BMJ 1992;305:160-164 (18 July), doi:10.1136/bmj.305.6846.160
Validating the SF-36 health survey questionnaire: new outcome measure for primary care.
J. E. Brazier,
R. Harper,
N. M. Jones,
A. O'Cathain,
K. J. Thomas,
T. Usherwood,
L. Westlake
Medical Care Research Unit, University of Sheffield Medical School.
OBJECTIVES--To test the acceptability, validity, and reliability
of the short form 36 health survey questionnaire (SF-36) and
to compare it with the Nottingham health profile. DESIGN--Postal
survey using a questionnaire booklet together with a letter
from the general practitioner. Non-respondents received two
reminders at two week intervals. The SF-36 questionnaire was
retested on a subsample of respondents two weeks after the first
mailing. SETTING--Two general practices in Sheffield. PATIENTS--1980
patients aged 16-74 years randomly selected from the two practice
lists. MAIN OUTCOME MEASURES--Scores for each health dimension
on the SF-36 questionnaire and the Nottingham health profile.
Response to questions on recent use of health services and sociodemographic
characteristics. RESULTS--The response rate for the SF-36 questionnaire
was high (83%) and the rate of completion for each dimension
was over 95%. Considerable evidence was found for the reliability
of the SF-36 (Cronbach's alpha greater than 0.85, reliability
coefficient greater than 0.75 for all dimensions except social
functioning) and for construct validity in terms of distinguishing
between groups with expected health differences. The SF-36 was
able to detect low levels of ill health in patients who had
scored 0 (good health) on the Nottingham health profile. CONCLUSIONS--The
SF-36 is a promising new instrument for measuring health perception
in a general population. It is easy to use, acceptable to patients,
and fulfils stringent criteria of reliability and validity.
Its use in other contexts and with different disease groups
requires further research.

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