Clinical appropriateness: a key factor in outcome measure selection: the 36 item short form health survey in multiple sclerosis

被引:99
作者
Freeman, J [1 ]
Hobart, JC [1 ]
Langdon, DW [1 ]
Thompson, AJ [1 ]
机构
[1] UCL Inst Neurol, Dept Clin Neurol, London WC1N 3BG, England
关键词
multiple sclerosis; SF-36; quality of life;
D O I
10.1136/jnnp.68.2.150
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives-Understanding the properties of an outcome measure is essential in choosing the appropriate instrument and interpreting the information it generates. The MOS 36 item short form health survey questionnaire (SF-36) is widely acknowledged as the gold standard generic measure of health status; few studies however have evaluated its use for clinical trials in multiple sclerosis. Its clinical appropriateness, internal consistency reliability; validity, and responsiveness was investigated across a broad range of patients with multiple sclerosis. Methods-A prospective study in which 150 adults with clinically definite multiple sclerosis completed a battery of questionnaires evaluating generic health status, disability, handicap, and emotional well-being. Of these, 44 patients undergoing inpatient rehabilitation completed the questionnaires before and after intervention to evaluate responsiveness. Results-Score distributions demonstrated significant floor and ceiling effects in four of the eight dimensions which were particularly marked when patient selection was restricted to a narrow band of disease severity (as is the case in most clinical trials). Internal consistency exceeded the standard for group comparisons for all dimensions. Convergent and discriminant construct validity was supported by the direction, magnitude, and pattern of correlations with other health measures. In comparison with instruments measuring associated constructs, the responsiveness of the SF-36 was poor in evaluating change in moderate to severely disabled patients participating in a programme of inpatient rehabilitation. Conclusions-The SF-36 has some limitations as an outcome measure in multiple sclerosis. The results highlight the need for all instruments to be examined in the specific sample population under question and for the specific research question being investigated. In multiple sclerosis clinical trials, the SF-36 should be supplemented with other relevant measures.
引用
收藏
页码:150 / 156
页数:7
相关论文
共 39 条
[1]  
Auty A, 1998, CAN J NEUROL SCI, V25, P31
[2]   VALIDATING THE SF-36 HEALTH SURVEY QUESTIONNAIRE - NEW OUTCOME MEASURE FOR PRIMARY CARE [J].
BRAZIER, JE ;
HARPER, R ;
JONES, NMB ;
OCATHAIN, A ;
THOMAS, KJ ;
USHERWOOD, T ;
WESTLAKE, L .
BMJ-BRITISH MEDICAL JOURNAL, 1992, 305 (6846) :160-164
[3]  
*BRIT SOC REH MED, 1993, MULT SCLER
[4]   Measurement of health related quality of life in multiple sclerosis patients [J].
Brunet, DG ;
Hopman, WM ;
Singer, MA ;
Edgar, CM ;
MacKenzie, TA .
CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES, 1996, 23 (02) :99-103
[5]   Validation of the functional assessment of multiple sclerosis quality of life instrument [J].
Cella, DF ;
Dineen, K ;
Arnason, B ;
Reder, A ;
Webster, KA ;
Karabatsos, G ;
Chang, C ;
Lloyd, S ;
Mo, F ;
Stewart, J ;
Stefoski, D .
NEUROLOGY, 1996, 47 (01) :129-139
[6]  
Cohen J., 1998, Statistical Power Analysis for the Behavioral Sciences, V2nd
[7]   CONSTRUCT VALIDITY IN PSYCHOLOGICAL TESTS [J].
CRONBACH, LJ ;
MEEHL, PE .
PSYCHOLOGICAL BULLETIN, 1955, 52 (04) :281-302
[8]  
DALOS NP, 1983, ANN NEUROL, V13, P573, DOI 10.1002/ana.410130517
[9]   Health-related quality of life for patients with progressive multiple sclerosis: Influence of rehabilitation [J].
Di Fabio, RP ;
Choi, T ;
Soderberg, J ;
Hansen, CR .
PHYSICAL THERAPY, 1997, 77 (12) :1704-1716
[10]  
DUQUETTE P, 1995, NEUROLOGY, V45, P1277