Disease-Specific Versus Generic Measurement of Health-Related Quality of Life in Cross-Sectional and Longitudinal Studies: an Inpatient Investigation of the SF-36 and Four Disease-Specific Instruments

  • Serge Briançon
  • Bernadette Gergonne
  • Francis Guillemin
  • Fabienne Empereur
  • Sylvie Klein


We studied the specificity and sensitivity to change of disease-specific questionnaires by assessing their relationship with generic questionnaires. The SF-36 and a disease-specific questionnaire were administered to 843 hospitalised patients on the day of admission and 15 days after discharge. The disease-specific questionnaire selected depended on the speciality of admission. The dimensions common to all questionnaires were studied. These were the physical, mental and social dimensions. Relationships were evaluated and compared for two groups of patients: those presenting with a disease for which the specific questionnaire was well matched, and those presenting with a disease for which it was not well matched. We hypothesised that correlations between generic and specific questionnaires would be lower when the disease-specific questionnaire was well matched. We found no significant differences in correlations at baseline; however, when considering changes in scores from baseline to follow-up, patients for whom the specific questionnaire was well matched had significantly lower correlations for the physical and mental dimensions. These results indicate that disease-specific questionnaires are not appropriate for use in cross-sectional studies, but are more sensitive to change than generic questionnaires and therefore more applicable to longitudinal investigations.


Carpal Tunnel Syndrome Mental Dimension Standardise Regression Coefficient Specific Questionnaire Standardise Response Mean 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kantz, M.E., Harris, W.J., Levitsky, K., Ware, J.E. and Davies, A.R. (1992). Methods for assessing condition-specific and generic functional status outcomes after total knee replacement. Medical Care 30, 240–252.CrossRefGoogle Scholar
  2. 2.
    Weinberger, M., Samsa, G.P., Tierney, W.M., Belya, M.J. and Hiner, S.L. (1992). Generic versus disease specific health status measure: comparing the Sickness Impact Profile and the Arthritis Measurement Scales. Journal of Rheumatology 19, 543–546.PubMedGoogle Scholar
  3. 3.
    Bombardier, C., Melfi, C.A., Paul, J., Green, R., Hawker, G., Wright, J. and Coyte P. (1995). Comparison of a generic and a disease-specific measure of pain and physical function after knee replacement surgery. Medical Care 33 (supplement), AS BIAS 144.Google Scholar
  4. 4.
    Parkerson, G.R., Broadhead, W.E. and Chiu-Kit, J.C. (1990). The DUKE Health Profile. A 17-item measure of health and dysfunction. Medical Care 28, 1056–1071.PubMedCrossRefGoogle Scholar
  5. 5.
    Patrick, D.L., Deyo, R.A. (1989). Generic and disease-specific measure in assessing health status and quality of life. Medical Care 27, S217–S232.PubMedCrossRefGoogle Scholar
  6. 6.
    Till, J.E., Osoba, D., Pater, J.L. and Young, J.R. (1994). Research on health-related quality of life: dissemination into practical application. Quality of Life Research 3, 279–283.PubMedCrossRefGoogle Scholar
  7. 7.
    Parkerson, G.R., Connis, R.T., Broadhead, W.E., Patrick, D.L., Taylor, T.R. and Tse, C.K. (1993). Disease-specific versus generic measurement of health-related quality of life in insulin-dependent diabetic patients. Medical Care 31, 629–639.PubMedCrossRefGoogle Scholar
  8. 8.
    Vickrey, B.G., Hays, R.D., Genovese, B.J., Myers, L.W. and Ellison, G.W. (1997). Comparison of generic to disease targeted health related quality of life measure for multiple sclerosis. Journal of Clinical Epidemiology 50, 557–569.PubMedCrossRefGoogle Scholar
  9. 9.
    Ware, J.E., Kemp, J.P., Buchner, D.A., Singer, A.E., Nolop, K.B., Goss, T.F. (1998). The responsiveness of disease-specific and generic health measure to change in the severity of asthma among adults. Quality of Life Research 7, 235–244.PubMedCrossRefGoogle Scholar
  10. 10.
    Gliklich, R.E. and Hilinski, J.M. (1995). Longitudinal sensitivity of generic and specific health measures in chronic sinusitis. Quality of Life Research 4, 27–32.PubMedCrossRefGoogle Scholar
  11. 11.
    Bessette, L., Sangha, O., Kuntz, K.M., Keller, R.B., Lew, R.A., Fossei, A.H. and Katz, J.N. (1998). Comparative responsiveness of generic versus disease-specific and weighted versus unweighted health status measures in carpal tunnel syndrome. Medical Care 36, 491–502.PubMedCrossRefGoogle Scholar
  12. 12.
    Garrat, A.M., Ruta, D.A., Abdalla, M.I. and Russell, I.T. (1998). Responsiveness of the SF 36 and a condition-specific measure of health for patients with varicose veins. Quality of Life Research 7, 223–234.Google Scholar
  13. 13.
    Fortin, P.R., Stucki, G. and Katz, J.N. (1995). Measuring relevant change: an emerging challenge in rheumatologic clinical trials. Arthritis and Rheumatism 38, 1027–1030.PubMedCrossRefGoogle Scholar
  14. 14.
    World Health Organization (WHO, 1993). International Classification of Diseases. 10th Revision. Geneva: WHO.Google Scholar
  15. 15.
    Brazier, J.E., Harper, R., Jones, N.M., O’Cathain, A., Thomas, K.J., Usherwood, T. and Westlake, L. (1992). Validating the SF-36 health survey questionnaire: new outcome measure for primary care. British Medical Journal 305, 160–164.PubMedCrossRefGoogle Scholar
  16. 16.
    Guillemin, F., Coste, J., Pouchot, J., Ghezail, M., Bregeon, C., Sany, J. (1997). The AIMS2-SF: a short form of the Arthritis Impact Measurement Scales 2. French Quality of Life in Rheumatology Group. Arthritis and Rheumatism 40, 1267–74.PubMedGoogle Scholar
  17. 17.
    Pouchot, J., Guillemin, F., Coste, J., Bregeon, C., Sany, J. and the French Quality of Life in Rheumatology Group. (1996). Validity, reliability and sensitivity to change of a French version of the Arthritis Measurement Scales 2 (AIMS) in patients with rheumatoid arthritis treated with methotrexate. Journal of Rheumatology 23, 52–60.PubMedGoogle Scholar
  18. 18.
    Bouchet, C., Guillemin, F., Hoang Thi, T.H., Cornette, A. and Briançon, S. (1996). Validation of the St George’s questionnaire for measuring the quality of life in patients with chronic obstructive pulmonary disease. Revue des Maladies Respiratoires 13, 43–46 (French).PubMedGoogle Scholar
  19. 19.
    Jones, P.W., Quirk, F.H. and Baveystock, C.M. (1991). The St. George’s Respiratory Questionnaire. Respiratory Medicine 85 (supplement B), 25–31.PubMedCrossRefGoogle Scholar
  20. 20.
    Briançon, S., Alla, F., Méjat, E., Guillemin, F., Villemot, J.L., Mertes, P.M. and Zannad, F. (1997). Assessment of functional capacity and quality of life among cardiac failure patients. Transcultural adaptation and validation of the Goldman, Minnesota and Duke questionnaires. Archives des Maladies du Coeur et des Vaisseaux 90, 1577–1585 (French).PubMedGoogle Scholar
  21. 21.
    Rector, T.S., Kubo, S.H. and Cohn, J.N. (1987). Patient’s self-assessment of their congestive heart failure. Part 2: content, reliability and validity of a new measure, The Minnesota Living with Heart Failure Questionnaire. Heart Failure 3, 198–209.Google Scholar
  22. 22.
    Hays, R.D., Kallich, J.D., Mapes, D.L., Coons, S.J. and Carter, W.B. (1994). Development of the Kidney Disease Quality of Life (KDQOL) instrument. Quality of Life Research 3, 329–338.PubMedCrossRefGoogle Scholar
  23. 23.
    Katz, J.N., Larson, M.G., Phillips, C.B., Fossei, A.H. and Liang, M.H. (1992). Comparative measurement sensitivity of short and longer health status instruments. Medical Care 30, 917–925.PubMedCrossRefGoogle Scholar
  24. 24.
    Anderson, J.J. and Chernoff, M.C. (1993). Sensitivity to change of rheumatoid arthritis clinical trial outcome measure. Journal of Rheumatology 20, 535–537.PubMedGoogle Scholar
  25. 25.
    Liang, M.H., Fossei, A.H. and Larson, M.G. (1990). Comparison of five health status instruments for orthopedic evaluation. Medical Care 28, 632–642.PubMedCrossRefGoogle Scholar
  26. 26.
    Chavance, M. (1992). Le canif et les bretelles, Jackknife and bootstrap. Revue d’Epidemiologie et de Santé Publique 40, 209–218.PubMedGoogle Scholar
  27. 27.
    Dixon, W.J. (1992). BMDP Statistical Software Manual, Version 7.0.Google Scholar
  28. 28.
    Hawley, D.J. and Wolfe, F. (1992). Sensitivity to change of health assessment questionnaire (HAQ) and other clinical and health status measures in rheumatoid arthritis. Result of short-term clinical trials and observational studies versus long-term observational studies. Arthritis Care and Research 5, 130–136.PubMedCrossRefGoogle Scholar
  29. 29.
    Kazis, L.E., Anderson, J.J. and Meenan, R.F. (1989). Effect sizes for interpreting hanges in health status. Medical Care 27, S178–S189.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2002

Authors and Affiliations

  • Serge Briançon
    • 1
  • Bernadette Gergonne
    • 1
  • Francis Guillemin
    • 1
  • Fabienne Empereur
    • 1
  • Sylvie Klein
    • 1
  1. 1.University of NancyFrance

Personalised recommendations