Comparison of the SF-36 health survey questionnaire with the Nottingham Health Profile in long-term survivors of a myocardial infarction

Background Health-related quality of life, an important outcome measure in health interventions, can readily be assessed by questionnaire. Two widely evaluated examples are the Short Form 36 (SF-36) and Nottingham Health Prof ile (NHP) questionnaires, but as yet the discriminatory power of these tool s has not been compared in a large population of patients with coronary hea rt disease. Methods All 4-year survivors of a myocardial infarction, identified from th e Nottingham heart attack register, were sent the SF-36, NHP and additional ly the Rose angina and dyspnoea questionnaires. Mean scores on the SF-36 an d NHP were compared with age- and sex-adjusted norms in patients under and over 65 years. Sensitivity of the respective tools was assessed in distingu ishing patients with differing deg rees of cardiovascular symptomatology. Results In patients under 65 years the SF-36 and NHP differed to the same e xtent from normative data - scores were lower in the comparable domains phy sical functioning/mobility, bodily pain/pain and energy/vitality, but not i n mental health/emotional reaction scores. In social functioning/social iso lation results were disparate - SF-36 scores were lower and the NHP similar to normative data. In patients over 65 years mean scores in all five domai ns were not significantly different from normative data for either tool. Th e SF-36 was more sensitive than the NHP at detecting the impact of breathle ssness, particularly in patients with mild symptoms. Similarly, the SF-36, but not the NHP, could distinguish the effect of differing degrees of angin a severity and frequency on social functioning. Conclusion At least in myocardial infarction survivors, the SF-36 appears a more sensitive tool and may have benefits for assessing health-related qua lity of life in this patient group.