The Short Form 36 (SF-36) Health Survey measures overall health, as opposed to one that targets a specific disease or area of the body. Therefore, it’s often paired with a more disease-specific PRO.

Developed by RAND in 1992, the SF-36 is a 36-question survey derived from the Medical Outcomes Study (MOS), a multi-year study to explain variations in patient outcomes. A second version was developed in 1996 (SF-36v2) to correct deficiencies identified in the original version. For example, six-level response scales were reduced to five-level response scales to improve the two role functioning scales.

As the literature on PROsetta Stone points out, the survey relies upon patient self-reporting and has eight sections: Physical functioning (10), role limitations due to physical health (4), role limitations due to emotional problems (3), energy/fatigue (4), emotional well-being (5), social functioning (2), pain (2), and general health (5). Each scale is transformed into a 0-100 scale on the assumption that each scale carries equal weight. The lower the score, the more disability.

Global Health Patient-Reported Outcome Measures Guide

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Strengths

The SF-36 is a widely used and accepted global health assessment measure that has proven to be useful in differentiating the health benefits produced by a wide range of different treatments.  Many improvements were made to the SF-36v2 to shorten and simplify the wording and make it more familiar. It also allowed for cultural adaptations widely used in the U.S.

Also, a shorter version, the SF-12 and SF-8 are also available. The SF-12 is most likely to prove to be a satisfactory alternative to the SF-36 when samples are large and the objective is to monitor overall physical and mental health outcomes. The SF-12 is also a widely used and accepted global health assessment measure.

Weaknesses

Since the SF-36 is a general health assessment, it frequently needs to be paired with a more specific PRO measure which can make the overall assessment process long. It also has a low response rate in the >65 population. When it comes to generating actual results, the scoring method is rather complicated to calculate.

Licensing

This measure is not free and requires a license for use.