Which Is More Valid for Stroke Patients: Generic or Stroke-Specific Quality of Life Measures?

Background: It remains unclear whether a generic or specific health-related quality of life (HRQOL) measure is more valid for stroke. Aim: The aim of this study is to compare the validity of SF-36, a generic measure, and HRQOL in stroke patients (HRQOLISP), a stroke-specific measure, for assessing post-stroke HRQOL. Methods: The validity of HRQOLISP and SF-36 was compared in a cross-sectional study of 100 stroke survivors. The Stroke Levity Scale and modified Rankin Scale were applied to measure stroke severity and disability, respectively. Results: Both measures exhibited adequate 'known-groups' and construct validity. However, the SF-36 lacked content validity for the cognitive domain and personal constructs including spiritual functioning. Most SF-36 subscales had substantial floor or ceiling effects. The HRQOLISP demonstrated better content and internal consistency validity and no significant floor or ceiling effect. Conclusions: Like other stroke-specific measures, HRQOLISP was better than SF-36 in most parameters of validity considered. The SF-36 is designed for comparison among different diseases and may not be suitable for clinical trials or studies of internal adaptation, cognitive or spiritual functioning in stroke. This is because it lacks content validity for these domains and may underestimate health changes in most subscales. Copyright (C) 2009 S. Karger AG, Basel