Measurement of Overall and Disease-specific Health Status: Does the Order of Questionnaires Make a Difference?

Objectives: This study was designed to detect any effect of order when modules on disease-specific and overall health status are combined in an outcomes research questionnaire.

Methods: Men with symptomatic benign prostatic hyperplasia (BPH) were prospectively enrolled in a clinical trial of an educational intervention in Group Health Cooperative of Puget Sound, a prepaid group practice. Within the trial, 392 consecutive men were randomized to one of two versions of a baseline questionnaire. One had a 38-item module on BPH-specific health status first, followed by a 30-item module on overall health status; the other had the modules in reverse order. Scores were compared for three BPH-specific scales and eight scales measuring overall health. Data were collected in the form of self-administered questionnaires.

Results: Comparing the groups assigned the two versions of the questionnaire, no significant differences in scores on any of the health status scales were found.

Conclusions: In this dataset, we could find no evidence of an order effect when modules on BPH-specific and overall health status were combined in different sequences.