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Cited by 211Health Systems, Economic Evaluations, Quality of LifePsychometric Methodologies and TestingMusculoskeletal pain and rehabilitation

SF-36 Summary Scores: Are Physical and Mental Health Truly Distinct

Simon, Gregory E., Revicki, Dennis A., Grothaus, Louis, Vonkorff, Michael·1998·Medical Care
DOI 10.1097/00005650-199804000-00012
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Abstract

OBJECTIVES: Data from 536 primary care patients initiating antidepressant treatment were used to examine the performance of the Medical Outcomes Study SF-36 Physical Component and Mental Component summary scores. METHODS: The SF-36 was administered at baseline and readministered after 1 month and 3 months (n = 482). RESULTS: At the baseline assessment, patients reported modest impairment on the Physical Function, Role--Physical, Bodily Pain, and General Health Perceptions subscales (0.10 to 0.68 standard deviations below national norms), but the Physical Component summary (mean = 51) indicated no impairment based on a population norm of 50. During 3 months of follow-up evaluation, the Physical Function, Role--Physical, Bodily Pain, and General Health Perceptions subscales all showed moderate and statistically significant improvement (range from 0.28 to 0.49 standard deviation units), whereas the Physical Component summary score was essentially unchanged (mean = 50 at both 1-month and 3-month assessments). This pattern of results is a natural consequence of the assumptions and methods used to calculate these summary scores-orthogonal factor rotation and negative scoring coefficients. CONCLUSIONS: These findings suggest caution in the interpretation of Mental Component Summary and Physical Component Summary scores when the condition or treatment of interest has strong effects on scales with negative scoring coefficients (Mental Health and Role--Emotional for the Physical Component; Physical Function, Role--Physical, and Bodily Pain for the Mental Component).

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  • This negative weighting produces inconsistent results between SF-36 scale scores and summary scores when responses follow a consistent pattern across the eight SF-36 scales.

    “This leads to inconsistent results between SF-36 scale scores and the summary scores when there is a consistent pattern of responses for the 8 SF-36 scale score (i.e., a majority of or all high scores or low scores) [38].”

    From PROMIS®-29 v2.0 profile physical and mental health summary scores (2018) · cites this paper as [38]

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Authors
Simon, G. E., Revicki, D. A., Grothaus, L., & Vonkorff, M.
Affiliations
Group Health Cooperative (US)
Corresponding author
  • Simon, Gregory E.
  • Grothaus, Louis
  • Vonkorff, Michael
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-04
Volume
36
Issue
4
Pages
567-572
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/00005650-199804000-00012
OpenAlex
W2039456416
Cited by
211
References
16
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 9 · 2014: 4 · 2013: 13 · 2012: 5
FWCI
24.00
Type
journal article
Language
en
Open access
closed
Locations
  • Medical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (51338)
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, antidepressant treatment, depression, primary care patients, health-related quality of life, scale interpretation, bodily pain, physical function
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Antidepressive Agents, Depression, Female, Health Status Indicators, Health Surveys, Humans, Male, Middle Aged, Primary Health Care, Quality of Life, United States, Washington, Treatment Outcome, Outcome Assessment, Health Care

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