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SF-36 Summary Scores: Are Physical and Mental Health Truly Distinct
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 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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Metadata
- 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
- Venue
- Medical Care
- Published
- 1998-04
- Volume
- 36
- Issue
- 4
- Pages
- 567-572
- ISSN
- 0025-7079 (ISSN-L)
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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