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Cited by 73Health Systems, Economic Evaluations, Quality of LifePsychometric Methodologies and TestingMusculoskeletal pain and rehabilitation

The SF-36 scales are not accurately summarised by independent physical and mental component scores.

Hann, Mark, Reeves, David·2008·Quality of Life Research
DOI 10.1007/s11136-008-9310-0
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Abstract

Objectives The Short Form 36 Health Status Questionnaire (SF-36) has eight scales that can be condensed into two components: physical component summary (PCS) and mental component summary (MCS). This paper investigates: (1) the assumption that PCS and MCS are orthogonal, (2) the applicability of a single model to different condition-specific subgroups, and (3) a reduced five-scale model.Study design and setting We performed a secondary analysis of two large-scale data sets that utilised the SF-36: the Health Survey for England 1996 and the Welsh Health Survey 1998. We used confirmatory factor analysis to compare hypothetical orthogonal and oblique factor models, and exploratory factor analysis to derive data-driven models for condition-specific subgroups.Results Oblique models gave the best fit to the data and indicated a considerable correlation between PCS and MCS. The loadings of the eight scales on the two component summaries varied significantly by disease condition. The choice of model made an important difference to norm-referenced scores for large minorities, particularly patients with a mental illness or mental-physical comorbidity.Conclusions We recommend that users of the SF-36 adopt the oblique model for calculating PCS and MCS. An oblique five-scale model provides a more universal factor structure without loss of predictive power or reliability.

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  • The use of the SF-36 Physical Functioning single subscale is supported by recent literature as being a better measure of change for clinical trials than composite summary scores.

    “The use of this single subscale of the SF-36 is supported by recent literature as being a better measure of change for clinical trials than the composite summary scores that can be derived from this same measure [30; 57].”

    From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [30]

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Authors
Hann, M., & Reeves, D.
Affiliations
University of Manchester (GB)
Corresponding author
Hann, Mark
ORCID
Venue
Quality of Life Research
Publisher
Springer Science and Business Media LLC
Published
2008-02-08
Volume
17
Issue
3
Pages
413-423
ISSN
  • 0962-9343 (ISSN-L)
  • 1573-2649
DOI
10.1007/s11136-008-9310-0
OpenAlex
W2005208065
Cited by
73
References
34
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 6 · 2014: 6 · 2013: 10 · 2012: 7
FWCI
12.34
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Quality of Life Research (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
Funders
University of Essex
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
SF-36, physical component summary, mental component summary, health-related quality of life, factor models, mental illness, Health Survey for England
MeSH terms
England, Factor Analysis, Statistical, Health Status, Health Status Indicators, Health Surveys, Humans, Psychological Tests, Psychometrics, Surveys and Questionnaires, Wales, Models, Statistical

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