The Short Health Scale: a valid measure of subjective health in ulcerative colitis.
OBJECTIVE
Assessment of health-related quality of life (HRQOL) is important in both clinical practice and clinical trials, and several multi-item questionnaires are currently in use. We have devised and evaluated a simplified four-item questionnaire, the Short Health Scale (SHS), representing each of four health dimensions: (a) symptom burden, (b) social function, (c) disease-related worry and (d) general well-being.


METHODS
Three hundred patients with ulcerative colitis completed the SHS and three other HRQOL questionnaires (IBDQ, RFIPC and PGWB). Half of the patients repeated the questionnaires after 6 months - or earlier if disease activity changed. Test-retest reliability was derived from measurements of the SHS questions, 2 weeks apart, on 18 patients in remission.


RESULTS
Patients in relapse scored higher on each of the four SHS questions than patients in remission (p < 0.001). Each of the four SHS scores were associated with results of their corresponding health dimension obtained with the other three questionnaires (rs=0.57-0.78, p < 0.001) (validity). The results of the SHS proved stable on repeated measurement with a 2-week interval in patients in remission (rs=0.71-0.91, p < 0.01) (test-retest reliability). Patients with a change in disease activity had a significant change in their SHS scores (p < 0.05) (responsiveness).


CONCLUSIONS
The SHS is a valid, reliable and responsive measure of subjective health in patients with ulcerative colitis. It is simple to administer, quickly completed and the results do not need further calculations. The SHS can be used in clinical trials and in clinical practice to identify the patient's main problems affecting health.
Hjortswang
Henrik
H
Division of Gastroenterology and Hepatology, Department of Molecular and Clinical Medicine, Linköping University Hospital, Sweden. Henrik.Hjortswang@lio.se
Järnerot
Gunnar
G
Curman
Bengt
B
Sandberg-Gertzén
Hanna
H
Tysk
Curt
C
Blomberg
Björn
B
Almer
Sven
S
Ström
Magnus
M
D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000523:psychology*; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D011788:Quality of Life; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires