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

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Abstract

Purpose

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.

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Acknowledgments

This work has been conducted without financial support, and the authors declare no conflict of interest. We would like to thank the Rick Hansen Institute for the provision of the data and Dr. Penny Brasher for her contribution to the statistical analysis.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Lidia Engel & David G. T. Whitehurst

  2. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Lidia Engel, Stirling Bryan & David G. T. Whitehurst

  3. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Stirling Bryan

  4. Department of Health Services Research, Maastricht University, Maastricht, The Netherlands

    Silvia M. A. A. Evers

  5. CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

    Silvia M. A. A. Evers & Carmen D. Dirksen

  6. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands

    Carmen D. Dirksen

  7. Rick Hansen Institute, Vancouver, BC, Canada

    Vanessa K. Noonan

  8. International Collaboration On Repair Discoveries (ICORD), Vancouver, BC, Canada

    David G. T. Whitehurst

Authors
  1. Lidia Engel
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  2. Stirling Bryan
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  3. Silvia M. A. A. Evers
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  4. Carmen D. Dirksen
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  5. Vanessa K. Noonan
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  6. David G. T. Whitehurst
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Corresponding author

Correspondence to Lidia Engel.

Appendix

Appendix

See Figs. 3, 4, 5, 6, and 7.

Fig. 3
figure 3

Scatterplot presenting individual-level scores (small markers) and mean scores (large markers) for the SF-6D across each response option of the self-reported health status item (SF-36v2 item 1)

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Fig. 4
figure 4

Scatterplot presenting individual-level scores (small markers) and mean scores (large markers) for the SF-6D across each response option of the ‘life satisfaction as a whole’ item (LiSat-11 item 1)

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Fig. 5
figure 5

Scatterplot presenting individual-level scores (small markers) and mean scores (large markers) for the SF-6D across each response option of the pain interference with quality of life question

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Fig. 6
figure 6

Scatterplots grouped by calculated health changes (improvement, no change, and worsening) between 1- and 2-year follow-up for a change scores in SF-6D and FIM and b change scores in SF-6D and LiSat-11 for individuals with paraplegia

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Fig. 7
figure 7

Scatterplots grouped by calculated health changes (improvement, no change, and worsening) between 1- and 2-year follow-up for a change scores in SF-6D and FIM and b change scores in SF-6D and LiSat-11 for individuals with tetraplegia

Full size image

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Engel, L., Bryan, S., Evers, S.M.A.A. et al. Exploring psychometric properties of the SF-6D, a preference-based health-related quality of life measure, in the context of spinal cord injury. Qual Life Res 23, 2383–2393 (2014). https://doi.org/10.1007/s11136-014-0677-9

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