There is no consensus regarding what a clinically meaningful change for either instrument might be, so even this approach has limited value. Because the mobility, self-care, social functioning, pain, and psychological domains of the EuroQol have just three distinct levels for example, mobility:  I have no problems in walking about,  I have some problems in walking about,  I am confined to bed , we considered any change for these domains to be potentially important. The definition of a potentially important change with the SF is more controversial. Some investigators consider differences of five points in any of its domains as potentially important.
We therefore reported the frequency of disagreement for four empirically chosen differences in score 5, 10, 20, and 40 points. We were only able to compare the reliability of the EuroQol and SF indirectly.
The groups who received the initial EuroQol and SF were similar, but there were inevitably some differences between the groups who were sent repeat questionnaires because some selection bias had taken place at this stage. An alternative approach would have been to give all patients both instruments twice test-retest. We felt, however, that this would place an unacceptable burden on patients and so might have adversely affected the response rates.
The comparison may also have been biased because the EuroQol asks patients to report their health state on that particular day, whereas the SF asks patients about their health over the previous 4 weeks. We were therefore surprised that the qualitative estimates of reliability of the SF and EuroQol were so similar. In summary, both the EuroQol and SF have acceptable and qualitatively similar test-retest reliability when administered after stroke and completed by patients or their proxies. Either instrument might function effectively as a discriminatory measure for assessing HRQoL outcomes in groups of patients, as in a large, parallel group, randomized, controlled trial or an audit study.
Sample size calculations for observational studies and randomized trials must take the reliability of both instruments into account. Doing so will generally increase the sample size but should reduce the risk of a false-negative or type II statistical error. Our data do not support the use of either instrument for serial assessments in individual patients unless very large differences over time are expected.
Download figure Download PowerPoint Figure 1. The flow of patients through the study.
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Table 1. Table 2. Table 3. Note that for 1 patient it was not clear whether the form was completed by the patient or with the help of a proxy. Table 4.
Table 5. Table 6. This study was supported by a grant from Glaxo Wellcome plc. We would like to thank all the patients, their families, and caregivers for their keen participation. Home Stroke Vol. View PDF. Tools Add to favorites Download citations Track citations Permissions. Jump to. Jim Slattery Jim Slattery Search for more papers by this author. Barbara Farrell Barbara Farrell Search for more papers by this author.
Martin Dennis Martin Dennis Search for more papers by this author. Peter Sandercock Peter Sandercock Search for more papers by this author. Download figure Download PowerPoint. References 1 Scientific Advisory Committee. Instrument review criteria. Medical Outcome Trust Bulletin. Evaluating neurological outcome measures: the bare essentials. J Neurol Neurosurg Psychiatry.
Measuring health : a guide to rating scales and questionnaires / Lan McDowell, Claire Newell.
Measuring health-related quality of life. Ann Intern Med. Assessment of quality-of-life outcomes. N Engl J Med. Validation of the Short Form 36 SF health survey questionnaire among stroke patients. Is the EuroQol a valid measure of health-related quality of life after stroke? Validating the SF health survey questionnaire: new outcome measure for primary care. Test-retest reliability of health state valuations collected with the EuroQol questionnaire. Soc Sci Med. EuroQol: the current state of play.
Health Policy. A randomised comparison of the EuroQol and SF after stroke. The International Stroke Trial IST : a randomised trial of aspirin, subcutaneous heparin, both or neither among patients with acute ischaemic stroke.go to site
Reproducibility and responsiveness of health status measures. Control Clin Trials. Assessing agreement. Med J Aust. Statistical methods for assessing observer variability in clinical measures. The role of cognitive impairment in the quality of life after ischaemic stroke. J Neurol. Are proxy assessments of health status after stroke with the EuroQol questionnaire feasible, accurate and unbiased? SF 36 health survey questionnaire, I: reliability in two patient based studies.
Quality Health Care. The SF health survey questionnaire: is it suitable for use with older adults? Age Ageing. Are health-related quality-of-life measures affected by the mode of administration? Social surveys. Health status indicators -- Measurement.
Measuring health : a guide to rating scales and questionnaires
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Contents The theoretical and technical foundations of health measurement -- Physical disability and handicap -- Social health -- Psychological well-being -- Anxiety -- Depression -- Mental status testing -- Pain measurements -- General health status and quality of life -- Recommendations and conclusion. You are browsing titles by their Library of Congress call number classification. Just a moment Finding nearby items.
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