Tong Lai Kun, Au Mio Leng, Liu Yong Bing, Zheng Mu Rui, Fu Guang Lei, Li Yue Yi
Research Management and Development Department, Kiang Wu Nursing College of Macau, Macao, China.
Education Department, Kiang Wu Nursing College of Macau, Macao, China.
BMC Public Health. 2025 Mar 17;25(1):1019. doi: 10.1186/s12889-025-22226-0.
The Suboptimal Health Status Questionnaire (SHSQ-25) is a widely used tool for assessing suboptimal health, however, the determination of an optimal cutoff point remains unclear. This study aimed to determine the optimal cutoff point for the SHSQ-25 using latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses.
A cross-sectional online survey was conducted among adults aged 18 years and above in five regions in China. Participants completed questionnaires assessing demographic characteristics and suboptimal health status using the SHSQ-25. LPA was applied to identify distinct subgroups based on participants' responses to the SHSQ-25 items. ROC analysis was performed to establish the optimal cutoff point for the SHSQ-25. The optimal cutoff point was determined using the maximum Youden index.
A total of 4918 participants (mean age = 30.1 ± 12.6 years) were included in the final analysis. The majority of participants were female (73.6%), college-educated (60.1%), single (55.1%), and living with others (93.5%). The LPA revealed a 3-profile model, including high-risk group (19.0%), middle-risk group (51.4%), and a low-risk group (29.6%). The optimal cutoff point for the SHSQ-25 was determined to be 44, maximizing sensitivity (97.53%) and specificity (97.77%) in identifying individuals with suboptimal health. Furthermore, individuals living with others exhibited a lower likelihood of developing suboptimal health compared to those living alone, even after adjusting for demographic factors (OR = 0.617, p < 0.001).
This study determined an optimal cutoff point of 44 for the SHSQ-25, enhancing its utility in identifying individuals with suboptimal health. These findings have implications for clinical practice, public health interventions, and future research endeavors aimed at improving the identification, understanding, and management of suboptimal health.
次优健康状况问卷（SHSQ - 25）是一种广泛用于评估次优健康状况的工具，然而，最佳截断点的确定仍不明确。本研究旨在使用潜在类别分析（LPA）和受试者工作特征曲线（ROC）分析来确定SHSQ - 25的最佳截断点。
在中国五个地区对18岁及以上成年人进行了横断面在线调查。参与者完成了使用SHSQ - 25评估人口统计学特征和次优健康状况的问卷。应用LPA根据参与者对SHSQ - 25项目的回答来识别不同的亚组。进行ROC分析以确定SHSQ - 25的最佳截断点。使用最大约登指数确定最佳截断点。
最终分析纳入了4918名参与者（平均年龄 = 30.1 ± 12.6岁）。大多数参与者为女性（73.6%）、大学学历（60.1%）、单身（55.1%）且与他人同住（93.5%）。LPA揭示了一个三类别模型，包括高风险组（19.0%）、中风险组（51.4%）和低风险组（29.6%）。确定SHSQ - 25的最佳截断点为44，在识别次优健康个体时使敏感性（97.53%）和特异性（97.77%）最大化。此外，即使在调整人口统计学因素后，与独居者相比，与他人同住的个体出现次优健康的可能性更低（OR = 0.617，p < 0.001）。
本研究确定SHSQ - 25的最佳截断点为44，提高了其在识别次优健康个体方面的效用。这些发现对临床实践、公共卫生干预以及旨在改善次优健康的识别、理解和管理的未来研究工作具有启示意义。
