Showing papers in "Quality of Life Research in 2010"
TL;DR: The resulting COSMIN checklist could be useful when selecting a measurement instrument, peer-reviewing a manuscript, designing or reporting a study on measurement properties, or for educational purposes.
Abstract: Aim of the COSMIN study (COnsensus-based Standards for the selection of health status Measurement INstruments) was to develop a consensus-based checklist to evaluate the methodological quality of studies on measurement properties. We present the COSMIN checklist and the agreement of the panel on the items of the checklist. A four-round Delphi study was performed with international experts (psychologists, epidemiologists, statisticians and clinicians). Of the 91 invited experts, 57 agreed to participate (63%). Panel members were asked to rate their (dis)agreement with each proposal on a five-point scale. Consensus was considered to be reached when at least 67% of the panel members indicated ‘agree’ or ‘strongly agree’. Consensus was reached on the inclusion of the following measurement properties: internal consistency, reliability, measurement error, content validity (including face validity), construct validity (including structural validity, hypotheses testing and cross-cultural validity), criterion validity, responsiveness, and interpretability. The latter was not considered a measurement property. The panel also reached consensus on how these properties should be assessed. The resulting COSMIN checklist could be useful when selecting a measurement instrument, peer-reviewing a manuscript, designing or reporting a study on measurement properties, or for educational purposes.
2,772 citations
TL;DR: The newly developed EQ-5D-Y is a useful tool to measure HRQOL in young people in an age-appropriate manner and was satisfactorily understood by children and adolescents in different countries.
Abstract: Purpose
To develop a self-report version of the EQ-5D for younger respondents, named the EQ-5D-Y (Youth); to test its comprehensibility for children and adolescents and to compare results obtained using the standard adult EQ-5D and the EQ-5D-Y.
556 citations
TL;DR: The results indicate that the KidSCREEN-10 provides a valid measure of a general HRQoL factor in children and adolescents, but the instrument does not represent well most of the single dimensions of the original KIDSCREen-52.
Abstract: Background
To assess the criterion and construct validity of the KIDSCREEN-10 well-being and health-related quality of life (HRQoL) score, a short version of the KIDSCREEN-52 and KIDSCREEN-27 instruments.
451 citations
TL;DR: The approach described combines an overarching phenomenological theoretical framework with grounded theory data collection and analysis methods to yield PRO items and scales that have content validity.
Abstract: Recently published articles have described criteria to assess qualitative research in the health field in general, but very few articles have delineated qualitative methods to be used in the development of Patient-Reported Outcomes (PROs). In fact, how PROs are developed with subject input through focus groups and interviews has been given relatively short shrift in the PRO literature when compared to the plethora of quantitative articles on the psychometric properties of PROs. If documented at all, most PRO validation articles give little for the reader to evaluate the content validity of the measures and the credibility and trustworthiness of the methods used to develop them. Increasingly, however, scientists and authorities want to be assured that PRO items and scales have meaning and relevance to subjects. This article was developed by an international, interdisciplinary group of psychologists, psychometricians, regulatory experts, a physician, and a sociologist. It presents rigorous and appropriate qualitative research methods for developing PROs with content validity. The approach described combines an overarching phenomenological theoretical framework with grounded theory data collection and analysis methods to yield PRO items and scales that have content validity.
411 citations
TL;DR: This sample provides initial calibrations of anxiety and depressive symptoms item banks and creates PROMIS pediatric instruments, version 1.0, to provide efficient assessment of health-related quality of life domains.
Abstract: Purpose
The Patient-Reported Outcomes Measurement Information System (PROMIS) aims to develop self-reported item banks for clinical research. The PROMIS pediatrics (aged 8–17) project focuses on the development of item banks across several health domains (physical function, pain, fatigue, emotional distress, social role relationships, and asthma symptoms). The psychometric properties of the anxiety and depressive symptom item banks are described.
351 citations
TL;DR: Results provide preliminary evidence of the instrument’s feasibility, reliability and validity, and differences between groups classified according to presence of chronic conditions, self-rated overall health and psychological problems provided preliminaryevidence of known groups’ validity.
Abstract: Purpose
To examine the feasibility, reliability, and validity of the newly developed EQ-5D-Y.
331 citations
TL;DR: Mental health-related quality of life was statistically diminished in transgendered women without surgical intervention compared to the general female population and transwomen who had gender reassignment surgery (GRS), facial feminization surgery (FFS), or both.
Abstract: To determine the self-reported quality of life of male-to-female (MTF) transgendered individuals and how this quality of life is influenced by facial feminization and gender reassignment surgery. Facial Feminization Surgery outcomes evaluation survey and the SF-36v2 quality of life survey were administered to male-to-female transgender individuals via the Internet and on paper. A total of 247 MTF participants were enrolled in the study. Mental health-related quality of life was statistically diminished (P < 0.05) in transgendered women without surgical intervention compared to the general female population and transwomen who had gender reassignment surgery (GRS), facial feminization surgery (FFS), or both. There was no statistically significant difference in the mental health-related quality of life among transgendered women who had GRS, FFS, or both. Participants who had FFS scored statistically higher (P < 0.01) than those who did not in the FFS outcomes evaluation. Transwomen have diminished mental health-related quality of life compared with the general female population. However, surgical treatments (e.g. FFS, GRS, or both) are associated with improved mental health-related quality of life.
284 citations
TL;DR: This initial validation study resulted in revised item pools that are currently undergoing testing in new clinical samples and populations and EFA-, CFA- and IRT-guided item banks help provide increased measurement precision and flexibility.
Abstract: Purpose
To develop a social health measurement framework, to test items in diverse populations and to develop item response theory (IRT) item banks.
250 citations
TL;DR: Using several polytomous items in a calibrated unidimensional bank to measure depressive symptoms yielded a CAT that provided marginally superior efficiency compared to static short forms, but CAT outperformed each static short form in almost all criteria.
Abstract: Purpose
Short-form patient-reported outcome measures are popular because they minimize patient burden. We assessed the efficiency of static short forms and computer adaptive testing (CAT) using data from the Patient-Reported Outcomes Measurement Information System (PROMIS) project.
226 citations
TL;DR: Describing CRF as a component of quality of life (QOL) and addressing measurement issues that have slowed progress toward an understanding of mechanisms underlying this symptom are described.
Abstract: The goal of this paper is to discuss cancer-related fatigue (CRF) and address issues related to the investigation into potential biological and genetic causal mechanisms. The objectives are to: (1) describe CRF as a component of quality of life (QOL); (2) address measurement issues that have slowed progress toward an understanding of mechanisms underlying this symptom; (3) review biological pathways and genetic approaches that have promise for the exploration of causal mechanisms of CRF; and (4) offer directions for future research. Review, synthesis, and interpretation of the literature. Until recently, CRF and QOL have been understood primarily as subjective patient-reported experiences. With increased understanding of human genetics, theories and research are being expanded to incorporate biological and genetic understandings of these subjective experiences. Proposed biological and genetic mechanisms of CRF that have been examined include cytokine dysregulation, hypothalamic–pituitary–adrenal (HPA) axis dysfunction, five hydroxy tryptophan (5-HT) neurotransmitter dysregulation, circadian rhythm disruption, alterations in adenosine triphosphate (ATP) and muscle metabolism, and vagal afferent activation. Approaches to the study of genetic mechanisms have also been addressed including candidate genes, genome-wide scanning, and gene expression. Based on the review and synthesis of the literature, directions for future research are proposed. Understanding the biological and genetic basis of CRF has the potential to contribute to a more complete understanding of the genetic determinants of QOL.
173 citations
TL;DR: It was concluded that religiosity may be considered as a salient component of, and a contributing factor to, QOL among this sample of Muslim college students and Islamic beliefs and practices may have the potential to be integrated in the psychotherapeutic procedures among Muslim clients.
Abstract: The majority of published research in quality of life (QOL), subjective well-being (SWB), and religiosity has been carried out on Western populations. The objective of this study was to explore the associations between QOL, SWB, and religiosity in an Arabic, Muslim, and understudied sample. A convenience sample of 224 Kuwait University undergraduates was recruited. Their ages ranged from 18 to 28 years. The Arabic version of the World Health Organization QOL scale-Brief (WHOQOL-Bref), along with six self-rating scales of physical health, mental health, happiness, satisfaction with life, religiosity, and strength of religious belief were used. The test–retest reliabilities of all the scales ranged between 0.72 and 0.88, indicating good temporal stability. All the correlations of the scales with criteria were significant and ranged from 0.39 to 0.65 indicating from acceptable to good criterion-related validity. Sex-related differences were significant favoring men in nine out of the 13 scales. All the 66 correlations but two were significant and positive. The principal components analysis followed by varimax orthogonal rotation yielded two factors: “Quality of life and well-being” and “Religiosity”. Based on the significant and positive correlations between QOL, SWB, and religiosity, it was concluded that religiosity may be considered as a salient component of, and a contributing factor to, QOL among this sample of Muslim college students. Therefore, Islamic beliefs and practices may have the potential to be integrated in the psychotherapeutic procedures among Muslim clients.
TL;DR: There are clear gender differences in HRQoL in the United States and these differences are partly explained by sociodemographic and SES differentials.
Abstract: The purpose of this study was to describe gender differences in self-reported health-related quality-of-life (HRQoL) and to examine whether differences are explained by sociodemographic and socioeconomic status (SES) differentials between men and women. Data were from four US nationally representative surveys: US Valuation of the EuroQol EQ-5D Health States Survey (USVEQ), Medical Expenditure Panel Survey (MEPS), National Health Measurement Study (NHMS) and Joint Canada/US Survey of Health (JCUSH). Gender differences were estimated with and without adjustment for sociodemographic and SES indicators using regression within and across data sets with SF-6D, EQ-5D, HUI2, HUI3 and QWB-SA scores as outcomes. Women have lower HRQoL scores than men on all indexes prior to adjustment. Adjusting for age, race, marital status, education and income reduced but did not remove the gender differences, except with HUI3. Adjusting for marital status or income had the largest impact on estimated gender differences. There are clear gender differences in HRQoL in the United States. These differences are partly explained by sociodemographic and SES differentials.
TL;DR: This reevaluation of domain names and definitions following psychometric item pruning appears to be an important procedure for refining conceptual frameworks and further supporting content validity.
Abstract: Purpose
Content validity of patient-reported outcomes (PROs) is evaluated primarily during item development, but subsequent psychometric analyses, particularly for item response theory (IRT)-derived scales, often result in considerable item pruning and potential loss of content. After selecting items for the PROMIS banks based on psychometric and content considerations, we invited external content expert reviews of the degree to which the initial domain names and definitions represented the calibrated item bank content.
TL;DR: Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population.
Abstract: Child oral health-related quality of life (COHRQoL) has been increasingly assessed; however, few studies appraised the influence of socioeconomic status on COHRQoL in developing countries This study assessed the relationship of COHRQoL with socioeconomic backgrounds and clinical factors This study followed a cross-sectional design, with a multistage random sample of 792 schoolchildren aged 12 years, representative of Santa Maria, a southern city in Brazil Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ11–14), their parents or guardians answered questions on socioeconomic status, and a dental examination provided information on the prevalence of caries, dental trauma and occlusion The assessment of association used hierarchically adjusted Poisson regression models Higher impacts on COHRQoL were observed for children presenting with untreated dental caries (RR 120; 95% CI 107–135) and maxillary overjet (RR 119; 95% CI 102–140) Socioeconomic factors also associated with COHRQoL; poorer scores were reported by children whose mothers have not completed primary education (RR 130; 95% CI 117–144) and those with lower household income (RR 113; 95% CI 102–126) Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population
TL;DR: A large-scale administration of the Patient-Reported Outcomes Measurement Information System pediatric items to evaluate measurement characteristics and the final PROMIS pediatric item banks include physical function, emotional distress, social role relationship, fatigue, pain, and asthma.
Abstract: Purpose
This paper describes a large-scale administration of the Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric items to evaluate measurement characteristics
TL;DR: This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment CenterSM) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments.
Abstract: Introduction
The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases.
TL;DR: Overall satisfaction from social support and hope was significantly correlated with QOL; the greatest effect of social support was on environmental functioning, and the lowest was on social relationships, emotional support was less a predictor of social relationship than other types of supports.
Abstract: This study investigates the relationship among perceived satisfaction from social support, hope, and QOL of PLWHA. A cross-sectional in design was applied, among a sample of 160 HIV-infected persons receiving treatment, care, and support from eight community-based NGOs. QOL was assessed using the WHO (QOL)-26 tool, and social support was assessed by use of a modified Sarason’s Social Support Questionnaire. A Hope Assessment Scale was also developed. The non-family support network was greater than family support network. Overall satisfaction from social support and hope was significantly correlated with QOL; the greatest effect of social support was on environmental functioning, and the lowest was on social relationships, emotional support was less a predictor of social relationship than other types of supports. The effect of perceived satisfaction from social support was through the mediation variable hope. As it has widely been recognized that community-based support is vital for issues of quality of life, strategies to improve social support and hope intervention programs are strongly encouraged. The results of the study have implications for providing care, treatment, and psycho-social support to maintain or enhance quality of life of PLWHA.
TL;DR: First evidence of an inverse relationship of noise annoyance and HrQoL in a general population is presented, although the estimated effects are small to moderate for individuals, they may add up to a relevant public health impact.
Abstract: Purpose
To estimate the impact of traffic-related noise annoyance on health-related quality of life (HrQoL) in a population-based study and potential effect modification by gender.
TL;DR: Self-efficacy was a significant predictor of an active adjustment style and emotional well-being in breast cancer patients and could be a valuable target of rehabilitation programs.
Abstract: Purpose
As many patients experience distress after breast cancer, we investigated whether perceived self-efficacy predicts breast cancer patients’ emotional, physical and social well-being and whether mental adjustment styles mediate this association.
TL;DR: Although the basic structure of the SF-12 is stable, summary scores derived from oblique rotation are preferable and more consistent with changes in individual scales, and on empirical and conceptual grounds, this study suggests using summary scores based on oblique CFA.
Abstract: Summary scores for the SF-12, version 2 (SF-12v2) health status measure are based on scoring coefficients derived for version 1 of the SF-36, despite changes in item wording and response scales and despite the fact that SF-12 scales only contain a subset of SF-36 items. This study derives new summary scores based directly on SF-12v2 data from a recent U.S. sample and compares the new summary scores to the standard ones. Due to controversy regarding methods for developing scoring coefficients for the summary score, we compare summary scores produced by different methods. We analyzed nationally representative U.S. data, which provided 53,399 observations for the SF-12v2 in 2003–2005. In addition to the standard SF-12V2 scoring algorithm, summary scores were generated using exploratory factor analysis (EFA), principal components analysis (PCA), and confirmatory factor analysis (CFA), with orthogonal and oblique rotation. We examined correlations among different summary scores, their associations with demographic and clinical variables, and the consistency between changes in scale scores and in summary scores over time. The 8 scale means in the current data were similar to the 1998 SF-12v2 means, with the exception of the vitality scale. Correlations among the scales based on SF-12v2 data differed slightly from correlations derived from scales based on the SF-36 data. Correlations among summary scores derived using different methods were high (≥0.84). However, changes in summary scores derived using orthogonal rotation of components or factors were not consistent with changes in sub-scales, whereas changes in summary scores derived using oblique rotation were more consistent with patterns of change in sub-scales. Although the basic structure of the SF-12 is stable, summary scores derived from oblique rotation are preferable and more consistent with changes in individual scales. On empirical and conceptual grounds, we suggest using summary scores based on oblique CFA.
TL;DR: The PIH scale exhibits construct validity and internal consistency and is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self- management knowledge and behaviour over time.
Abstract: The purpose of this study was to test the internal consistency and construct validity of the revised 12-item self-rated Partners in Health (PIH) scale used to assess patients’ chronic condition self-management knowledge and behaviours. Baseline PIH data were collected for a total of 294 patients with a range of co-morbid chronic conditions including diabetes, cardiovascular disease and arthritis. Scale data for the initial sample of 176 patients were analysed for internal consistency and construct validity using Reliability Analysis and Factor Analysis. Construct validity was tested in a separate sample of 118 patients using confirmatory factor analysis and a structural equation model. Good internal consistency was indicated with a Cronbach’s alpha coefficient of 0.82 in the initial sample. Factor analysis for this sample revealed four key factors (knowledge, coping, management of condition and adherence to treatment) across the twelve items of the scale. These four key factors were then confirmed by applying the exploratory structural equation model to the separate sample. The PIH scale exhibits construct validity and internal consistency. It therefore is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self-management knowledge and behaviour over time. The four domains of self-management provide a valid measure of patient competency in relation to the self-management of their chronic condition(s).
TL;DR: The development of an add-on module for the World Health Organization WHOQOL measures of quality of life for use with adults with physical or intellectual disabilities, known as theWHOQOL-DIS, was derived following standard WHOQol methodology and is designed to assess people with disabilities.
Abstract: Purpose
This paper describes the development of an add-on module for the World Health Organization WHOQOL measures of quality of life for use with adults with physical or intellectual disabilities. The add-on module, known as the WHOQOL-DIS, was derived following standard WHOQOL methodology and is designed to assess people with disabilities.
TL;DR: The HADS showed satisfactory psychometric properties as a screening instrument in assessing anxious and depressive states as two correlated but distinct factors in adolescents.
Abstract: Purpose
The Hospital Anxiety and Depression Scale (HADS) is widely used in adult populations; however, its usefulness with adolescents has been explored less. This study sought to evaluate the reliability, validity, and factor structure of the Chinese version of HADS in a community sample of adolescents residing in Hong Kong.
TL;DR: The veteran home elderly, as a group ‘in transition’ between community and institution, should be the first target of psychological preventive and health-promoting measures aimed at improving QOL in older population.
Abstract: Purpose
To describe the relationship of dispositional optimism, health locus of control and self-efficacy to quality of life (QOL) in older subjects differing in level of disability and institutionalisation.
TL;DR: The guidelines-checklist has the potential to stimulate rigorous and replicable research using the thentest approach and may be of use for journal editors and reviewers as ‘gate keepers’ of stringent research.
Abstract: Health-state changes can lead to response shifts in internal standards. The most commonly used method for detecting such recalibration response shift is the retrospective pretest–posttest design, here referred to as thentest. Since this design faces significant problems, there is a pressing need to improve the stringency of studies using the thentest approach. Our objective is to provide guidelines for the optimal use of the thentest approach for detecting recalibration response shift. Discussion of methods based on relevant literature. A checklist is provided that includes recommendations for studies using the thentest approach focusing on: (1) designing the study; (2) formulating hypotheses; (3) constructing the thentest; (4) identifying change; (6) taking alternative explanations into account; (7) using analytic standards; and (8) interpreting results. The guidelines-checklist has the potential to stimulate rigorous and replicable research using the thentest. This checklist might also be of use for journal editors and reviewers as ‘gate keepers’ of stringent research. Many of these suggestions also apply to other methods of detecting response shift.
TL;DR: The EQ-5D and SF-12 were largely comparable in estimating the health burden of chronic conditions, recent health problems, and social inequalities, and the SF-6D was less sensitive than the EQ- 5D index andSF-12, particularly for physical chronic conditions.
Abstract: To compare the EQ-5D, SF-6D, and SF-12 in terms of their capacity to discriminate between groups defined by relevant socio-demographic and health characteristics in a general population survey. Data were obtained from the 2006 Catalan Health Interview Survey, a representative sample (n = 4,319) of the general population of Catalonia (Spain). Effect sizes (ES) and Receiver Operating Characteristic (ROC) curves were calculated to evaluate the instruments’ capacity to distinguish between groups based on socio-demographic variables, recent health problems, perceived health, psychological distress, and selected chronic conditions. All instruments showed a similar discriminative capacity between groups based on socio-demographic variables, recent medical visit (ES = 0.47–0.55), activity limitations (ES = 0.92–0.98), perceived health (ES = 0.97–1.33), and psychological well-being (ES = 1.17–1.57). Effect sizes between respondents with and without any of fourteen selected chronic conditions were large (0.76–1.04) for 4, moderate (0.55–0.74) for 8, and small (0.17–0.39) for two on the EQ-5D index. A similar pattern was observed for the SF-12 but ES were predominantly moderate (7 conditions) or small (6 conditions) on the SF-6D. The EQ-5D and SF-12 were largely comparable in estimating the health burden of chronic conditions, recent health problems, and social inequalities. The SF-6D was less sensitive than the EQ-5D index and SF-12, particularly for physical chronic conditions.
TL;DR: It is found that the inclusion of HRQL in routine clinical care would improve patient–clinician communication, affect clinical management, and improve patients’ HRQL, without detecting improvement in patient outcome.
Abstract: This randomized controlled clinical trial examined the usefulness of including an assessment of health-related quality of life (HRQL) in the routine clinical care of lung-transplant patients. We hypothesized that the inclusion of HRQL in routine clinical care would improve patient–clinician communication, affect clinical management, and improve patients’ HRQL. At the outpatient clinic, University of Alberta Hospital, patients were randomly assigned to intervention (completion of Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) on touch-screen computer with feedback to clinicians) and control group (completion of HUI2 and HUI3 on touch-screen computer without feedback). Feedback involved a graphical representation included in patients’ chart. All clinical encounters were audio-taped. Changes in clinical management (medication changes, number of referrals and test ordered) were summed to produce an overall management composite. At the end of every visit, patients completed the EQ-5D. Two hundred and thirteen patients were randomized (108 to intervention and 105 to control groups). There were statistically significant differences between the groups in mean number of issues discussed per encounter (P = 0.003; Cohen’s d = 0.03) and mean management composite score (P = 0.001; Cohen’s d = 0.41). EQ-5D index was not statistically significant different between the groups (P = 0.48). We detected very small effects on patient–clinician communication and small effects on patient management, without detecting improvement in patient outcome.
TL;DR: Health-related quality of life (HRQoL) was found to be strongly and negatively associated with PTSD and depression, and Utilization of mental health services may significantly reduce the risk of developing PTSD symptoms.
Abstract: Purpose
To characterize child survivors’ mental health and quality of life after a massive earthquake.
TL;DR: Left-behind children report poorer health-related quality of life (HRQOL) than non-left-behindChildren due to psychosocial dysfunction, and as age, education level and economic status increased, HRQOL of the children was significantly improved.
Abstract: To estimate the prevalence of children in rural China without constant parental guardians (i.e., “left-behind”), to examine whether left-behind children were associated with lower health-related quality of life (HRQOL) than their counterparts (“non-left-behind”) . A stratified two-stage cluster survey was conducted among 640 children aged between 8 and 14 in a county of Shandong province. HRQOL was assessed in 606 participants using the Pediatric Quality of Life Inventory (PedsQL). The estimated prevalence of left-behind children in the area was estimated at 53.5% (324/606). The mean PedsQL total scores were lower in the left-behind children than the non-left-behind (84.1 vs. 88.4; P < 0.01), as were psychosocial summary, emotional functioning, social functioning and school performance scores, while mean physical subscale scores did not differ significantly (85.4 vs. 86.2; P = 0.31). As age, education level and economic status increased, HRQOL of the children was significantly improved. Left-behind children report poorer HRQOL than non-left-behind children due to psychosocial dysfunction. An assessment of such problems is essential to estimate the need of rural children, for the identification of those at particular risk for lower quality of life, and for planning and implementation of appropriate health interventions.
TL;DR: The SIS appears to be more suited for assessing changes after stroke rehabilitation, because it had better overall responsiveness and the SIS hand function showed medium responsiveness and good criterion validity.
Abstract: This study compared the responsiveness and criterion-related validity of the Stroke Impact Scale (SIS) and Stroke-Specific Quality of Life Scale (SS-QOL) for patients after stroke rehabilitation. The SIS and SS-QOL, along with five criterion measures—the Fugl-Meyer Assessment, the Motor Activity Log, the Functional Independence Measure, the Frenchay Activities Index, and the Nottingham Extended Activities of Daily Living Scale—were administered to 74 patients with stroke before and after a 3-week intervention. Responsiveness was examined using the Wilcoxon signed rank test and standardized response mean (SRM). Criterion-related validity was investigated using the Spearman correlation coefficient (ρ). Whereas the SS-QOL subscales were nonresponsive to changes, the SIS hand function showed medium responsiveness (SRM = .52, Wilcoxon Z = 4.24, P < .05). Responsiveness of the SIS total also was significantly larger than that of the SS-QOL total (SRM difference, .36; 95% confidence interval, .02–.71). Criterion validity of the SIS hand function was good (ρ = .51–.68; P < .01), but that of the SS-QOL was only fair (ρ = .25–.31; P < .05). Because the SIS had better overall responsiveness and the SIS hand function showed medium responsiveness and good criterion validity, the SIS appears to be more suited for assessing changes after stroke rehabilitation.