EVALUATING CHANGES IN HEALTH-STATUS - RELIABILITY AND RESPONSIVENESS OF 5 GENERIC HEALTH-STATUS MEASURES IN WORKERS WITH MUSCULOSKELETAL DISORDERS

Objectives: To compare the measurement properties over time of five ge neric health status assessment techniques. Methods: Five health status measures were completed on two occasions by a sample of workers with musculoskeletal disorders. They included the SF-36, Nottingham Health Profile, Health Status Section of the Ontario Health Survey (OHS), Duk e Health Profile, the Sickness Impact Profile and a self-report of cha nge in health between tests. Setting: Subjects were accrued from a wor k site (within one week of injury) (n = 53), physiotherapy clinics (fo ur weeks after injury), (n = 34), and a tertiary level rehabilitation center (more than four weeks after injury) (n = 40). Analysis: Intracl ass correlation coefficients (ICC) derived from nonparametric one-way analysis of variance were used for test-retest reliability in those wh o had not chanced (n = 49). Various responsiveness statistics were use d to evaluate responsiveness in those who claimed they had a positive change in health (n = 45) and in those who would have been expected to have a positive change (n = 79). Results: Of the 127 subjects recruit ed, 114 completed both questionnaires (89.8%). In the subjects who rep orted no change in health, analysis of targeted dimensions (overall sc ores, physical function, and pain) demonstrated acceptable to excellen t test-retest reliability in all but the Duke Health Profile. In subje cts with change in health, the SF-36 was the most responsive measure ( moderate to large effect sizes [0.55-0.97] and standardized response m eans ranging between 0.81 and 1.13). Conclusions: The results suggest that the SF-36 was the most appropriate questionnaire to measure healt h changes in the population studied. The selection of a health status measure must be context-specific, taking into account the purpose and population of the planned research. Copyright (C) 1997 Elsevier Scienc e Inc.