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Cited by 2,206Health Systems, Economic Evaluations, Quality of LifeHealth Education and ValidationMedical Practices and Rehabilitation

Individual-patient monitoring in clinical practice: are available health status surveys adequate?

McHorney, C. A., Tarlov, A. R.·1995·Quality of Life Research
DOI 10.1007/bf01593882
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Abstract

Interest has increased in recent years in incorporating health status measures into clinical practice for use at the individual-patient level. We propose six measurement standards for individual-patient applications: (1) practical features, (2) breadth of health measured, (3) depth of health measured, (4) precision for cross-sectional assessment, (5) precision for longitudinal monitoring and (6) validity. We evaluate five health status surveys (Functional Status Questionnaire, Dartmouth COOP Poster Charts, Nottingham Health Profile, Duke Health Profile, and SF-36 Health Survey) that have been proposed for use in clinical practice. We conducted an analytical literature review to evaluate the six measurement standards for individual-patient applications across the five surveys. The most problematic feature of the five surveys was their lack of precision for individual-patient applications. Across all scales, reliability standards for individual assessment and monitoring were not satisfied, and the 95% CIs were very wide. There was little evidence of the validity of the five surveys for screening, diagnosing, or monitoring individual patients. The health status surveys examined in this paper may not be suitable for monitoring the health and treatment status of individual patients. Clinical usefulness of existing measures might be demonstrated as clinical experience is broadened. At this time, however, it seems that new instruments, or adaptation of existing measures and scaling methods, are needed for individual-patient assessment and monitoring.

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  • Floor and ceiling effects are considered present if more than 15% of respondents achieved the lowest or highest possible score, respectively.

    “I considered floor and ceiling effects to be present if more than 15% of respondents achieved the lowest or highest possible score, respectively72.”

    From A systematic review of AI literacy scales (2024) · cites this paper as [72]

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Authors
McHorney, C. A., & Tarlov, A. R.
Affiliations
  • University of Wisconsin–Madison (US)
  • Tufts University (US)
ORCID
McHorney, C. A.
Venue
Quality of Life Research
Publisher
Springer Science and Business Media LLC
Published
1995-08
Volume
4
Issue
4
Pages
293-307
ISSN
  • 0962-9343 (ISSN-L)
  • 1573-2649
DOI
10.1007/bf01593882
OpenAlex
W2069398327
Cited by
2,206
References
146
Citations by year
2026: 89 · 2025: 121 · 2024: 154 · 2023: 132 · 2022: 138 · 2021: 159 · 2020: 156 · 2019: 127 · 2018: 93 · 2017: 85 · 2016: 95 · 2015: 75 · 2014: 92 · 2013: 75 · 2012: 64
FWCI
48.20
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Quality of Life Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Education › Health Education and Validation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
health status survey, health-related quality of life measurement, measurement standards, reliability statistics, validity, Nottingham Health Profile, Duke Health Profile, SF-36 Health Survey, long-term monitoring, screening and diagnosis
MeSH terms
Health Status Indicators, Health Surveys, Humans, Sensitivity and Specificity, Reproducibility of Results, Outcome Assessment, Health Care

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