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Ann Rheum Dis. 2004 June; 63(6): 723–729.
PMCID: PMC1755044

Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study


Objective: To examine the health related quality of life of persons with one or more self reported musculoskeletal diseases, as measured by the short form 36 item health status survey (SF-36) and the Euroqol questionnaire (EQ-5D).

Methods: A sample of Dutch inhabitants aged 25 years or more (n = 3664) participated in a questionnaire survey. Twelve lay descriptions of common musculoskeletal diseases were presented and the subjects were asked whether they had ever been told by a physician that they had any of these. Their responses were used to assess the prevalence of these conditions. Commonly used scores of SF-36 and descriptive scores from EQ-5D are presented, along with standardised differences between disease groups and the general population.

Results: Subjects with musculoskeletal diseases had significantly lower scores on all SF-36 dimensions than those without musculoskeletal disease, especially for physical functioning (SF-36 score (SE), 75.2 (0.5) v 87.8 (0.5)); role limitations caused by physical problems (67.1 (0.9) v 85.8 (0.8)); and bodily pain (68.5 (0.5) v 84.1 (0.5)). The worst health related quality of life patterns were found for osteoarthritis of the hip, osteoporosis, rheumatoid arthritis, and fibromyalgia. Those with multiple musculoskeletal diseases had the poorest health related quality of life. Similar results were found for EQ-5D.

Conclusions: All musculoskeletal diseases involve pain and reduced physical function. The coexistence of musculoskeletal diseases should be taken into account in research and clinical practice because of its high prevalence and its substantial impact on health related quality of life.

Figure 1
Health related quality of life by comorbidity of musculoskeletal diseases (MSD). (A) Absolute scores of SF36 (left) and EQ-5D (right). (B) Standardised scores of SF-36 and EQ-5D. bp, bodily pain; gh, general health; mh, mental health; pf, physical functioning; ...
Figure 2
Patterns of health related quality of life for musculoskeletal diseases compared with the general population. SF-36 scores and EQ-5D scores expressed as number of standard deviations from the population mean. bp, bodily pain; gh, general health; mh, ...

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