SF-36 total score as a single measure of health-related quality of life: Scoping review

TLDR

Although the SF‑36 developers state that a global score cannot be derived, many studies still report an SF‑36 Total/Global/Overall Score. This scoping review examined how frequently and in what ways the SF‑36 Total/Global/Overall Score is reported in the literature. Using an adapted PRISMA framework, we searched PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library for articles that used such scores. Among 172 articles (1997‑2015), 75% omitted the calculation method, 30% used arithmetic averaging of the eight domains, and the use of the score has risen sharply since 2010, underscoring the need for researchers to be cautious about its potential impact on health outcomes.

Abstract

According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the “SF-36 Total/Global/Overall Score” cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the “SF-36 Total Score”; 13 studies did not specify their methods but referred to the SF-36 developers’ studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the “SF-36 Total/Global/Overall Score” has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.