Combining scores from different patient reported outcome measures in meta-analyses: When is it justified?

Milo A. Puhan, Irene Soesilo, Gordon H. Guyatt, Holger J. Schünemann

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Background: Combining outcomes and the use of standardized effect measures such as effect size and standardized response mean across instruments allows more comprehensive meta-analyses and should avoid selection bias. However, such analysis ideally requires that the instruments correlate strongly and that the underlying assumption of similar responsiveness is fulfilled. The aim of the study was to assess the correlation between two widely used health-related quality of life instruments for patients with chronic obstructive pulmonary disease and to compare the instruments' responsiveness on a study level. Methods: We systematically identified all longitudinal studies that used both the Chronic Respiratory Questionnaire (CRQ) and the St. George's Respiratory Questionnaire (SGRQ) through electronic searches of MEDLINE, EMBASE, CENTRAL and PubMed. We assessed the correlation between CRQ (scale 1-7) and SGRQ (scale 1-100) change scores and compared responsiveness of the two instruments by comparing standardized response means (change scores divided by their standard deviation). Results: We identified 15 studies with 23 patient groups. CRQ change scores ranged from -0.19 to 1.87 (median 0.35, IQR 0.14-0.68) and from -16.00 to 3.00 (median -3.00, IQR -4.73-0.25) for SGRQ change scores. The correlation between CRQ and SGRQ change scores was 0.88. Standardized response means of the CRQ (median 0.51, IQR 0.19-0.98) were significantly higher (p

Original languageEnglish (US)
Article number94
JournalHealth and Quality of Life Outcomes
StatePublished - Dec 7 2006
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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