Using the short form-36 with multiple sclerosis patients in five countries: A cross-cultural comparison

Questionnaires measuring health-related quality of life are increasingly us ed in international studies of medical effectiveness. It is important to kn ow if data from these instruments are comparable across countries. We initi ated a collaboration among five research groups-from the USA, The Netherlan ds, Belgium, France, and the UK-in the field of health-related quality of l ife in multiple sclerosis. All groups used the 36-item Short Form Health Su rvey. The goal of our study was to make a cross-cultural comparison. In the five countries under study the sample size varied from 50 to 134 patients with multiple sclerosis. The survey was completed by a total of 457 patient s, who were heterogeneous in relation to age, duration of illness, severity and type of multiple sclerosis. There appeared ro be major differences amo ng the samples in scores on each of the eight scales. These findings may be influenced by differences in method of recruitment, demographic and diseas e-related characteristics, administration, and cultural factors. After havi ng performed ii number of analyses, it appeared that the differences were m ainly attributable to sampling effects; however, cultural influences could nor be excluded.