title: Intervals between response choices on a single-item measure of quality of life.
abstract: BACKGROUND
  A single overall rating of quality of life (QoL) is a sensitive method that is often used in population surveys. However, the exact meaning of response choices is unclear. In particular, uneven spacing may affect the way QoL ratings should be analyzed and interpreted. This study aimed to determine the intervals between response choices to a single-item QoL assessment.
  
  
  METHODS
  A secondary analysis was conducted on data from the Lc65+ cohort study and two additional, population-based, stratified random samples of older people (N = 5,300). Overall QoL was rated as excellent, very good, good, fair or poor. A QoL score (range 0-100) was derived from participants' answers to a 28-item QoL assessment tool. A transformed QoL score ranging from 1 (poor) to 5 (excellent) was calculated. The same procedure was repeated to compute seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; Social and cultural life).
  
  
  RESULTS
  Mean (95 % confidence intervals) QoL scores were 96.23 (95.81-96.65) for excellent, 93.09 (92.74-93.45) for very good, 81.45 (80.63-82.27) for good, 65.44 (62.67-68.20) for fair and 54.52 (45.31-63.73) for poor overall QoL, corresponding to transformed QoL scores of respectively 5.00, 4.70, 3.58, 2.05, and 1.00. Ordinality of the categories excellent to poor was preserved in all seven QoL subscores.
  
  
  CONCLUSIONS
  The excellent-to-poor rating scale provides an ordinal measure of overall QoL. The intervals between response choices are unequal, but an interval scale can be obtained after adequate recoding of excellent, very good, good, fair and poor.
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University of Lausanne Hospital Centre, Route de la Corniche 10, CH-1010, Lausanne, Switzerland. yves.henchoz@chuv.ch.
authors.forename: Yves
authors.initials: Y
authors.lastname: Henchoz
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University of Lausanne Hospital Centre, Route de la Corniche 10, CH-1010, Lausanne, Switzerland.
authors.forename: Lionel
authors.initials: L
authors.lastname: Meylan
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), University of Lausanne Hospital Centre, Route de la Corniche 10, CH-1010, Lausanne, Switzerland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Santos-Eggimann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Intervals; Older people; Quality of life; Scale; Single-item