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

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Abstract

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.

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Authors and Affiliations

  1. Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands

    A.G.E.M. de Boer, P.F.M. Stalmeier, J.C.J.M. de Haes & M.A.G. Sprangers

  2. Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands

    J.J.B. van Lanschot, J.W. van Sandick & J.B.F. Hulscher

  3. Radiotherapy/Nijmegen Institute Cognition and Information, University Center Nijmegen, Nijmegen, The Netherlands

    P.F.M. Stalmeier

  4. The Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University Center Nijmegen, Nijmegen, The Netherlands

    P.F.M. Stalmeier

Authors
  1. A.G.E.M. de Boer
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  2. J.J.B. van Lanschot
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  3. P.F.M. Stalmeier
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  4. J.W. van Sandick
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  5. J.B.F. Hulscher
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  6. J.C.J.M. de Haes
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  7. M.A.G. Sprangers
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de Boer, A., van Lanschot, J., Stalmeier, P. et al. Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life?. Qual Life Res 13, 311–320 (2004). https://doi.org/10.1023/B:QURE.0000018499.64574.1f

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  • DOI: https://doi.org/10.1023/B:QURE.0000018499.64574.1f

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