Exploring psychometric properties of the SF-6D, a preference-based health-related quality of life measure, in the context of spinal cord injury.

TitleExploring psychometric properties of the SF-6D, a preference-based health-related quality of life measure, in the context of spinal cord injury.
Publication TypeJournal Article
Year of Publication2014
AuthorsEngel L, Bryan S, Evers SM, Dirksen CD, Noonan VK, Whitehurst DG
JournalQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Volume23
Issue8
Pagination2383-93
Date Published2014 Oct
ISSN1573-2649
KeywordsAdult; Aged; Female; Humans; Longitudinal Studies; Male; Middle Aged; Outcome Assessment (Health Care); Psychometrics; Quality of Life; Questionnaires; Spinal Cord Injuries
AbstractPURPOSE: The validity of the SF-6D, a preference-based measure of health-related quality of life, is not well explored in the context of spinal cord injury (SCI). The aim of this analysis was to assess appropriate measurement properties of the SF-6D in a sample of individuals living with SCI. METHODS: Longitudinal data from the Rick Hansen Spinal Cord Injury Registry were used. Responses to the 36-item short-form health survey were transformed into SF-6D utility scores. We investigated practicality, floor and ceiling effects, and responsiveness to change. Responsiveness to change was explored using three different anchors that reflected changes in self-reported health, functional independence, and life satisfaction. Discriminative validity was assessed by ten a priori defined hypotheses, with a distinction made between 'strong' and 'weak' hypotheses. RESULTS: Three hundred and fifty-eight individuals with SCI were included in this analysis. Practicality was deemed acceptable based on a completion rate of 94%. The SF-6D showed low responsiveness to detect important health changes over time, and differences in responsiveness were found between individuals with paraplegia and tetraplegia. All five strong hypotheses and three weak hypotheses were confirmed. CONCLUSION: The SF-6D demonstrated good practicality and discriminative validity in this sample. The failure to detect self-reported and clinically important health changes requires further consideration. Comparative performance of the SF-6D (i.e., how the SF-6D performs against other preference-based measures) is unknown in the SCI context and requires further research.
DOI10.1007/s11136-014-0677-9
Alternate JournalQual Life Res