5D in determining health and quality of life after elective cervical spine surgery . METHODS A total of 420 patients undergoing elective cervical spine surgery over a period of 2 years were enrolled in a prospect i ve longitudinal registry . Patient-reported outcomes Neck Disability Index ( NDI ) , EQ-5D , and SF-12 were recorded . Based on previously published equations , SF-6D was calculated using NDI and SF-12 scores . Patients were asked whether " surgery met their expectations " ( meaningful improvement ) . The validity and relative responsiveness of SF-6D ( NDI ) , SF-6D ( SF-12 ) , and EQ-5D to discriminate between meaningful and nonmeaningful improvement were calculated . RESULTS Sixty-six percent of patients ( 277 ) reported a level of improvement after surgery that met their expectations ( meaningful improvement ) . SF-6D ( NDI ) ( area under the curve [ AUC ] = 0.69 ) was a more valid discriminator of meaningful improvement compared with the SF-6D ( SF-12 ) ( AUC = 0.65 ) and EQ-5D ( AUC = 0.62 ) . SF-6D ( NDI ) was also a more responsive measure compared with SF-6D ( SF-12 ) and EQ-5D ( st and ardized response mean difference : 0.66 , 0.48 , and 0.44 , respectively ) . CONCLUSION SF-6D is a more valid and responsive measure of general health and quality of life compared with EQ-5D . SF-6D derived from disease-specific disability scores was more valid and responsive than that derived from the generic preference-based SF-12 . Cost-effective studies should use SF-6D as a measure of QALY after cervical spine surgery Background Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies . Aim To compare two widely used preference measures , the EQ-5D and SF-6D , in terms of their dimensions and health utility values . Method EQ-5D and SF-6D data collected from 114 patients with depression , who participated in a cluster , r and omised controlled trial to evaluate a collaborative care intervention in UK , primary care practice s.  Utilities were examined across the whole sample and by level of depression severity using the PHQ-9 . Results Depression was associated with disutility at baseline . At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D . Health gains were observed in patients in remission from depression and those with the mildest level of depression severity . Conclusions Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period ; larger health gain was observed for the EQ-5D Various  preference-based measures of health are available for use as an outcome measure in cost-utility analysis . The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients . Baseline data from a Dutch multi-centre r and omised trial of 616 patients with mood and /or anxiety disorders were used . Mean and median  EQ-5D  and  SF-6D utilities were compared , both in the total sample and between severity subgroups based on quartiles of SCL-90 scores . Utilities were expected to decline with increased severity . Both EQ-5D and SF-6D utilities differed significantly between patients of adjacent severity groups . Mean utilities increased from 0.51 at baseline to 0.68 at 1.5 years follow-up for EQ-5D and from 0.58 to 0.70 for SF-6D . For all severity subgroups , the mean change in EQ-5D utilities as well as in SF-6D utilities was statistically significant . St and ardised response means were higher for SF-6D utilities . We concluded that both EQ-5D and SF-6D discriminated between severity subgroups and captured improvements in health over time . However , the use of EQ-5D result ed in larger health gains and consequent lower cost-utility ratios , especially for the subgroup with the highest severity of mental health problems Background Mapping from health status measures onto generic preference-based measures is becoming a common solution when health state utility values are not directly available for economic evaluation . However the accuracy and reliability of the models employed is largely untested , and there is little evidence of their suitability in patient data sets . This paper examines whether mapping approaches are reliable and accurate in terms of their predictions for a large and varied UK patient data set . Methods SF-36 dimension scores are mapped onto the EQ-5D index using a number of different model specifications . The predicted EQ-5D scores for subsets of the sample are compared across inpatient and outpatient setting s and medical conditions . This paper compares the results to those obtained from existing mapping functions . Results The model including SF-36 dimensions , squared and interaction terms estimated using r and om effects GLS has the most accurate predictions of all models estimated here and existing mapping functions as indicated by MAE ( 0.127 ) and MSE ( 0.030 ) . Mean absolute error in predictions by EQ-5D utility range increases with severity for our models ( 0.085 to 0.34 ) and for existing mapping functions ( 0.123 to 0.272 ) . Conclusion Our results suggest that models mapping the SF-36 onto the EQ-5D have similar predictions across inpatient and outpatient setting and medical conditions . However , the models overpredict for more severe EQ-5D states ; this problem is also present in the existing mapping functions Abstract The EQ-5D question naire is a widely used generic instrument for describing and valuing health that was developed by the EuroQol Group . A primary objective of the EuroQol Group is the investigation of values for health states in the general population in different countries . As part of the EuroQol enterprise 11 population surveys were carried out in six Western European countries ( Finl and , Germany , The Netherl and s , Spain , Sweden and the UK ) to value health states as defined by the EQ-5D using a st and ardised visual analogue scale ( EQ-5D VAS ) . This contribution reports how a European set of general population preference weights was derived from the data collected in the 11 valuation studies . The scores from this set of preference weights can be applied to generate a VAS-based weighted health status index for all the potential 243 EQ-5D health states for use in multi-national studies . To estimate the preference weights a multi-level regression analysis was performed on 82,910 valuations of 44 EQ-5D health states elicited from 6,870 respondents . Stable and plausible solutions were found for the model parameters . The R2 value was 75 % . The analysis showed that the major source of variance , apart from ' r and om error ' , was variance between individuals ( 28.3 % of the total residual variance ) . These results suggest that VAS values for EQ-5D health states in six Western European countries can be described by a common model BACKGROUND AND PURPOSE The EuroQol and Medical Outcome Survey 36-item short-form health survey ( SF-36 ) question naires have both been vali date d for the assessment of health-related quality of life after stroke . However , the relationship between these instruments has not been studied after stroke . We therefore sought to compare the responses of a group of stroke patients to both instruments . METHODS A total of 2253 patients with stroke entered by United Kingdom hospitals in the International Stroke Trial were r and omized to follow-up with either the EuroQol or SF-36 instruments . We r and omly selected one third of patients who had responded to the EuroQol for follow-up , again using the SF-36 , and two thirds of patients who had responded to the SF-36 for follow-up , again using the EuroQol . We assessed the patients ' mean score for each domain of the SF-36 categorized by their response to the corresponding EuroQol domain and the correlation between the domains of the 2 instruments . RESULTS The domains for both instruments , which assessed physical functioning , social functioning , bodily pain , and overall health-related quality of life , correlated closely . The mental health domain of the SF-36 correlated only poorly with the psychological functioning domain of the EuroQol . CONCLUSIONS Both the EuroQol and SF-36 measure broadly similar domains of health . The weak relationship between the assessment s of mental health may reflect a difference in content or more fundamental problems with the validity or reliability of the items in one of the instruments with respect to this domain . This study has provided the first empirical qualitative evidence by which the data on the SF-36 after stroke may be interpreted Purpose : To determine the effect on patient responses from the order in which the generic health-related and vision-targeted instruments are administered in a set of r and omized clinical trials of intraocular surgery . Patients and methods : Patients who agreed to enroll in the Submacular Surgery Trials ( SST ) completed baseline  quality of life interviews  prior to r and om assignment to surgery or observation . Interviews were conducted by trained interviewers located at the SST Coordinating Center , via a computer-assisted telephone interview system that r and omly assigned the order of instrument administration . Either the generic health-related instruments were administered first , the SF-36 Health Survey ( SF-36 ) followed by the Hospital Anxiety and Depression Scale ( HADS ) , followed by the vision-targeted instruments , National Eye Institute-Vision Function Question naire ( NEI-VFQ ) followed by the SST-Vision Preference Value Scale , or the vision-targeted questions were asked first , followed by the generic health instruments . The four instruments have 25 subscales total . Results : Of the 1015 patients enrolled in the SST , 992 patients had all four instruments administered in r and om order : 483 ( 49 % ) patients responded to the generic instruments first and 509 ( 51 % ) patients responded to the vision-targeted instruments first . Order of administration produced significantly different scores for three health status subscales : SF-36 mental health , HADS depression and HADS anxiety ( p≤0.05 , Wilcoxon rank sum test ) . Conclusions : Overall , the order of administration did not have a large effect on responses to the baseline interviews in this study . However , three mental health subscales were affected by order , though the order effect was small in magnitude . When the generic health instruments followed the vision-targeted instrument the HADS depression and anxiety scores were higher and the SF-36 mental health scores were lower , both suggesting poorer mental health status . Thus , the order of administration in other setting s in which both a generic health-related instrument and a condition-targeted instrument are used may be decided based on individual study goals and priorities but order of administration should be consistent throughout the study Background The aim of this study was to assess the psychometric properties , namely acceptability , validity , reliability , interpretability and responsiveness of the EuroQol EQ-5D ( EQ-5D visual analogue ( VAS ) and EQ-5D ( utility ) ) , Short Form 12 Dimensions ( SF-12 ) , SF-6D and Michigan H and Outcome Question naire ( MHQ ) in patients with rheumatoid arthritis ( RA ) of the h and . Methods The empirical investigation was based upon data from a r and omised controlled trial of 488 adults with rheumatoid arthritis who had pain and dysfunction of the h and s and /or wrists . Participants completed the EQ-5D , SF-12 and MHQ at baseline and at 4 and 12 months follow up . Acceptability was measured using completion rates over time ; construct validity using the “ known groups ” approach , based on pain troublesomeness ; convergent validity using spearman ’s rho correlation ( ρ ) ; reliability using internal consistency ( Cronbach ’s alpha ) ; interpretability using minimal important differences ( MID ) ; and responsiveness using effect sizes and st and ardised response means ( SRM ) stratified by level of self-rated improvement in h and and wrist function or level of self-rated benefit and satisfaction from trial treatments . Results At baseline , the study population had a mean age of 62.4 years , a mean MHQ score of 52.1 and included 76 % women . The EQ-5D ( utility ) had the highest completion rates across time points . All instruments discriminated between pre-specified groups based on pain troublesomeness . Convergent validity analysis indicated that the MHQ score correlated strongly with the EQ-5D ( ρ = 0.65 ) and SF-6D ( ρ = 0.63 ) utility scores . The MHQ was most responsive at detecting change in indicators of RA pain severity between baseline and 4 months , whilst minimal important differences varied considerably across PROMs . Conclusions The instruments evaluated in this study displayed varying psychometric properties in the context of RA of the h and . The selection of a preferred instrument in evaluative studies should ultimately depend on the relative importance placed on individual psychometric properties and the importance placed on generation of health utilities for economic evaluation purpose OBJECTIVES The purpose s of this analysis were to evaluate the construct validity of the EQ-5D and compare responses on the EQ-5D with the Physical Component Summary ( PCS-12 ) and Mental Component Summary ( MCS-12 ) scores of the SF-12 Health Survey . METHODS Data were collected via a survey instrument mailed to 4,200 r and omly selected subjects in the province of Alberta , Canada . The instrument contained the EQ-5D and SF-12 health surveys , with additional questions eliciting clinical and demographic information from the respondents . RESULTS 1,555 respondents returned mailed question naires ; 606 question naires were returned undeliverable . The SF-12 summary scores were calculated for 1,380 respondents . Analysis of the EQ-5D responses by demographic variables found significant differences among categories of age , gender , and self-reported chronic medical conditions . Corresponding dimensions and summary scores were more strongly related ( eg , mobility and PCS-12 ; F ratio = 598.3 , P < 0.001 ) than dissimilar dimensions ( eg , mobility and MCS-12 ; F ratio = 18.8 , P < 0.001 ) . The EQ-5D index scores were moderately correlated with SF-12 summary scores ( r = 0.41 for MCS-12 and r = 0.68 for PCS-12 ) . For subjects reporting no problems on the EQ-5D , PCS-12 and MCS-12 scores were significantly lower for people reporting medical problems or feelings of depression . CONCLUSIONS The results of this investigation generally supported the validity of the EQ-5D . However , an important ceiling effect was observed for the EQ-5D in this sample . The combination of the EQ-5D and SF-12 provides relatively broad coverage of important health domains and scores for various purpose The purpose of this paper was to document the impact of Parkinson 's disease ( PD ) upon patients using both a generic health status measure  ( the Short-form 36 health survey question naire , SF-36 ) and a disease-specific measure  ( the 39-item Parkinson 's Disease Question naire , PDQ-39 ) . Comparing the results of the SF-36 in this population with a similar aged group selected r and omly from two general practice s it was evident that the disease has considerable impact on general levels of functioning and well-being . Furthermore , other areas not contained on the SF-36 were found to be relevant to PD patients . It is suggested that the disease-specific measure will be of value , ideally alongside a generic measure , in studies aim ed at determining the impact of a treatment régimen upon PD patients , or to monitor the long-term progress of cohorts of patients with PD . The paper highlights the need for careful consideration of measures for evaluation BACKGROUND CONTEXT Clinimetric properties of the EuroQol-5D ( EQ-5D ) in patients with nonspecific chronic low back pain ( CLBP ) are largely unknown . PURPOSE To study the criterion validity , responsiveness , and minimal clinical ly important change ( MCIC ) of EQ-5D in patients with CLBP . STUDY DESIGN Prospect i ve study design carried out in a multispecialist Spine Center in The Netherl and s. PATIENT SAMPLE One hundred fifty-one patients with CLBP . OUTCOME MEASURES Quality of life ( QOL ) was measured with EQ-5D , consisting of two scales : one scale measuring QOL with five categorical questions and the other measuring health state on a visual analog scale ( 0 - 100 ) . Criterion measures were disability , measured with the Pain Disability Index ( PDI ) and the Rol and Morris Disability Question naire ( RMDQ ) , and pain intensity , measured with a numeric rating scale ( NRS ) . METHODS Pearson correlation coefficients between the EQ-5D and RMDQ , PDI , and NRS were calculated to test the criterion validity . Correlations were interpreted based on predefined criteria . Responsiveness of the EQ-5D was calculated with area under the receiver operating characteristics ( ROC ) curve . Minimal clinical ly important change was calculated with the optimal cutoff point under the ROC curve , and sensitivity and specificity were also calculated . RESULTS Correlations between EQ-5D and criterion measures ranged between 0.39 and 0.59 and were considered moderate to good . Areas under the ROC curve ranged from 0.59 to 0.72 depending on the external criterion and EQ-5D subscale . The MCIC was 0.03 points for the categorical scales of the EQ-5D and 10.5 points for the EQ-5D visual analog scale . CONCLUSIONS The EQ-5D is a valid and responsive QOL scale in patients with CLBP
Most of the evidence concerns the SF-36 and EQ-5D , and for these instruments there was evidence for known group validity .
Although the evidence base is limited in a number of important respects , including problems with the measures used to develop constructs in the validation studies , it is sufficient to raise doubts about the use of generic measures of health like the EQ-5D and SF-36 in patients with schizophrenia
OBJECTIVES Generic health status measures such as the short form health survey ( SF-36 ) and EuroQol-5D ( EQ-5D ) are increasingly being used to inform health policy .
They are cl aim ed to be applicable across disease areas and have started to be used within mental health research .
This review aims to assess the construct validity and responsiveness of four generic health status measures in schizophrenia , including the preference-based SF-6D and EQ-5D .