Original article
Measuring Health in Patients With Cervical and Lumbosacral Spinal Disorders: Is the 12-Item Short-Form Health Survey a Valid Alternative for the 36-Item Short-Form Health Survey?

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Abstract

Lee CE, Browell LM, Jones DL. Measuring health in patients with cervical and lumbosacral spinal disorders: is the 12-Item Short-Form Health Survey a valid alternative for the 36-Item Short-Form Health Survey?

Objectives

To determine the convergent validity of the 12-Item Short-Form Health Survey, version 2 (SF-12v2), with 36-Item Short-Form Health Survey, version 2 (SF-36v2), in patients with spinal disorders, and to determine other key factors that might further explain the variances between the 2 surveys.

Design

Cross-sectional study.

Participants

Eligible participants (N=98; 24 with cervical, 74 with lumbosacral disorders) who were aged 18 years and older, scheduled to undergo spinal surgery, and completed the SF-36v2.

Interventions

Not applicable.

Main Outcome Measures

SF-36v2 and SF-12v2 (extracted from the SF-36v2).

Results

The 2 summary scores, physical and mental component scores (r range, .88–.97), and most of the scale scores (r range, .81–.99) correlated strongly between the SF-12v2 and SF-36v2, except for the general health score (cervical group, r=.69; lumbosacral group, r=.76). Stepwise linear regression analyses showed the SF-12v2 general health scores (cervical: β=.61, P<.001; lumbosacral: β=.68, P<.001) and the level of comorbidities (cervical: β=−.37, P=.014; lumbosacral: β=−.18, P=.039) were significant predictors of the SF-36v2 general health score in both groups, whereas age (β=.32, P<.001) and smoking history (β=−.22, P=.005) were additional predictors in the lumbosacral group.

Conclusions

SF-12v2 is a practical and valid alternative for the SF-36v2 in measuring health of patients with cervical or lumbosacral spinal disorders. The validity of the SF-12v2 general health score interpretation is further improved when the level of comorbidities, age, and smoking history are taken into consideration.

Section snippets

Methods

This cross-sectional study was performed by using patients recruited from an outpatient orthopedic clinic between February 2005 and August 2006. The study was approved by the institutional review board of West Virginia University, and all patients provided written informed consent.

Results

Table 1 provides the descriptive summary of the sociodemographic and clinical data for both groups. The lumbosacral group tended to be older, have more comorbidities, have a higher proportion of smokers, and have more previous spine surgeries than the cervical group, but this was not statistically significant.

Table 2 displays the scale scores and summary scores of the SF-36v2 and SF-12v2 for the cervical and lumbosacral groups. There were strong correlations between the SF-36v2 and SF-12v2 in

Discussion

The SF-12v2 is an efficient method of collecting health outcome data for patients with spinal disorders. The SF-12v2 provides clinicians with the assessment of the broad health summaries and the detailed individual health profiles that are not available in SF-12v1. However, there is a paucity of evidence supporting the validity of the SF-12v2 in patients with spinal disorders. This study validated the use of the SF-12v2 in patients undergoing elective spinal surgery and determined additional

Conclusions

This study shows for the first time that the SF-12v2 is a valid alternative for the SF-36v2 in assessing the health status of patients with spinal disorders. The SF-12v2 adequately reflects both the health summary scores and the individual health profiles of SF-36v2. However, important factors including age, level of comorbidities, and smoking history need to be taken into consideration when assessing the SF-12v2 general health profile. These important factors are often part of the standard

Acknowledgment

We thank Lola Burke, BS, for her technical assistance in electronically scoring the surveys.

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