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Medical Outcomes Study Short Form-36
The Short Form-36 (SF-36) is a generic health profi le that has been developed with
the aim to compare various aspects of health status across a general and broad
patient population [ 87 ]. Generic health profi les are questionnaires that provide
assessment of more than one dimension of health status and the SF-36 is intended
to measure “general health concepts not specifi c to any disease, or treatment group.”
The SF-36 has 36 items that are divided into eight subdomains: physical functioning
(PF), role limitations due to physical problems (RP), bodily pain (BP), general
health (GH), vitality (VT), social functioning (SF), role limitations due to emotional
problems (RE), and mental problems (MH). The SF-36 has been used to capture
health-related outcomes in a variety of rheumatic conditions, e.g., AS and PsA [ 88 ].
The SF-36 has been validated in PsA, and is often used in clinical trials to assess
the domain of health-related quality of life in PsA populations [ 46 , 48 , 89 ]. A
comparative study of quality of life in patients with PsA versus RA or psoriasis
indicated signifi cant alteration of quality of life in particular in RA and PsA, with
great alterations in the mental components for patients with RA [ 90 ].
In clinical settings, large intra-individual variations in the SF-36 scale scores and
its low ability to detect deterioration make it unsuitable for use with individual
patients, although the scale appears to have satisfactory ability to detect treatment-
related improvements in health at a group level. In research settings, the SF-36 can
be used to compare disease groups with the general population [ 5 ].
Conclusion
Patient assessment in SpA is multidimensional, and the evaluation of disease status
is challenging because of the large phenotypic heterogeneity of the disease. The
principal clinical features in patients with SpA are pain, stiffness, and fatigue, which
are clearly patient-reported complaints. Therefore, assessing these complaints with
PROs is straightforward and will help to quantify the current disease state, to follow
the disease progression, and to measure the effect of any intervention. The major
decisions facing the clinician are what to measure and what is the best way to mea-
sure it? The ASAS core set for AS patients and the OMERACT outcome measures
core set for PsA should be regarded as a guide to minimum recommended practice.
Physical function, pain, patient global, and joint measures are recommended for
clinical record keeping in both core sets.
PRO measures that are currently used and widely available can provide impor-
tant perspectives not captured in composite clinical response criteria with the poten-
tial of better informing treatment decisions in clinical practice.
Acknowledgments We wish to thank Maarten de Wit (Netherlands) and Tania Gudu (Romania)
for their help and participation in the psoriatic arthritis chapter.
U. Kiltz et al.