{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:40:22Z","timestamp":1792694422139,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Single\u2010item self\u2010rated health (SRH) is widely used as a brief measure of perceived health because of its simplicity and feasibility in population\u2010based research. However, its agreement with a reference measure and the extent to which its performance varies across sociodemographic and health\u2010related subgroups remain important considerations. This study evaluated the performance of single\u2010item SRH against the 28\u2010item General Health Questionnaire (GHQ\u201028) reference criterion among adults participating in the Dehgolan Prospective Cohort Study (DehPCS) in Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional analysis used baseline data from 2,009 adults aged 35\u201370 years. SRH was assessed using a five\u2010point response scale and dichotomized into poor health (scores 0\u20132) and good health (scores 3\u20134). The GHQ\u201028 was used as a reference criterion rather than a gold standard for general health. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios, while agreement was evaluated using observed percentage agreement and Cohen's kappa. Binary and multinomial logistic regression models were used to examine factors associated with SRH classification and discordance with the GHQ\u201028 reference classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 30.9% (95% CI: 28.9\u201332.9) of participants were classified as having poor health according to the SRH measure. The observed percentage agreement between SRH and the GHQ\u201028 reference classification was 77.7%, with a Cohen's kappa coefficient of 0.469 (95% CI: 0.427\u20130.511), indicating moderate agreement. Overall sensitivity and specificity were 64.8% and 83.0%, respectively. Sensitivity was higher among participants aged &gt;\u200960 years (79.1%), women (67.1%), and those with chronic disease (70.7%) or hypertension (74.7%). Specificity was higher among university graduates (88.0%) and men (86.9%). PPV was higher among women (66.1%) and illiterate participants (69.9%), whereas NPV was higher among university graduates (94.6%) and men (90.9%). In multivariable analyses, smoking history was associated with higher odds of disagreement, including current smoking (adjusted OR\u2009=\u20091.64, 95% CI: 1.16\u20132.33) and former smoking (adjusted OR\u2009=\u20091.74, 95% CI: 1.16\u20132.62). Chronic disease was associated with higher odds of false\u2010positive (adjusted OR\u2009=\u20091.50, 95% CI: 1.11\u20132.03) and true\u2010positive (adjusted OR\u2009=\u20092.18, 95% CI: 1.67\u20132.83) classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single\u2010item SRH showed moderate agreement with the GHQ\u201028 reference classification at the population level, while its performance varied across sociodemographic and health\u2010related subgroups. These findings support the use of single\u2010item SRH as a brief population\u2010level measure of perceived health, while emphasizing the importance of considering subgroup characteristics and the specific health construct represented by the reference criterion when interpreting its performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70656","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:20:40Z","timestamp":1792693240000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single\u2010Item Self\u2010Rated Health Question for Assessing General Health: A Population\u2010Based Study Among Kurdish Population"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5119-1314","authenticated-orcid":false,"given":"Soheyb","family":"Ghafouri","sequence":"first","affiliation":[{"name":"Student Research committee Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0917-8123","authenticated-orcid":false,"given":"Jalal","family":"Asadi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Faculty of Medicine Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2612-6528","authenticated-orcid":false,"given":"Ghobad","family":"Moradi","sequence":"additional","affiliation":[{"name":"Social Determinants of the Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Aghaei","sequence":"additional","affiliation":[{"name":"Social Determinants of the Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6973-5764","authenticated-orcid":false,"given":"Bakhtiar","family":"Piroozi","sequence":"additional","affiliation":[{"name":"Social Determinants of the Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2936-5930","authenticated-orcid":false,"given":"Yousef","family":"Morad","sequence":"additional","affiliation":[{"name":"Social Determinants of the Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4449-1978","authenticated-orcid":false,"given":"Farhad","family":"Moradpour","sequence":"additional","affiliation":[{"name":"Social Determinants of the Health Research Center, Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1146\/annurev-publhealth-090419-102529","article-title":"Understanding and Responding to Health Literacy as a Social Determinant of Health","volume":"42","author":"Nutbeam D.","year":"2021","journal-title":"Annual Review of Public Health"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"4886","DOI":"10.1038\/s41598-020-61603-0","article-title":"Self\u2010Reported Health as a Predictor of Mortality: A Cohort Study of Its Relation to Other Health Measurements and Observation Time","volume":"10","author":"Lorem G.","year":"2020","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/0022-3956(94)90036-1","article-title":"Reliability and Validity Studies of the WHO\u2014Composite International Diagnostic Interview (CIDI): A Critical Review","volume":"28","author":"Wittchen H. 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