Quality of Life Research

, Volume 13, Issue 2, pp 311–320 | Cite as

Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life?

  • A.G.E.M. de Boer
  • J.J.B. van Lanschot
  • P.F.M. Stalmeier
  • J.W. van Sandick
  • J.B.F. Hulscher
  • J.C.J.M. de Haes
  • M.A.G. Sprangers


Purpose: To compare the validity, reliability and responsiveness of a single, global quality of life question to multi-item scales. Method: Data were obtained from 83 consecutive patients with oesophageal adenocarcinoma undergoing either transhiatal or transthoracic oesophagectomy. Quality of life was measured at baseline, 5 weeks, 3 and 12 months post-operatively with a single-item Visual Analogue Scale (VAS) ranging from 0 to 100, the multi-item Medical Outcomes Study Short Form-20 (MOS SF-20) and Rotterdam Symptom Check-List (RSCL). Convergent and discriminant validity, test–retest reliability and both distribution-based and anchor-based responsiveness were evaluated. Major findings: At baseline and at 5 weeks, the VAS showed high correlations with the MOS SF-20 health perceptions scale (r = 0.70 and 0.72) and moderate to high correlations with all other subscales of the MOS SF-20 and RSCL (r = 0.29–0.70). The test–retest reliability intra-class correlation for the VAS was 0.87. At 5 weeks post-operatively, the distribution-based responsiveness was moderate for the VAS (standardised response mean: −0.47; effect size: −0.56), high for the physical subscales of the MOS SF-20 and RSCL (−1.08 to −1.51) and low for the psychological subscales (0.11 to −0.25). Five weeks post-operatively, anchor-based responsiveness was highest for the VAS (r = 0.54). Conclusion: The VAS is an instrument with good validity, excellent reliability, moderate distribution-based responsiveness and good anchor-based responsiveness compared to multi-item questionnaires. Its use is recommended in clinical trials to assess global quality of life.

Oesophageal neoplasms Quality of life Questionnaires 


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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • A.G.E.M. de Boer
    • 1
  • J.J.B. van Lanschot
    • 2
  • P.F.M. Stalmeier
    • 1
    • 3
    • 4
  • J.W. van Sandick
    • 2
  • J.B.F. Hulscher
    • 2
  • J.C.J.M. de Haes
    • 1
  • M.A.G. Sprangers
    • 1
  1. 1.Department of Medical PsychologyAcademic Medical CentreAmsterdamThe Netherlands
  2. 2.Department of SurgeryAcademic Medical CentreAmsterdamThe Netherlands
  3. 3.Radiotherapy/Nijmegen Institute Cognition and InformationUniversity Center NijmegenNijmegenThe Netherlands
  4. 4.The Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN)University Center NijmegenNijmegenThe Netherlands

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