Hurst N P, Ruta D A, Kind P
Department of Rheumatology, Western General Hospitals Trust, Edinburgh.
Br J Rheumatol. 1998 Aug;37(8):862-9. doi: 10.1093/rheumatology/37.8.862.
To compare the performance of the MOS SF12 health survey (SF12) with the SF36 in a sample of 233 patients with rheumatoid arthritis (RA) stratified by functional class.
The SF12 and SF36 physical and mental component summary scales (PCS and MCS) were compared for test retest reliability [intra-class correlation coefficient (RC) and repeatability], construct validity and responsiveness [standardized response mean (SRM)] to self-reported change in health.
Overall, despite its brevity, the SF12 is comparable to the SF36 with only some loss of performance. The SF12-PCS is slightly less reliable (RC = 0.75) and responsive to improvements in health (SRM = 0.52) than the SF36-PCS (RC = 0.81; SRM = 0.61). The SF12-PCS correlates strongly with the SF36-PCS (R = 0.94), SF36 physical function subscale (R = 0.77) and modified Stanford Health Assessment Questionnaire (MHAQ) (R = 0.71), but only weakly with the SF36 mental health subscale (R = 0.22). SF12-PCS discriminated well between Steinbrocker functional classes; patients in functional classes 1-4, respectively, have SF12-PCS scores 1sigma, 2sigma, 2.4sigma and 2.7sigma below the population norm (ANOVA, F = 35.8, P < 0.000). The SF12-MCS is relatively unresponsive to reported improvement in RA (SRM = 0.31), but is reliable (RC = 0.71) and correlates well with the SF36-MCS (R = 0.71). SF12-MCS correlates more closely than the SF36-MCS with the SF36 mental health subscale (R = 0.86) and Hospital Anxiety and Depression (HAD) scale (R = 0.76). In ANOVA models, only the HAD (R2 = 57%) score contributes significantly to variance in SF12-MCS (F = 254.8; P < 0.000), but both the HAD (R2 = 24%) and MHAQ (R2 = 10%) scores contribute to variance in the SF36-MCS (F = 50.9; P < 0.000). Thus, the SF12-MCS has better construct validity for mental health than SF36-MCS in RA subjects. Missing responses to items were high amongst patients in functional class 4 (34%).
The SF12 is a reliable, valid and responsive measure of health status in the majority of RA patients, and meets standards required for comparing groups of patients. Its application in the most severely disabled subjects is uncertain.
在233例按功能分级的类风湿关节炎（RA）患者样本中，比较MOS SF12健康调查（SF12）与SF36的性能。
比较SF12和SF36的生理和心理成分汇总量表（PCS和MCS）的重测信度[组内相关系数（RC）和重复性]、结构效度以及对自我报告的健康变化的反应性[标准化反应均值（SRM）]。
总体而言，尽管SF12简短，但与SF36相当，只是性能略有损失。SF12-PCS的可靠性（RC = 0.75）和对健康改善的反应性（SRM = 0.52）略低于SF36-PCS（RC = 0.81；SRM = 0.61）。SF12-PCS与SF36-PCS（R = 0.94）、SF36身体功能子量表（R = 0.77）和改良的斯坦福健康评估问卷（MHAQ）（R = 0.71）密切相关，但与SF36心理健康子量表的相关性较弱（R = 0.22）。SF12-PCS在Steinbrocker功能分级之间有良好的区分度；功能分级1-4的患者，其SF12-PCS得分分别比总体均值低1个标准差、2个标准差、2.4个标准差和2.7个标准差（方差分析，F = 35.8，P < 0.000）。SF12-MCS对RA报告的改善相对无反应（SRM = 0.31），但可靠（RC = 0.71），且与SF36-MCS密切相关（R = 0.71）。SF12-MCS与SF36心理健康子量表（R = 0.86）和医院焦虑抑郁（HAD）量表（R = 0.76）的相关性比SF36-MCS更紧密。在方差分析模型中，只有HAD得分（R2 = 57%）对SF12-MCS的方差有显著贡献（F = 254.8；P < 0.000），但HAD得分（R2 = 24%）和MHAQ得分（R2 = 10%）均对SF36-MCS的方差有贡献（F = 50.9；P < 0.000）。因此，在RA患者中，SF12-MCS在心理健康方面的结构效度优于SF36-MCS。功能分级4的患者中，项目缺失回答率较高（34%）。
SF12是大多数RA患者健康状况的可靠、有效且有反应性的测量工具，符合比较患者组所需的标准。其在最严重残疾患者中的应用尚不确定。
