Validation and calibration of the SF-36 health transition question against an external criterion of clinical change in health status

Qual Life Res. 2009 Jun;18(5):637-45. doi: 10.1007/s11136-009-9467-1. Epub 2009 Mar 28.


Purpose: Cross-sectional surveys depend on retrospective health transition questions (HTQ) to estimate recent changes in health status. This paper assesses the validity of the SF-36 HTQ and calibrates its categories against change assessed prospectively on the SF-36 domain scales in a sub-group known to have experienced clinically important changes in health status.

Methods: Adults (n = 9,649) from a longitudinal population survey completed the SF-36 in 2001 and 2002. Prospective measures were calculated as mean changes in SF-36 scale scores adjusted for age and gender, and also expressed as standardised response means. Comparison groups were those who had developed a long-term health condition since the last interview and the HTQ response categories for those who had not developed any new conditions.

Results: Those with a new condition and those without a new condition but who described their health as "somewhat worse" than a year ago had comparable declines in health status on all domain scales except role physical, where those with a new condition experienced a greater decline.

Conclusions: This analysis demonstrates the validity and limitations of the HTQ as a measure of change in population studies. The calibration is useful for interpreting the meaning of the HTQ categories at the group level but not at the individual level.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Australia / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Status Indicators*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Recall
  • Middle Aged
  • Surveys and Questionnaires / standards*