Comparison of Rasch and summated rating scales constructed from SF-36 physical functioning items in seven countries: results from the IQOLA Project. International Quality of Life Assessment

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Aged; Aged, 80 and over; Algorithms; Cross-Cultural Comparison; *Health Status Indicators; Humans; Middle Aged; Psychometrics; *Quality of Life; Reproducibility of Results; Translations


Biostatistics | Epidemiology | Health Services Research


Rasch models for polytomous items were used to assess the scaling assumptions and compare item response patterns in the 10-item SF-36 physical functioning scale (PF-10) for general population respondents in Denmark, Germany, Italy, the Netherlands, Sweden, the United Kingdom, and the United States. The Rasch model of physical functioning developed in the United States was compared to models for other countries, and each country was compared to a multinational composite. Strong scale congruence across the seven countries was demonstrated; items that varied between countries and from the composite may reflect unique cultural response patterns or differences in translation. Scoring algorithms based on the Rasch model for each country were superior to the current Likert scoring in tests of relative validity (RV) in discriminating among age groups in all countries. In relation to the Likert PF-10 scoring (RV = 1.00), scores estimated using the Rasch rating scale model achieve a median RV of 1.31 (range: 1.01-1.59), while the Rasch partial credit model attained a median RV of 1.44 (range: 1.01-2.23). Rasch models hold good potential for improving health status measures, estimating individual scores when responses to scale items are missing, and equating scores across countries.

DOI of Published Version



J Clin Epidemiol. 1998 Nov;51(11):1203-14. Link to article on publisher's site

Journal/Book/Conference Title

Journal of clinical epidemiology

PubMed ID


Related Resources

Link to Article in PubMed