The Nottingham health profile: a useful tool for epidemiologists?

The Nottingham health profile has been portrayed as a multipurpose measure of health status, capable of being used in population surveys and in evaluation of medical interventions. This paper examines basic operating characteristics of the profile, using data collected in a large survey of the community. Examination of the response pattern suggests that the NHP is not effective in discriminating health statuses as the modal response is zero. If it is to be used as a screening tool then there are considerable redundancies so that two or three items are sufficient; and for a diagnostic purpose, the existence of substantial covariation between items makes interpretation difficult. There is a need for an instrument fulfilling one or all of these purposes, but we need to know the operating characteristics of any instrument in detail before applying it. These results demonstrate that the methodological base of the NHP has yet to be established.