Ferguson Robert J, Robinson Amy B, Splaine Mark
Department of Psychiatry, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Qual Life Res. 2002 Sep;11(6):509-16. doi: 10.1023/a:1016350431190.
The SF-36 Health Survey is the most widely used self-report measure of functional health. It is commonly used in both randomized controlled trials (RCT) and non-controlled evaluation of medical or other health services. However, determining a clinically significant change in SF-36 outcomes from pre-to-post-intervention, in contrast to statistically significant differences, is often not a focus of medical outcomes research. We propose use of the Reliable Change Index (RCI) in combination with SF-36 norms as one method for researchers, provider groups, and health care policy makers to determine clinically significant healthcare outcomes when the SF-36 is used as a primary measure. The RCI is a statistic that determines the magnitude of change score necessary of a given self-report measure to be considered statistically reliable. The RCI has been used to determine clinically significant change in mental health and behavioral medicine outcomes research, but is not widely applied to medical outcomes research. A usable table of RCIs for the SF-36 has been calculated and is presented. Instruction and a case illustration of how to use the RCI table is also provided. Finally, limitations and cautionary guidelines on using SF-36 norms and the RCI to determine clinically significant outcome are discussed.
SF-36健康调查是功能健康方面使用最广泛的自我报告测量工具。它常用于随机对照试验（RCT）以及对医疗或其他健康服务的非对照评估中。然而，与具有统计学意义的差异相比，确定干预前后SF-36结果的临床显著变化往往并非医学结果研究的重点。我们建议将可靠变化指数（RCI）与SF-36常模结合使用，作为研究人员、医疗服务提供方和医疗保健政策制定者在将SF-36用作主要测量工具时确定具有临床意义的医疗保健结果的一种方法。RCI是一种统计量，用于确定给定自我报告测量工具中被视为具有统计可靠性所需的变化分数大小。RCI已被用于确定心理健康和行为医学结果研究中的临床显著变化，但尚未广泛应用于医学结果研究。本文计算并给出了SF-36的可用RCI表格。还提供了如何使用RCI表格的说明和案例示例。最后，讨论了使用SF-36常模和RCI来确定具有临床意义结果的局限性及警示指南。
