Original Article
US general population norms for telephone administration of the SF-36v2

https://doi.org/10.1016/j.jclinepi.2011.09.008Get rights and content

Abstract

Objective

US general population norms for mail administration of the Medical Outcomes Study 36-Item Short Form Version 2 (SF-36v2) were established in 1998. This article reports SF-36v2 telephone-administered norms collected in 2005–2006 for adults aged 35–89 years.

Study Design and Setting

The SF-36v2 was administered to 3,844 adults in the National Health Measurement Study (NHMS), a random-digit dial telephone survey. Scale scores and physical and mental component summary (PCS and MCS) scores were computed.

Results

When compared with 1998 norms (mean = 50.00, standard deviation [SD] = 10.00), SF-36v2 scores for the 2005–2006 general population tended to be higher: physical functioning (mean = 50.68, SD = 14.48); role limitations due to physical health problems (mean = 49.47, SD = 14.71); bodily pain (mean = 50.66, SD = 16.28); general health perceptions (mean = 50.10, SD = 16.87); vitality (mean = 53.71, SD = 15.35); social functioning (mean = 51.37, SD = 13.93); role limitations due to emotional problems (mean = 51.44, SD = 13.93); mental health (mean = 54.27, SD = 13.28); PCS (mean = 49.22, SD = 15.13); MCS (mean = 53.78, SD = 13.14). PCS and MCS factor scoring coefficients were similar to those previously reported for the 1998 norms. SF-36v2 norms for telephone administration were created.

Conclusion

The higher scores for NHMS data are likely due to the effect of telephone administration. The 2005–2006 norms can be used as a reference to interpret scale and component summary scores for telephone-administered surveys with the SF-36v2.

Introduction

What is new?

  • This study provides Medical Outcomes Study 36-Item Short Form Version 2 (SF-36v2) telephone-administered norms for the 2005–2006 US general population aged 35–89 years.

  • The 2005–2006 SF-36v2 scores are higher than the 1998 norms, which are likely due to telephone administration.

  • The 2005–2006 norms can be used to help interpret SF-36v2 scale and component summary scores.

The Medical Outcomes Study 36-Item Short Form Version 2 (SF-36v2; QualityMetric, Lincoln, RI) is one of the most commonly used generic health-related quality of life (HRQOL) instruments. The SF-36v2 was derived from 40 concepts captured in the Medical Outcomes Study [1], [2]. It is composed of eight multi-item scales: physical functioning, role limitations due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and mental health. Additionally, the scores from the SF-36v2 scales can be combined into physical and mental component summary (PCS and MCS) scores [3].

The first version of the SF-36 was made available in 1990 [4]. Based on work in the International Quality of Life Assessment project [5] and the Veterans Health Survey [6], item wording and response categories were refined to create the SF-36v2. The SF-36v2 uses norm-based scoring in which the scale and component summary scores have a mean of 50 and standard deviation of 10 in the US general population. Norms were derived from the 1998 National Survey of Functional Health Status sample of respondents that was designed, based on geographical region, market size, age, income, and household size, to be representative of the noninstitutionalized adult US population [5]. The 1998 SF-36v2 US general population norms have allowed for comparisons of scores from groups with different demographic characteristics or different health conditions.

Standard scoring of the PCS and MCS is based on factor score coefficients or weights from each scale of the SF-36v2 obtained from principal component analysis with orthogonal rotation (i.e., uncorrelated factors) [7]. Alternatively, physical and mental component summaries can be viewed as correlated. Physical and mental health summary scores derived from obliquely rotated factor solutions have also been derived for the SF-36v1 [8], [9].

Norms for the SF-36v2 have not been updated since 1998. However, the median age and proportion of minorities have increased in the US population since then [10]. Furthermore, the prevalence of obesity has increased among men from 1999 to 2004 [11], whereas age-adjusted mortality from cardiovascular disease has declined [12]. In order for scale and component summary score comparisons to be more current and relevant, the SF-36v2 norms need updating.

Over a 13-month period in 2005–2006, a cross-sectional survey of 3,844 US adults was conducted in the National Health Measurement Study (NHMS). Several generic HRQOL were administered, including the SF-36v2. In this study, we report new US norms for the eight scales of the SF-36v2, and the PCS and MCS. We provide both orthogonal and oblique factor score coefficients.

Section snippets

Study design

The NHMS is a random-digit dial telephone survey of adults in the United States aged 35–89 years. The cross-sectional survey was administered using a computer-assisted telephone interview script by the University of Wisconsin Survey Center from June 2005 to August 2006. All subjects in the NHMS provided verbal informed consent, and the survey was approved by the University of Wisconsin Institutional Review Board (protocol #H-2004-0083).

Sample

Participants in the NHMS were household residents aged

Sample characteristics

The age range was 35–89 years and the weighted mean age of the estimated 2005–2006 US general population was about 54 years (standard error [SE] = 0.35) (Table 1). A greater proportion of the population was white (82%), non-Hispanic (96%), and female (53%). The population was well educated, as more than 60% of individuals had some college education or had a college degree. A greater proportion of the population was in the higher income groups, with almost 60% earning an annual household income of

Discussion

We offer new SF-36v2 norms for the US general population aged 35–89 years. The standard (orthogonally rotated) MCS score and nearly all scale scores for the 2005–2006 US general population were higher than the 1998 US general population norms. The physical and mental summary orthogonally rotated factor score coefficients in this sample were similar in magnitude and direction to those reported by Ware et al. [5], [7]. Likewise, most of the physical and mental summary obliquely rotated factor

Conclusions

Comparisons to other general population studies indicate that the norms are representative of the 2005–2006 national population, but they are most applicable to telephone administration of the SF-36v2. Researchers conducting telephone-administered surveys that include the SF-36v2 can use the 2005–2006 norms as a reference to interpret scale and component summary scores.

Acknowledgments

This research was supported by a grant from the National Institute on Aging (P01-AG020679). Hays and Kaplan were also supported in part by NIA grants (P30AG021684 and P30-AG028748), and Hays had partial support from NCMHD (P20MD000182).

The authors would like to thank Dennis G. Fryback for his thoughtful review of this article.

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