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Are Single-Item Global Ratings Useful for Assessing Health Status?

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Abstract

The research performance of the single-item self-rating In general, would you say your health is: excellent, very good, good, fair, or poor? was evaluated relative to the SF-36 General Health Scale that contains this item, using data for a sample of psychiatric outpatients who had co-occurring chronic physical conditions (N = 177). The scale was more robust than the single-item in cross-sectional validity tests and for predicting 2-year outcomes, but the single-item had stronger discriminant validity as a measure of physical health, especially in post-baseline analyses. Single-item and scale were both sensitive enough to detect change in perceived health over 2 years and a conditional experimental effect on health self-perceptions in a randomized trial. These findings demonstrate that a global single-item can be as valid, reliable, and sensitive as a multi-item scale for longitudinal research purposes, even if the scale performs better in cross-sectional surveys or as a screening measure.

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Acknowledgments

This research was funded by a grant from the National Institute of Mental Health (MH62628; CM-PI), and by the Community Support Program at McLean Hospital (BMC-PI).

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Cathaleene Macias, Dost Öngür & Bruce M. Cohen

  2. McLean Hospital, Belmont, MA, USA

    Cathaleene Macias

  3. Counseling, Higher Education, and Special Education, University of Maryland at College Park, College Park, USA

    Paul B. Gold

  4. Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA

    Dost Öngür

  5. Program for Neuropsychiatric Research, McLean Hospital, Belmont, MA, USA

    Bruce M. Cohen

  6. Wellframe, Inc., Boston, MA, USA

    Trishan Panch

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  1. Cathaleene Macias
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Correspondence to Cathaleene Macias.

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Drs. Macias, Gold, Öngür, Cohen, and Panch declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from every participant after study procedures were explained.

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Macias, C., Gold, P.B., Öngür, D. et al. Are Single-Item Global Ratings Useful for Assessing Health Status?. J Clin Psychol Med Settings 22, 251–264 (2015). https://doi.org/10.1007/s10880-015-9436-5

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