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Retrospective baseline measurement of self-reported health status and health-related quality of life versus population norms in the evaluation of post-injury losses
  1. W L Watson1,
  2. J Ozanne-Smith1,
  3. J Richardson2
  1. 1Monash University Accident Research Centre, Melbourne, Victoria, Australia
  2. 2Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to:
 Dr W Watson
 Monash University Accident Research Centre, Building 70, Monash University, Melbourne, Victoria 3800, Australia; wendy.watson{at}


Background: Owing to the difficulty in prospectively measuring pre-injury health status and health-related quality of life (HRQL) in an injured cohort, population norms or retrospective baseline scores are often used as comparators for evaluating post-injury losses. However, there has been little discussion in the literature or research into the soundness of these approaches for this purpose.

Objectives: To investigate the appropriateness of the retrospectively measured baseline health status and HRQL in an injured population for the purpose of evaluating post-injury losses.

Methods: A cohort of injured admitted to hospital (n = 186) was followed up for 12 months after injury. Retrospectively measured pre-injury health status and HRQL scores were compared with those at 12 months after injury for participants who reported complete recovery (n = 61) and those who did not. Retrospective baseline scores for the whole cohort were also compared with Australian population norms.

Results: For participants who completely recovered, no significant difference was observed between scores at baseline (measured retrospectively) and those at 12 months after injury (36-item Short Form Questionnaire physical component summary z = −1.274, p = 0.203; 36-item Short Form Questionnaire mental component summary z = −1.634, p = 0.102; Short Form 6 Dimensions: z = −1.405, p = 0.296). A borderline significant difference was observed in HRQL as measured by the Assessment of Quality of Life (z = −1.970, p = 0.049). Retrospectively measured pre-injury scores were consistently higher than Australian norms for all measures.

Conclusions: The injured population may not be representative of the general population. Consequently, retrospective baseline measurement of pre-injury health states may be more appropriate than general population norms for the purpose of evaluating post-injury losses in this population.

  • AQoL, Assessment of Quality of Life
  • FCI, Functional Capacity Index
  • HRQL, health-related quality of life
  • SF-36, 36-item Short Form Questionnaire
  • SF-6D, Short Form 6 Dimensions

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  • i For full details of the inclusion criteria, see Watson et al4

  • Competing interests: None.