The discriminative ability of the 12-Item short form health survey (SF-12) in a sample of persons infected with HIV

doi:10.1016/S0149-2918(00)80088-0

Clinical Therapeutics

Volume 22, Issue 9, September 2000, Pages 1112-1120

https://doi.org/10.1016/S0149-2918(00)80088-0 Get rights and content

Abstract

Background

Self-reported health-related quality of life (HRQOL) assesses constructs that transcend laboratory-based clinical parameters. Corroboration of the hypothesized relationships between the 2 types of health indicators (ie, clinical and HRQOL) could provide evidence of the validity of an HRQOL measurement tool.

Objective

The purpose of this study was to evaluate the ability of scores on the mental component summary (MCS-12) and physical component summary (PCS-12) of the 12-Item Short Form Health Survey (SF-12) to discriminate between HIV-infected persons in predefined disease-severity groups based on surrogate markers.

Methods

This cross-sectional study involved the collection of clinical data (ie, CD4 cell count, viral load [HIV-1 RNA copies/mL]) from patients' medical records and HRQOL data from the SF-12 at 2 HIV specialty clinics. The ability of SF-12 summary scores to discriminate between patients stratified by disease severity (ie, CD4 cell count <200 vs ≥200/mm³; HIV-1 RNA >55,000 vs ≤55,000 copies/mL) was assessed by receiver operating characteristic curve analysis.

Results

Data were collected from 478 patients. The scores from the PCS-12 were able to discriminate between groups of patients stratified by disease severity based on CD4 cell count (P < 0.001) and HIV-1 RNA copies/mL (P < 0.01). MCS-12 scores did not discriminate between disease-severity groups.

Conclusions

Although the SF-12 is a brief generic measure of HRQOL, these findings provide further evidence of the validity of the SF-12 and suggest that it may be a practical way to monitor health status from the perspective of the HIV-infected patient.

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Health-Related Quality of Life (HRQoL) was assessed using the Medical Outcomes Study Short-Form 12 questionnaire (SF-12). As a generic instrument, the SF-12 has been shown to be valid in both apparently healthy individuals and chronic diseases [17]. The SF-12 is a 12-item version of the Medical outcomes study Short Form-36 (SF-36) addressing physical functioning, role limitations due to physical health, role limitations due to emotional health, social functioning, bodily pain, general health perceptions, vitality, and mental health [18].
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There were 83(55.3%) women, means of age and FBG of participants were 64.2 ± 8.7 years and 7.4 ± 2.4 mmol/L respectively. The means of 6-min walk distance (6-MWD) and estimated VO₂ max were 341.55 ± 41.82 m and 9.2 ± 0.7 mL/kg/min respectively. Significant differences were found between pre and post HR (t = −44.71; p = 0.001), SBP (t = −38.38; p = 0.001) and DBP (t = −38.58; p = 0.001) following 6MWT. The means of PCS and MCS of HRQoL were 48.67 ± 5.51 and 58.39 ± 2.86 respectively. There were significant correlations between FC and each of PCS (r = 0.678; p = 0.001) and MCS (r = 0.211; p = 0.009).
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The SF-12 has been extensively validated, is well-accepted by patients, and performs well across diverse population groups. In particular, SF-12 has demonstrated excellent reliability and validity in the general population (Ware et al., 1996); among individuals with severe mental illness and substance dependence (Salyers, Bosworth, Swanson, Lamb-Pagone, & Osher, 2000); and among people living with HIV (Chariyalertsak et al., 2011; Delate & Coons, 2000; Han, Pulling, Telke, & Huppler Hullsiek, 2002; Viswanathan, Anderson, & Thomas, 2005; Wu, Hays, Kelly, Malitz, & Bozzette, 1997). The use of the SF-36, from which the SF-12 is based, has also demonstrated validity in Tanzania (Magafu et al., 2009; Wagner et al., 1999; Wyss et al., 1999).
Injection of heroin has become widespread in Dar es Salaam, Tanzania and is spreading throughout the country. To prevent potential bridging of HIV epidemics, the Tanzanian government established a methadone maintenance treatment (MMT) clinic in February 2011. We assess the effect of MMT on health-related quality of life (HRQOL) and examine factors, particularly HIV infection and methadone dose, associated with changes in HRQOL.
This study utilized routine data on clients enrolling in methadone from February 2011 to April 2012 at Muhimbili National Hospital. Change in physical (PCS) and mental health (MCS) composite scores, as measured by the SF-12 tool, were the primary outcomes. Backward stepwise linear regression, with a criterion of p < 0.2 was used to identify baseline exposure variables for inclusion in multivariable models, while adjusting for baseline scores.
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Aspects of mental and physical health, risk behaviors and quality of life among drug users are intertwined and complex. Our research revealed positive short-term effects of MMT on HRQOL and highlights the importance of sustained retention for optimal benefits. Comprehensive supportive services in addition to provision of methadone are needed to address the complex health needs of people who inject drugs.
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Eight subscale scores are computed as the sum of item responses, rescaled on a 0- to 100-point scale, with higher values reflecting better life quality. The 12-item SF v2 survey is derived from the SF-36 and has demonstrated its reliability and validity as a generic measure of health functioning in clinical and nonclinical samples [10], including HIV-positive patients [11]. It provides two summary composites scores: a physical component summary (PCS) and a mental component summary (MCS) score, which are standardized on a T-scale [with mean 50 and standard deviation (SD) 10 points].
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The discriminative ability of the 12-Item short form health survey (SF-12) in a sample of persons infected with HIV

Abstract

Background

Objective

Methods

Results

Conclusions

Strategies for long-term success in the treatment of HIV infection

JAMA

A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection

Med Care

Health-related quality of life in persons with acquired immune deficiency syndrome

Med Care

Measuring healthrelated quality of life among patients infected with human immunodeficiency virus

Clin Infect Dis

Antiretroviral therapy for HIV infection in 1998: Updated recommendations of the International AIDS Society-USA Panel

JAMA

Preface

Quality of life in persons with human immunodeficiency virus infection: Measurement by the Medical Outcomes Study instrument

Ann Intern Med

Applications of the Medical Outcomes Study healthrelated quality of life measures in HIV/ AIDS

Qual Life Res

A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity

Med Care

SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales

An empirical comparison of four generic health status measures. The Nottingham Health Profile, the Medical Outcomes Study 36-item Short-Form Health Survey, the COOP/WONCA Charts, and the EuroQol instrument

Med Care

Recommendations for evaluating the validity of quality of life claims for labeling and promotion

Value Health

Assessing the reliability and validity of measurement in clinical trials