MEASURING CHANGE OVER TIME - A COMPARISON OF RESULTS FROM A GLOBAL SINGLE ITEM OF HEALTH-STATUS AND THE MULTIDIMENSIONAL SF-36 HEALTH-STATUS SURVEY QUESTIONNAIRE IN PATIENTS PRESENTING WITH MENORRHAGIA

This paper compares the sensitivity to change of a multi-item, multi-d imensional health status measure with a single global health status qu estion, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered post ally at baseline and follow up. General practices in Berkshire, Buckin ghamshire, Northamptonshire and Oxfordshire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two administrations of the questionnaires. A single global question was g iven to patients asking them to rate their overall health status as 'e xcellent', 'very good', 'good', 'fair' or 'poor'. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels o f improvement for patients who received drug treatment. However, on ma ny dimensions of the SF-36, a moderate to large improvement was detect ed for the surgical group. However, small changes were reported in ove rall health status, as indicated by the single global question, for bo th groups. Single item measures of health status may not provide a suf ficiently accurate indication of health status to be appropriate for u se in longitudinal studies.