Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
School of Nursing, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
Qual Life Res. 2018 Sep;27(9):2459-2469. doi: 10.1007/s11136-018-1908-2. Epub 2018 Jun 13.
The evidence on the responsiveness of the Short Form-12 Health Survey version 2 (SF-12v2) in patients with type 2 diabetes mellitus (T2DM) is limited. The aim of this study was to examine both the internal and external responsiveness of the SF-12 measures in Chinese patients with T2DM.
A prospective longitudinal observational study was conducted on 1443 T2DM patients managed in public primary care clinics between 2012 and 2013. These patients were surveyed at baseline and at 12 months using SF-12v2. The internal responsiveness was evaluated by linear mixed effect models. Meanwhile, the external responsiveness was tested by multiple linear regression models and receiver operating characteristic (ROC) curve analysis.
The internal responsiveness of the SF-12v2 to detect negative change was satisfactory among T2DM patients in worsened group, but only the general health domain of SF-12v2 could detect positive change among T2DM patients with improved group. For external responsiveness, the SF-12v2 detected a significant difference-in-difference between patients with worsened and stable/improved group, but not between patients with stable and improved group. The areas under the ROC curve for all domains and summary scales of the SF-12v2 were not statistically different from 0.7.
This study showed that the responsiveness of SF-12v2 might not achieve the standard. Despite the wide use of the SF-12v2, we would like to urge that both clinicians and researchers should use it with caution in longitudinal study.
有关 2 型糖尿病(T2DM)患者短表 12 健康调查版本 2(SF-12v2)反应度的证据有限。本研究旨在检验 T2DM 中国患者 SF-12 测量的内部和外部反应度。
2012 年至 2013 年期间,在公立基层医疗诊所对 1443 例 T2DM 患者进行了前瞻性纵向观察性研究。这些患者在基线和 12 个月时使用 SF-12v2 进行了调查。通过线性混合效应模型评估内部反应度。同时,通过多元线性回归模型和接收者操作特征(ROC)曲线分析测试外部反应度。
SF-12v2 对恶化组 T2DM 患者检测负面变化的内部反应度令人满意,但仅 SF-12v2 的一般健康领域能够检测出改善组 T2DM 患者的阳性变化。对于外部反应度,SF-12v2 在恶化和稳定/改善组患者之间检测到显著的差异,但在稳定和改善组患者之间没有检测到差异。SF-12v2 的所有领域和综合量表的 ROC 曲线下面积均未显著大于 0.7。
本研究表明,SF-12v2 的反应度可能不符合标准。尽管 SF-12v2 应用广泛,但我们还是希望临床医生和研究人员在纵向研究中谨慎使用它。