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

  • Cathaleene Macias
  • Paul B. Gold
  • Dost Öngür
  • Bruce M. Cohen
  • Trishan Panch


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.


Single-item measure Global health SF-36 Patient report Response shift 



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).

Compliance with Ethical Standards

Conflict of Interest

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

Human and Animal Rights and Informed Consent

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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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Cathaleene Macias
    • 1
    • 2
  • Paul B. Gold
    • 3
  • Dost Öngür
    • 1
    • 4
  • Bruce M. Cohen
    • 1
    • 5
  • Trishan Panch
    • 6
  1. 1.Department of PsychiatryHarvard Medical SchoolBostonUSA
  2. 2.McLean HospitalBelmontUSA
  3. 3.Counseling, Higher Education, and Special EducationUniversity of Maryland at College ParkCollege ParkUSA
  4. 4.Psychotic Disorders DivisionMcLean HospitalBelmontUSA
  5. 5.Program for Neuropsychiatric ResearchMcLean HospitalBelmontUSA
  6. 6.Wellframe, Inc.BostonUSA

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