Modification of the SF-36 for a headache population changes patient-reported health status

Background.— Using standard quality of life and disability measures may not accurately capture these constructs in specific health populations such as headache patients. Modifying the wording of standard measures such as the Short‐Form 36 (SF‐36) should be considered in order to make them more applicable to specific patient populations. Objective.— To investigate the possibility that headache patients may not consider their headaches when responding to SF‐36 questions pertaining to health, physical health, pain, and bodily pain. Methods.— The wording of several SF‐36 questions were adapted for a headache population by making specific reference to “headaches” when asking people to rate the impact of health issues on their life. The results of the modified “Headache” SF‐36 were compared with a similar population of transformed migraine patients who had completed the “Standard” SF‐36. Results.— Significant differences were found between scores for the “Standard” SF‐36 group and the “Headache” SF‐36 group across all SF‐36 variables except for “General Health.” Conclusions.— Misinterpretation of the concepts of “health,”“physical health,”“pain,” and “bodily pain,” although commonly used by the SF‐36 in many populations, could influence responses on this measure, as respondents may not relate their head/headaches to these constructs. To ensure that accurate data are obtained in relation to the quality of life of headache patients, consideration should be given to using a form of the SF‐36 that has been modified to allow appropriate interpretation of the questions completed by headache patients.