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SAGE Open Med. 2016 Oct 4;4:2050312116671725. eCollection 2016.

SF-36 total score as a single measure of health-related quality of life: Scoping review.

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Federal University of Bahia, Salvador, Brazil.


According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the "SF-36 Total/Global/Overall Score" cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the "SF-36 Total Score"; 13 studies did not specify their methods but referred to the SF-36 developers' studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the "SF-36 Total/Global/Overall Score" has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.


Epidemiology/public health; bias (epidemiology); health status indicators; medical ethics; quality of life; questionnaires

Conflict of interest statement

The authors declare no financial or non-financial competing interests with organizations that hold copyrights and trademarks of questionnaires, particularly the SF-36. The findings of this study were not discussed with the SF-36 developers or with the SF-36 organization.

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