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...

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Published in:HEALTH AND QUALITY OF LIFE OUTCOMES Vol. 15; no. 1; pp. 143 - 9
Main Authors: Patel, Anik R., Lester, Richard T., Marra, Carlo A., van der Kop, Mia L., Ritvo, Paul, Engel, Lidia, Karanja, Sarah, Lynd, Larry D.
Format: Journal Article Publication
Language:English
Published: London BioMed Central 17.07.2017
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - physiopathology
Acquired Immunodeficiency Syndrome - psychology
Adult
Aged
AIDS
Analysis
Analysis of Variance
Antiretroviral drugs
Area Under Curve
CD4 antigen
Cellular telephones
Cost analysis
Cross-Sectional Studies
Demographics
Disease control
Drug therapy
Female
Health aspects
Health state utility
Health Surveys
HIV
HIV patients
Human immunodeficiency virus
Humans
Infections
Kenya
Kiswahili
Male
Medicine
Medicine & Public Health
Mental disorders
Mental health
Middle Aged
Patients
Preferences
Quality of Life
Quality of Life Research
Severity of Illness Index
SF6D
Short-form 12
Studies
Surveillance
Surveys
Surveys and Questionnaires
Translations
Variance analysis
Kenya
East Africa
Kiswahili
HIV
Short-form 12
SF6D
Quality of life
Health state utility
ISSN:1477-7525, 1477-7525
Online Access:Get full text
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Summary: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.
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ISSN:1477-7525
1477-7525
DOI:10.1186/s12955-017-0708-7