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The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya
BACKGROUND: Health-related quality of life (HRQoL) and health state utility value (HSUV) measurements are vital components of healthcare clinical and economic evaluations. Accurate measurement of HSUV and HRQoL require validated instruments. The 12-item Short-Form Health Survey (SF-12) is one of few...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513113/ https://www.ncbi.nlm.nih.gov/pubmed/28716065 http://dx.doi.org/10.1186/s12955-017-0708-7 |
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author | Patel, Anik R. Lester, Richard T. Marra, Carlo A. van der Kop, Mia L. Ritvo, Paul Engel, Lidia Karanja, Sarah Lynd, Larry D. |
author_facet | Patel, Anik R. Lester, Richard T. Marra, Carlo A. van der Kop, Mia L. Ritvo, Paul Engel, Lidia Karanja, Sarah Lynd, Larry D. |
author_sort | Patel, Anik R. |
collection | PubMed |
description | BACKGROUND: Health-related quality of life (HRQoL) and health state utility value (HSUV) measurements are vital components of healthcare clinical and economic evaluations. Accurate measurement of HSUV and HRQoL require validated instruments. The 12-item Short-Form Health Survey (SF-12) is one of few instruments that can evaluate both HRQoL and HSUV, but its validity has not been assessed in people living with HIV/AIDS (PLWHA) in east Africa, where the burden of HIV is high. METHODS: This cross-sectional study used baseline data from a randomized trial involving PLWHA in Kenya. Data included responses from a translated and adapted SF-12 survey as well as key demographic and clinical data. Construct validity of the survey was examined by testing the SF-12’s ability to distinguish between groups known in advance to have differences in their health based on their disease severity. We classified disease severity based on established definitions from the US Center for Disease Control (CDC) and WHO, as well as a previously studied viral load threshold. T-tests and ANOVA were used to test for differences in HRQoL and HSUV scores. Area under the receive operator curve (AUC) was used to test the discriminative ability of the HRQoL and HSUV instruments. RESULTS: Differences in physical component scores met the minimum clinically important difference among participants with more advanced HIV when defined by CD4 count (4.3 units) and WHO criteria (compared to stage 1, stages 2, 3 and 4 were 2.0, 7.2 and 9.8 units lower respectively). Mental score differences met the minimum clinically important difference between WHO stage 1 and stage 4 patients (4.4). Differences in the HSUV were statistically lower in more advanced HIV by all three definitions of severity. The AUC showed poor to weak discriminatory ability in most analyses, but had fair discriminatory ability between WHO clinical stage 1 and clinical stage 4 individuals (AUC = 0.71). CONCLUSION: Our findings suggest that the Kiswahili translated and adapted version of the SF-12 could be used as an assessment tool for physical health, mental health and HSUV for Kiswahili-speaking PLHWA. TRIAL REGISTRATION: Clinical trials.gov identifier: NCT00830622. Registered 26 January 2009. |
format | Online Article Text |
id | pubmed-5513113 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55131132017-07-19 The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya Patel, Anik R. Lester, Richard T. Marra, Carlo A. van der Kop, Mia L. Ritvo, Paul Engel, Lidia Karanja, Sarah Lynd, Larry D. Health Qual Life Outcomes Research BACKGROUND: Health-related quality of life (HRQoL) and health state utility value (HSUV) measurements are vital components of healthcare clinical and economic evaluations. Accurate measurement of HSUV and HRQoL require validated instruments. The 12-item Short-Form Health Survey (SF-12) is one of few instruments that can evaluate both HRQoL and HSUV, but its validity has not been assessed in people living with HIV/AIDS (PLWHA) in east Africa, where the burden of HIV is high. METHODS: This cross-sectional study used baseline data from a randomized trial involving PLWHA in Kenya. Data included responses from a translated and adapted SF-12 survey as well as key demographic and clinical data. Construct validity of the survey was examined by testing the SF-12’s ability to distinguish between groups known in advance to have differences in their health based on their disease severity. We classified disease severity based on established definitions from the US Center for Disease Control (CDC) and WHO, as well as a previously studied viral load threshold. T-tests and ANOVA were used to test for differences in HRQoL and HSUV scores. Area under the receive operator curve (AUC) was used to test the discriminative ability of the HRQoL and HSUV instruments. RESULTS: Differences in physical component scores met the minimum clinically important difference among participants with more advanced HIV when defined by CD4 count (4.3 units) and WHO criteria (compared to stage 1, stages 2, 3 and 4 were 2.0, 7.2 and 9.8 units lower respectively). Mental score differences met the minimum clinically important difference between WHO stage 1 and stage 4 patients (4.4). Differences in the HSUV were statistically lower in more advanced HIV by all three definitions of severity. The AUC showed poor to weak discriminatory ability in most analyses, but had fair discriminatory ability between WHO clinical stage 1 and clinical stage 4 individuals (AUC = 0.71). CONCLUSION: Our findings suggest that the Kiswahili translated and adapted version of the SF-12 could be used as an assessment tool for physical health, mental health and HSUV for Kiswahili-speaking PLHWA. TRIAL REGISTRATION: Clinical trials.gov identifier: NCT00830622. Registered 26 January 2009. BioMed Central 2017-07-17 /pmc/articles/PMC5513113/ /pubmed/28716065 http://dx.doi.org/10.1186/s12955-017-0708-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Patel, Anik R. Lester, Richard T. Marra, Carlo A. van der Kop, Mia L. Ritvo, Paul Engel, Lidia Karanja, Sarah Lynd, Larry D. The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title | The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title_full | The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title_fullStr | The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title_full_unstemmed | The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title_short | The validity of the SF-12 and SF-6D instruments in people living with HIV/AIDS in Kenya |
title_sort | validity of the sf-12 and sf-6d instruments in people living with hiv/aids in kenya |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513113/ https://www.ncbi.nlm.nih.gov/pubmed/28716065 http://dx.doi.org/10.1186/s12955-017-0708-7 |
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