Evidence map›Paper›PMID 40598501›Full record

ArticleBMC health services research2025

Healthy Lives 5 Axis Scale for individuals with complex health and social needs: assessment of validity and reliability.

Henry White, Peter Gonzalez, Sagi Shashar, Zoe Silver, Hannah Scott, Victor Novack

Erratum issuedAbstract readValidation Study
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Henry WhiteBrookline Center for Community Mental Health, Brookline, MA, USA. henrywhite@brooklinecenter.org.
Peter GonzalezDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Sagi ShasharClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
Zoe SilverBrookline Center for Community Mental Health, Brookline, MA, USA.
Hannah ScottBrookline Center for Community Mental Health, Brookline, MA, USA.
Victor NovackClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe field of complex care management for patients with urgent health and social challenges has rapidly grown, leading to calls for improved tools for measuring quality and outcomes. Most available measures were not developed specifically for a clinical context with a population with complex needs. The Healthy Lives 5 Axis Scale (HL-5) was created to fulfill this role. This concise, multidimensional scale measures key domains, including health-related functioning, physical and social needs, capacity for self-care, access, and utilization. The purpose of this study was to determine the interrater and test-retest reliability and the construct and concurrent validity of the HL-5.

methodsThe study population included adults who attended an appointment with a primary care physician at an urban community health center. The reliability assessment of the HL-5 questionnaire included test-retest ratings by the same scorer and between two different scorers. Criterion convergent validity was evaluated by comparing the HL-5 domains with relevant domains of external questionnaires using Pearson correlation coefficients (r). The comparison measures have a strong evidence base, are widely used, and are nonproprietary.

resultsThere were 64 participants, with a mean age of 39.1. Test-Retest Reliability, measured by the intraclass coefficient (ICC), was greater than 0.8 for Functioning, Needs, Utilization, and Access, indicating very strong internal consistency and 0.754 for Self-Care, representing good internal consistency. Criterion Validity for the axes, assessed by each axis' correlations with a criterion measure, was statistically significant at of p < 0.05.

conclusionsThis study of the psychometric properties of the Healthy Lives 5 Axis Scale (HL-5) demonstrated its value for assessing patients' complex health and social needs. It showed high levels of reliability in a clinical setting with a diverse patient populations and strong correlations with well-established measures of functioning, needs, self-care, access, and utilization. HL-5 requires only a few minutes to complete and yields actionable results, demonstrating its potential for integration into the workflow of a primary care practice or care management program.

Indexed as

Needs AssessmentAdultAgedFemaleHealth Services AccessibilityHumansMaleMiddle AgedPsychometricsReproducibility of ResultsSelf CareSurveys and QuestionnairesComplex care management, Reliability and validity, Health-related functioning, Social determinants of health, Primary care, Multidimensional assessment

Identifiers

PMID40598501
PMCPMC12219705

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.