Jenkinson et al show that London handicap scale scores are about the same if items are weighted equally rather than using the published scale weights.1 We reached much the same conclusion using the data from which the scale weights were derived.2

Handicap is defined as disadvantage in role performance due to impairments or disabilities, which implies valuation of the extent to which role performance is affected. Value—from the viewpoint of health services research—is quantified as the “utility” of a state of health. The scale weights were derived by asking various population samples to value different combinations of problems, described using the handicap dimensions and items from the handicap scale. These were analysed to determine the contribution of each of the component parts of the description.

The fact that equal weighting gives roughly the same scores as the empirically derived weights is probably because the items were carefully chosen on the basis of clinical experience to …