Multivariate models of self-reported health often neglected essential candidate determinants and methodological issues

J Clin Epidemiol. 2005 May;58(5):436-43. doi: 10.1016/j.jclinepi.2004.08.016.


Background and objective: Self-reported health is an important indicator of overall well-being that may be influenced by diverse parameters. We intended to evaluate the variety of candidate determinants used in models of self-reported health (SRH) and to examine the methodological problems encountered in multivariate models used in recent studies in this field.

Study design and setting: Medline searches identified articles published in 2002 in which SRH was included as an outcome, at least one other variable was used as a determinant of SRH, and the study population was not defined by the presence of specific diseases.

Results: Of 1,991 initially identified reports, 56 were eligible. In 91% of the eligible articles, multivariate models were used. In total, 133 different determinants of SRH were considered (median 7 determinants considered per study with multivariate models). The proportions of studies with problems in multivariate modeling were: overfitting, 10%; nonconformity to a linear gradient, 29%; no report of tests for interactions, 63%; unspecified coding of variables, 49%; and unspecified selection of variables, 29%.

Conclusion: Models that try to identify what influences SRH should consider appropriate lists of candidate determinants, with proper attention to methodological aspects of multivariate modeling.

Publication types

  • Review

MeSH terms

  • Epidemiologic Research Design
  • Health Status*
  • Humans
  • Models, Statistical
  • Multivariate Analysis
  • Quality of Life
  • Self-Assessment*