Validity and reliability of the Short Form—36 in cervical spondylotic myelopathy

2002 ◽  
Vol 97 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Joseph T. King ◽  
Mark S. Roberts

Object. Validity (the extent to which a test measures what it is intended to measure) and reliability (the stability and reproducibility of measures of the same concept over time or across methods of gathering data) are important characteristics of any outcomes instrument. Generic outcomes instruments are designed for use in any population; however, their validity and reliability in particular diseases should be verified to ensure their appropriateness for use in that disease. In this study the authors assessed the validity and reliability of the Medical Outcomes Study Short Form—36 (SF-36), a generic outcomes instrument, in a population of patients with cervical spondylotic myelopathy (CSM). Methods. The SF-36 was administered to a cohort of patients with CSM on an outpatient basis. Symptom-related data derived from a structured interview and physical examination findings were used to classify cases according to the myelopathy scales of Nurick, Cooper, Harsh, and a Western modification of the Japanese Orthopaedic Association (JOA). Construct validity was assessed by determining whether SF-36 scores varied in accordance with predefined hypotheses relating to the myelopathy scores by using the Cuzick nonparametric test for trend. The reliability of the SF-36 scores was assessed using Cronbach alpha. Eighty-eight patients with CSM completed the SF-36 and interview. Construct validity was demonstrated by confirming the hypothesized relationship between SF-36 scales and the myelopathy scales of Nurick (p ≤ 0.003), Cooper leg subscale (p ≤ 0.012, except the general health perceptions domain [p = 0.091]), Harsh (p ≤ 0.016), and the motor component of the modified JOA (p ≤ 0.006). Reliability was demonstrated for all eight SF-36 domain scales and the physical component and mental component summary scales, in which Cronbach alpha satisfied the Nunnally criterion of 0.7. Conclusions. The SF-36 provides valid and reliable data on patients with CSM.

2001 ◽  
Vol 94 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Helen C. Martin ◽  
Jagjit Sethi ◽  
Dorothy Lang ◽  
Glen Neil-Dwyer ◽  
Mark E. Lutman ◽  
...  

Object. The aim of this study was to assess whether outcomes from excision of acoustic neuroma vary among patients and have a material impact on their quality of life (QOL). Methods. A questionnaire concerning postoperative symptoms and the Short Form 36 (SF-36) QOL instrument were mailed to 97 consecutive patients who had undergone acoustic neuroma surgery via the translabyrinthine approach. The survey response rate was 78% and the symptomatology was consistent with other reports, supporting the representativeness of the sample. The respondents' QOL was rated significantly below published norms and their work capacity was reportedly reduced. Specifically, the following SF-36 dimensions were reduced: physical functioning and role-physical, together with vitality, general health, and social functioning. Greater numbers of postoperative symptoms and larger tumors were associated with a worse rating of physical functioning. More severe balance problems were associated with lower ratings of social functioning. The disparity between the patient's self-estimate and self-measurement and the clinician's assessment of the patient's facial functioning raises doubts about the validity of subjective reports and assessment. Conclusions. The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.


Author(s):  
Restu Nur Hasanah Haris ◽  
Rahmat Makmur ◽  
Tri Murti Andayani ◽  
Susi Ari Kristina

Quality of life (HRQoL) is a measure of a person's health in physical, spiritual, and emotional, and role functions in the society. Measurement of quality of life (HRQoL) is an important thing to understand and evaluate. Measurements are carried out not only on patients but also on the general population with the use of specific or generic instruments. The instrument used requires a psychometric properties test to ensure its validity and reliability. This article aims to conduct a systematic review of the psychometric properties of quality of life (HRQoL) instruments in the general population. Articles were collected in December 1st to 5th, 2018, from Pubmed and Google Scholar. The assessment was carried out using the checklist properties according to the cohen criteria and included the content validity, construct validity, internal consistency reliability, test-retest, ceiling effect and the level of credibility of the instruments. Among 80 articles obtained there were 24 articles that fulfilled the inclusion criteria. Short Form-36 (SF-36) instrument is the most widely used instrument in measuring the quality of life in the general population (26.6%). Some instruments have not been tested according to the criteria, while almost all instruments show a good level of validation of construct validity using convergent and discriminat validity with cronbach alpha values > 0.7. Test-retest reliability provides a good correlation. Some instruments show a ceiling effect. According to the assessment, the SF-36, SF-6D, EQ-5D, SF-12 and PedsQoL instruments are considered as established instruments. Further validation testing is needed to provide and support the measurement of subsequent quality of life (HRQoL) instruments.


2005 ◽  
Vol 3 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Richard Derby ◽  
John J. Lettice ◽  
Thomas A. Kula ◽  
Sang-Heon Lee ◽  
Kwan-Sik Seo ◽  
...  

Object. The authors examined the effect of psychological and emotional status on the outcome in patients with suspected chronic discogenic low-back pain (LBP) who have undergone lumbar fusion. Methods. The authors retrospectively analyzed the medical records, including the results of the 36-item Short Form (SF-36), of 57 consecutive patients (mean age 42.7 years) who underwent single-level lumbar reconstructive surgery between 1994 and 2000. The SF-36 physical component summary (PCS) and mental component summary (MCS) domains were evaluated. Data were sorted into the following categories: excellent, good, fair, same, and worse. Scores greater than 40 for MCS and PCS were defined as “normal” according to US general population data provided by the Medical Outcomes Trust. Of 57 patients, 47 completed postoperative SF-36 surveys at 1 year and 36 completed the 2-year follow-up surveys. Analysis showed that preoperative MCS scores exhibited a significant, direct correlation with PCS score improvements at 1 (r = 0.584, p = 0.000) and 2 (r = 0.623, p = 0.000) years after surgery. In patients in whom preoperative MCS scores reflected normal status, outcomes were excellent or good in 60% at 1-year (18 of 30 cases) and 2-year (15 of 25 cases) follow-up intervals. Patients in whom MCS scores represented abnormal status had less satisfactory outcomes, with excellent or good outcome in only two (18.2%) of all patients at the 2-year follow-up study. Conclusions. Analysis of the data suggests that psychological and emotional distress may negatively affect postoperative outcome in patients with chronic discogenic LBP. The SF-36 may be easily and effectively used to measure both preoperative psychosocial distress and postoperative outcome.


2005 ◽  
Vol 2 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Claudius Thomé ◽  
Martin Barth ◽  
Johann Scharf ◽  
Peter Schmiedek

Object. Microdiscectomy currently constitutes the standard treatment for herniated lumbar discs. Although limiting surgery to excision of fragments has occasionally been suggested, prospective data are lacking. Therefore, the objective of this study was to compare early outcome and recurrence rates after sequestrectomy and microdiscectomy. Methods. Eighty-four consecutive patients 60 years of age or younger who harbored free, subligamentary, or transanular herniated lumbar discs refractory to conservative treatment were randomized to one of two treatment groups. Intraoperative parameters and findings were documented as well as pre- and postoperative symptoms such as pain, Patient Satisfaction Index (PSI), Prolo Scale score, and Short Form (SF)—36 subscale results. Follow up of at least 12 months was available in 73 patients (87%). Preoperative intergroup symptoms did not differ significantly. Surgery was significantly shorter in the sequestrectomy-treated group. Overall, low-back pain and sciatica were drastically reduced in both groups and most sensorimotor deficits improved. At 4 to 6 months, SF-36 subscales and PSI scores showed a trend in favor of sequestrectomy, leaving 3% of patients unsatisfied compared with 18% of those treated with discectomy. Outcome according to the Prolo Scale was good or excellent in 76% of discectomy-treated patients and 92% of sequestrectomy-treated patients. Reherniation occurred in four patients after discectomy (10%) and two patients after sequestrectomy (5%) within 18 months. Conclusions. Sequestrectomy does not seem to entail a higher rate of early recurrences compared with microdiscectomy. Analysis of early outcome demonstrated a trend toward superior results when sequestrectomy is performed. Although long-term follow-up data are mandatory, sequestrectomy may be an advantageous alternative to standard microdiscectomy.


2005 ◽  
Vol 102 (3) ◽  
pp. 489-494 ◽  
Author(s):  
Joseph T. King ◽  
Michael B. Horowitz ◽  
Amin B. Kassam ◽  
Howard Yonas ◽  
Mark S. Roberts

Object. Cerebral aneurysms can affect a patient's health status by rupture and stroke, impingement on neural structures, treatment side effects, or psychological stress. The authors assessed the performance, validity, and reliability of the Short Form—12 (SF-12), a self-administered written survey instrument, to assess health status in patients with cerebral aneurysms. Methods. A cohort of 170 patients with cerebral aneurysms who were seen at a neurosurgery clinic underwent structured interviews including measurement of their health statuses (SF-12 physical component summary [PCS] and mental component summary [MCS]), functional status (Glasgow Outcome Scale score, modified Rankin Scale score, and Barthel Index), and mental health (Hospital Anxiety and Depression Scale score). The SF-12 scores were compared with US population norms by performing t-tests with unequal variances. The validity of the SF-12 was assessed by comparing the PCS and MCS scores with each patient's functional status and mental health scores by using rank-order methods. Inter-item reliability was assessed using the Cronbach alpha statistic. Patients with cerebral aneurysms had decreased health status PCS and MCS scores when compared with population norms (p < 0.001 for all). A history of subarachnoid hemorrhage (SAH) (p = 0.006) and previous surgical or endovascular treatment (p = 0.047) was associated with worse PCS scores. The validity of the SF-12 was supported by the relationship between the PCS and MCS scores and the patient's functional status and mental health (p < 0.001 for all). The reliability of the SF-12 was documented by the Cronbach alpha statistic (α = 0.76). Conclusions. Patients with cerebral aneurysms have a diminished physical and mental health status as measured using the SF-12. The presence of SAH and aneurysm treatment are associated with a worse physical health status. The SF-12 is a valid and reliable instrument for measuring health status in patients with cerebral aneurysms.


2004 ◽  
Vol 1 (3) ◽  
pp. 267-272 ◽  
Author(s):  
Zoher Ghogawala ◽  
Edward C. Benzel ◽  
Sepideh Amin-Hanjani ◽  
Fred G. Barker ◽  
J. Fred Harrington ◽  
...  

Object. There is considerable debate among spine surgeons regarding whether fusion should be used to augment decompressive surgery in patients with symptomatic lumbar spinal stenosis involving Grade I degenerative spondylolisthesis. The authors prospectively evaluated the outcomes of patients treated between 2000 and 2002 at two institutions to determine whether fusion improves functional outcome 1 year after surgery. Methods. Patients ranged in age from 50 to 81 years. They presented with degenerative Grade I (3- to 14-mm) spondylolisthesis and lumbar stenosis without gross instability (< 3 mm of motion at the level of subluxation). Those in whom previous surgery had been performed at the level of subluxation were excluded. Each patient completed Oswestry Disability Index (ODI) and Short Form—36 (SF-36) questionnaires preoperatively and at 6 to 12 months postoperatively. Some patients underwent decompression alone (20 cases), whereas others underwent decompression and posterolateral instrumentation-assisted fusion (14 cases), at the treating surgeon's discretion. Baseline demographic data, radiographic features, and ODI and SF-36 scores were similar in both groups. The 1-year fusion rate was 93%. Both forms of surgery independently improved outcome compared with baseline status, based on ODI and SF-36 physical component summary (PCS) results (p < 0.001). Decompression combined with fusion led to an improvement in ODI scores of 27.5 points, whereas decompression alone was associated with a 13.6-point increase (p = 0.02). Analysis of the SF-36 PCS data also demonstrated a significant intergroup difference (p = 0.003). Conclusions. Surgery substantially improved 1-year outcomes based on established outcomes instruments in patients with Grade I spondylolisthesis and stenosis. Fusion was associated with greater functional improvement.


2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Marina Carvalho Arruda Barreto ◽  
Fabianna Resende Jesus Moraleida ◽  
Cristiane Vitaliano Graminha ◽  
Camila Ferreira Leite ◽  
Shamyr Sulyvan Castro ◽  
...  

Abstract Background Fibromyalgia syndrome (FMS) is both a challenging and disabling condition. The International Association for the Study of Pain (IASP) classifies FMS as chronic primary pain, and it can negatively impact individuals’ functioning including social, psychological, physical and work-related factors. Notably, while guidelines recommend a biopsychosocial approach for managing chronic pain conditions, FMS assessment remains clinical. The WHODAS 2.0 is a unified scale to measure disability in the light of the International Classification of Functioning, Disability and Health. Thus, this study aimed to evaluate the reliability and validity of the Brazilian version of WHODAS 2.0 for use in individuals with FMS. Methods Methodological study of the validity and reliability of the Brazilian version of the 36-item WHODAS 2.0 with 110 individuals with FMS. The instrument gives a score from 0 to 100, the higher the value, the worse the level of functioning. We assessed participants with Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (0–100), Fibromyalgia Impact Questionnaire (FIQ) (0–10) and Beck Depression Inventory instrument (BDI) (0–63). The construct validity, internal consistency, and test–retest stability. We used SF-36, FIQ and BDI to study construct validity analysis. For statistical analysis, we performed the intraclass correlation (ICC), Spearman correlation, and Cronbach's alpha, with a statistical level of 5%. Results Most participants were female (92.27%), aged 45 (± 15) years. The test–retest reliability analysis (n = 50) showed stability of the instrument (ICC = 0.54; ρ = 0.84, p < 0.05). The test–retest correlation between the domains was moderate to strong (ρ > 0.58 and < 0.90). Internal consistency was satisfactory for total WHODAS 2.0 (0.91) and also for domains, ranging from 0.44 to 0.81. The construct validity showed satisfactory values with all moderately correlated with WHODAS 2.0 instruments (> 0.46 and < 0.64; p < 0.05). WHODAS 2.0 evaluates the functioning encompassing components of health-related quality of life, functional impact, and depressive symptoms in those with FMS. Conclusions WHODAS 2.0 is a reliable and valid instrument to evaluate functioning of Brazilians with FMS. It provides reliable information on individuals' health through of a multidimensional perspective, that allows for individual-centered care.


2016 ◽  
Vol 36 (12) ◽  
pp. 1759-1765 ◽  
Author(s):  
Yu Heng Kwan ◽  
Warren Weng Seng Fong ◽  
Nai Lee Lui ◽  
Si Ting Yong ◽  
Yin Bun Cheung ◽  
...  

2005 ◽  
Vol 2 (5) ◽  
pp. 526-534 ◽  
Author(s):  
Joseph T. King ◽  
John J. Moossy ◽  
Joel Tsevat ◽  
Mark S. Roberts

Object. Investigators reporting decompressive surgery to treat patients with cervical spondylotic myelopathy (CSM) have described inconsistent benefits. In the present study the authors used three types of outcomes instruments to assess the results of CSM surgery. Methods. The authors collected prospective baseline and 6-month follow-up data in a cohort of 62 patients with CSM. Data collection included those pertaining to demographics; symptoms; physical findings; myelopathy severity; health status measured with the Short Form—36; and health values according to the standard gamble, time trade-off, visual analog scale, and willingness to pay. Rank-order methods were used to compare surgical and nonsurgical patients, and multivariate regression techniques adjusting for baseline characteristics were performed to examine the effects of surgery. During the study period, 28 patients underwent surgery, 34 did not, and there were no baseline differences between the two groups in demographics, symptoms, myelopathy scores, health status, or health values (p ≥ 0.120 in all domains); there was a greater prevalence of hand intrinsic muscle atrophy (p = 0.035) and Hoffmann sign (p = 0.006) in the surgery-treated group. Neither raw comparisons nor regression analyses showed a consistent surgery-related benefit. There were sporadic associations between worse outcomes and older patients, higher income, Babinski sign, longer duration of CSM symptoms, hand clumsiness, lower-extremity numbness, and multilevel surgery (p ≤ 0.049 for all). Conclusions. Analysis of results obtained in the 62 patients with CSM failed to show a surgery-related benefit despite the use of three classes of outcomes instruments. Patient demographics, symptoms, physical signs, and the surgical approach may explain some of the variation in outcomes in patients with CSM.


Kontakt ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 16-26 ◽  
Author(s):  
Sylva Bártlová ◽  
Valérie Tóthová ◽  
Ivana Chloubová ◽  
Lenka Šedová ◽  
Věra Olišarová ◽  
...  

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