Loosman Wim L, Hoekstra Tiny, van Dijk Sandra, Terwee Caroline B, Honig Adriaan, Siegert Carl E H, Dekker Friedo W
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Nephrol Dial Transplant. 2015 Jul;30(7):1170-6. doi: 10.1093/ndt/gfv066. Epub 2015 Mar 31.
Short-Form 36 (SF-36) is a self-report health-related quality-of-life (HRQOL) questionnaire, widely used in dialysis patients. It consists of physical and mental component scores (PCS/MCS), ranging from 0 to 100. To improve efficiency, the Short-Form 12 (SF-12) was developed to reproduce PCS and MCS. We assessed the ability of SF-12 versus SF-36 to detect change over time, and the association of SF-12 versus SF-36 with short-term and long-term mortality in dialysis patients.
Patients were selected from the Netherlands Cooperative Study on the Adequacy of Dialysis (N = 1379), a prospective follow-up study among incident dialysis patients (62.1% HD) who completed SF-36 measurements every 6 months. Changes in scores of SF-12 versus SF-36 were compared with intra-class correlation coefficients (ICCs). Subsequently, Bland-Altman plots were used to assess limits of agreement. Relationship with mortality was assessed with Cox models with and without a time-dependent variable, adjusted for age, sex, ethnicity, comorbidity and dialysis modality at baseline.
ICC for change in scores was 0.90 for MCS and 0.84 for PCS. Mean difference was -0.1 and 0.2, respectively, and limits of agreement were -8.3 to 8.4 for MCS change in scores and -8.8 to 9.2 for PCS. Adjusted hazard ratio's for mortality per 5 units increment were 0.87 (95% CI: 0.84-0.91) for MCS12, 0.87 (95% CI: 0.84-0.90) for MCS36, 0.79 (95% CI: 0.76-0.83) for PCS12 and 0.75 (95% CI: 0.71-0.78) for PCS36.
SF-12 can be used to detect change in HRQOL in cohort studies on dialysis patients. SF-12 and SF-36 were similarly associated with short-term and long-term mortality. However, the wide limits of agreement indicate that SF-12 and SF-36 can give different scores on the individual level, suggesting that for individual purposes SF-36 instead of SF-12 should be used.
简明健康调查问卷36项（SF - 36）是一种自我报告的与健康相关的生活质量（HRQOL）问卷，广泛应用于透析患者。它由身体和心理成分得分（PCS/MCS）组成，范围从0到100。为提高效率，开发了简明健康调查问卷12项（SF - 12）以再现PCS和MCS。我们评估了SF - 12与SF - 36检测随时间变化的能力，以及SF - 12与SF - 36在透析患者短期和长期死亡率方面的关联。
患者选自荷兰透析充分性合作研究（N = 1379），这是一项对新发透析患者的前瞻性随访研究（62.1%为血液透析），这些患者每6个月完成一次SF - 36测量。将SF - 12与SF - 36得分的变化用组内相关系数（ICC）进行比较。随后，使用Bland - Altman图评估一致性界限。通过有和没有时间依赖性变量的Cox模型评估与死亡率的关系，并在基线时对年龄、性别族裔、合并症和透析方式进行调整。
MCS得分变化的ICC为0.90，PCS为0.84。平均差异分别为 - 0.1和0.2，MCS得分变化的一致性界限为 - 8.3至8.4，PCS为 - 8.8至9.2。每增加5个单位，MCS12的调整后死亡风险比为0.87（95%CI：0.84 - 0.91），MCS36为0.87（95%CI：0.84 - 0.90），PCS12为0.79（95%CI：0.76 - 0.83），PCS36为0.75（95%CI：0.71 - 0.78）。
在透析患者队列研究中，SF - 12可用于检测HRQOL的变化。SF - 12和SF - 36与短期和长期死亡率的关联相似。然而，较宽的一致性界限表明SF - 12和SF - 3正在个体水平上可能给出不同得分，这表明对于个体目的应使用SF - 36而非SF - 12。
