title: The Short Health Scale: A Simple, Valid, Reliable, and Responsive Way of Measuring Subjective Health in Patients With Irritable Bowel Syndrome.
abstract: OBJECTIVE
  To evaluate validity, reliability, and responsiveness of the Short Health Scale (SHS) in irritable bowel syndrome (IBS) patients.
  
  
  BACKGROUND
  Subjective health assessment is central when treating patients with IBS. The "Short Health Scale" is a quick 4-item questionnaire covering most aspects of subjective health that has been validated for inflammatory bowel disease.
  
  
  METHODS
  To test validity, 451 patients with IBS (mean age, 38 y; 81% females) completed the SHS and questionnaires assessing IBS symptom severity (IBS-SSS), gastrointestinal (GI)-specific anxiety (VSI), and quality of life (IBSQOL). To evaluate reliability and responsiveness to changes, the questionnaires were repeated after 2 weeks in 18 patients, and after 12 weeks in 212 patients who had completed a patient-education program.
  
  
  RESULTS
  Validity was documented with (1) gradually increasing mean scores for all 4 SHS items with increasing IBS-SSS (P<0.0001), and (2) correlations between the 4 SHS items and the corresponding items from the other subjective health assessment tools [item 1 (symptom burden): ρ=0.67, item 2 (daily function): ρ=-0.44 to -0.46, item 3 (disease-related worry): ρ=-0.51 to 0.57, item 4 (general well-being): ρ=-0.34 to -0.46, P<0.0001]. Reliability was confirmed (Spearman ρ>0.7 and intraclass correlations >0.7). Responsiveness was good with responders to the patient-education program (IBS-SSS reduction ≥50 points) having significant reductions in 3 of the SHS items (P<0.05), and borderline change for the fourth SHS item (P=0.06).
  
  
  CONCLUSIONS
  SHS is a health measure that shows promising evidence of validity, reliability, and responsiveness in IBS patients. It is quickly completed and evaluated, which supports its usefulness in the busy clinical practice.
authors.affiliation: *Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy †Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg ‡Department of Clinical and Experimental Medicine, Division of Gastroenterology and Hepatology, Linköping University §Department of Gastroenterology and Hepatology, UHL, County Council of Östergötland, Linköping, Sweden.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Krarup
authors.forename: Emma
authors.initials: E
authors.lastname: Peterson
authors.forename: Gisela
authors.initials: G
authors.lastname: Ringström
authors.forename: Hans
authors.initials: H
authors.lastname: Törnblom
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjortswang
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult