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Fujino H, Takahashi MP, Nakamura H, Heatwole CR, Takada H, Kuru S, Ogata K, Enomoto K, Hayashi Y, Imura O, Matsumura T. Facioscapulohumeral muscular dystrophy Health Index: Japanese translation and validation study. Disabil Rehabil 2024:1-10. [PMID: 38555736 DOI: 10.1080/09638288.2024.2322035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 02/17/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The Facioscapulohumeral Muscular Dystrophy Health Index (FSHD-HI) is a patient-reported outcome measure developed for patients with FSHD. This study aimed to translate the FSHD-HI into Japanese (FSHD-HI-J), evaluate cultural adaptation, and examine its psychometric properties. MATERIALS AND METHODS We created two forward translations, integrated them into a single Japanese version, and evaluated the back-translated version of the FSHD-HI. After finalizing the translation and cultural adaptation, we conducted a survey of 66 patients with FSHD to examine the reliability and validity of the FSHD-HI-J. For psychometric evaluations, we used Cronbach's alpha to assess internal consistency, the intraclass correlation coefficient (ICC) for test-retest reliability, and assessed validity based on the associations between FSHD-HI-J, clinical variables, and quality of life measures. RESULTS The FSHD-HI-J was found to be clinically relevant, indicating high internal consistency and test-retest reliability (ICC = 0.92 [95% confidence interval: 0.86-0.95] for the total score), as well as significant associations with clinical variables (D4Z4 repeats and functional impairment) and other quality of life measures (|rho| = 0.25-0.73). CONCLUSIONS The FSHD-HI-J is a valid and reliable patient-reported outcome measure for Japanese patients with FSHD. This validated, disease-specific patient-reported outcome is essential for future clinical practice and clinical trials.
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Affiliation(s)
- Haruo Fujino
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Masanori P Takahashi
- Clinical Neurophysiology, Department of Clinical Laboratory and Biomedical Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Harumasa Nakamura
- Department of Clinical Research Support, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Chad R Heatwole
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Center for Health and Technology, Rochester, NY, USA
| | - Hiroto Takada
- Department of Neurology, NHO Aomori National Hospital, Aomori, Japan
| | - Satoshi Kuru
- Department of Neurology, NHO Suzuka National Hospital, Suzuka, Mie, Japan
| | - Katsuhisa Ogata
- Department of Neurology, NHO Higashisaitama National Hospital, Hasuda, Saitama, Japan
| | - Kiyoka Enomoto
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
- Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
| | - Yuto Hayashi
- Department of Neurology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Osamu Imura
- Faculty of Social Sciences, Nara University, Nara, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, NHO Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
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Wohnrade C, Velling AK, Mix L, Wurster CD, Cordts I, Stolte B, Zeller D, Uzelac Z, Platen S, Hagenacker T, Deschauer M, Lingor P, Ludolph AC, Lulé D, Petri S, Osmanovic A, Schreiber-Katz O. Health-Related Quality of Life in Spinal Muscular Atrophy Patients and Their Caregivers-A Prospective, Cross-Sectional, Multi-Center Analysis. Brain Sci 2023; 13:brainsci13010110. [PMID: 36672091 PMCID: PMC9857112 DOI: 10.3390/brainsci13010110] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Spinal muscular atrophy (SMA) is a disabling disease that affects not only the patient’s health-related quality of life (HRQoL), but also causes a high caregiver burden (CGB). The aim of this study was to evaluate HRQoL, CGB, and their predictors in SMA. In two prospective, cross-sectional, and multi-center studies, SMA patients (n = 39) and SMA patient/caregiver couples (n = 49) filled in the EuroQoL Five Dimension Five Level Scale (EQ-5D-5L) and the Short Form Health Survey 36 (SF-36). Caregivers (CGs) additionally answered the Zarit Burden Interview (ZBI) and the Hospital Anxiety and Depression Scale (HADS). Patients were clustered into two groups with either low or high HRQoL (EQ-5D-5L index value <0.259 or >0.679). The latter group was mostly composed of ambulatory type III patients with higher motor/functional scores. More severely affected patients reported low physical functioning but good mental health and vitality. The CGB (mean ZBI = 22/88) correlated negatively with patients’ motor/functional scores and age. Higher CGB was associated with a lower HRQoL, higher depression and anxiety, and more health impairments of the CGs. We conclude that patient and CG well-being levels interact closely, which highlights the need to consider the health of both parties while evaluating novel treatments.
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Affiliation(s)
- Camilla Wohnrade
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
| | | | - Lucas Mix
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
| | | | - Isabell Cordts
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Benjamin Stolte
- Department of Neurology and Center for Translational Neuro- and Behavioral Science, University Medicine Essen, 45147 Essen, Germany
| | - Daniel Zeller
- Department of Neurology, University of Wuerzburg, 97080 Wuerzburg, Germany
| | - Zeljko Uzelac
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
| | - Sophia Platen
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
| | - Tim Hagenacker
- Department of Neurology and Center for Translational Neuro- and Behavioral Science, University Medicine Essen, 45147 Essen, Germany
| | - Marcus Deschauer
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Paul Lingor
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Albert C. Ludolph
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
- German Center for Neurodegenerative Diseases, 89081 Ulm, Germany
| | - Dorothée Lulé
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, 45147 Essen, Germany
| | - Olivia Schreiber-Katz
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany
- Correspondence:
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Psychometric Properties of the Short Form-36 (SF-36) in Parents of Children with Mental Illness. PSYCH 2022. [DOI: 10.3390/psych4020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Given the stressful experiences of parenting children with mental illness, researchers and health professionals must ensure that the health-related quality of life of these vulnerable parents is measured with sufficient validity and reliability. This study examined the psychometric properties of the SF-36 in parents of children with mental illness. The data come from 99 parents whose children were currently receiving mental health services. The correlated two-factor structure of the SF-36 was replicated. Internal consistencies were robust (α > 0.80) for all but three subscales (General Health, Vitality, Mental Health). Inter-subscale and component correlations were strong. Correlations with parental psychopathology ranged from r = −0.32 to −0.60 for the physical component and r = −0.39 to −0.75 for the mental component. Parents with clinically relevant psychopathology had significantly worse SF-36 scores. SF-36 scores were inversely associated with the number of child diagnoses. The SF-36 showed evidence of validity and reliability as a measure of health-related quality of life in parents of children with mental illness and may be used as a potential outcome in the evaluation of family-centered approaches to care within child psychiatry. Given the relatively small sample size of this study, research should continue to examine its psychometric properties in more diverse samples of caregivers.
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De Wel B, Goosens V, Sobota A, Van Camp E, Geukens E, Van Kerschaver G, Jagut M, Claes K, Claeys KG. Nusinersen treatment significantly improves hand grip strength, hand motor function and MRC sum scores in adult patients with spinal muscular atrophy types 3 and 4. J Neurol 2020; 268:923-935. [PMID: 32935160 DOI: 10.1007/s00415-020-10223-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/30/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nusinersen recently became available as the first treatment for Spinal Muscular Atrophy (SMA) and data on its effectiveness and safety in adult SMA patients are still scarce. METHODS We evaluated the effectiveness and safety of nusinersen treatment during 14 months in 16 adult patients with SMA types 3 and 4 in a prospective study, and retrospectively detailed the natural history of 48 adult SMA patients types 2, 3 and 4. RESULTS Hand grip strength (p = 0.03), hand motor function (p = 0.04) as assessed by a sub-score of the Revised Upper Limb Module (RULM) and the Medical Research Council (MRC) sum score (p = 0.04) improved significantly at month 14. Importantly, the MRC sum score had declined significantly (p < 0.01) prior to start of treatment in these patients. A minimal clinically important difference (MCID) in the Hammersmith Functional Motor Scale Expanded (HFMSE) and RULM scores was achieved in 31% and 50% of the patients, respectively, but the mean changes from baseline failed to reach significance. Forced Vital Capacity (FVC) transiently increased at month 6 (p = 0.01), whereas the Peak Expiratory Flow (PEF) did not. The Activity Limitations scale declined significantly prior to start of treatment (p < 0.01) and showed an improvement with nusinersen which was not significant. The safety evaluation did not reveal serious adverse events and no signs of nephrotoxicity or antisense oligonucleotide (ASO)-mediated inflammation. CONCLUSIONS We conclude that hand grip strength and hand motor function, as well as MRC sum scores improved significantly in nusinersen-treated adult patients with SMA types 3 and 4.
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Affiliation(s)
- Bram De Wel
- Department of Neurology, University Hospitals Leuven, Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Veerle Goosens
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Atka Sobota
- Department of Physical and Rehabilitation Medicine (Physiotherapy), University Hospitals Leuven, Leuven, Belgium
| | - Elke Van Camp
- Department of Physical and Rehabilitation Medicine (Physiotherapy), University Hospitals Leuven, Leuven, Belgium
| | - Ellen Geukens
- Department of Physical and Rehabilitation Medicine (Occupational Therapy), University Hospitals Leuven, Leuven, Belgium
| | - Griet Van Kerschaver
- Department of Physical and Rehabilitation Medicine (Occupational Therapy), University Hospitals Leuven, Leuven, Belgium
| | - Marlène Jagut
- Belgian Neuromuscular Diseases Registry, Sciensano, Brussels, Belgium
| | - Kathleen Claes
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium.
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Mori I, Fujino H, Matsumura T, Takada H, Ogata K, Nakamori M, Innami K, Shingaki H, Imura O, Takahashi MP, Heatwole C. The myotonic dystrophy health index: Japanese adaption and validity testing. Muscle Nerve 2019; 59:577-582. [PMID: 30681157 DOI: 10.1002/mus.26422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The Myotonic Dystrophy Health Index (MDHI) is a disease-specific, patient-reported outcome measure. The objective of this study was to translate, evaluate, and validate a Japanese version of the MDHI (MDHI-J). METHODS We utilized forward and backward translations and qualitative interviews with 11 myotonic dystrophy type 1 (DM1) participants. We subsequently tested the internal consistency, test-retest reliability, concurrent validity against muscle strength, and 3 quality-of-life measures, and the known-groups validity of the MDHI-J with 60 adult patients. RESULTS The MDHI-J was found to be culturally appropriate, comprehensive, and clinically relevant. The MDHI-J and its subscales had high internal consistency (mean Cronbach's α = 0.91), test-retest reliability (intraclass coefficient 0.678-0.915), and concurrent validity (Spearman's ρ - 0.869 to 0.904). MDHI-J scores were strongly associated with employment, duration of symptoms, and modified Rankin Scale. DISCUSSION The MDHI-J is suitable and valid to measure patient-reported disease burden in adult Japanese patients with DM1. Muscle Nerve 59:577-577, 2019.
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Affiliation(s)
- Itsuki Mori
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka Suita, Osaka 565-0871, Japan
| | - Haruo Fujino
- Department of Special Needs Education, Oita University, Oita, Japan.,Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization Aomori National Hospital, Aomori, Japan
| | - Katsuhisa Ogata
- Department of Neurology, National Hospital Organization Higashisaitama National Hospital, Hasuda, Japan
| | - Masayuki Nakamori
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keisuke Innami
- International and Translational Medicine Program, Osaka University Graduate School of Medicine Suita, Japan.,Knowledge Capital Association, Osaka, Japan
| | - Honoka Shingaki
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka Suita, Osaka 565-0871, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chad Heatwole
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
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Fujino H, Saito T, Takahashi MP, Takada H, Nakayama T, Ogata K, Rose MR, Imura O, Matsumura T. Validation of The Individualized Neuromuscular Quality of Life in Japanese patients with myotonic dystrophy. Muscle Nerve 2018; 58:56-63. [PMID: 29342319 DOI: 10.1002/mus.26071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The Individualized Neuromuscular Quality of Life (INQoL) is used to measure the quality of life (QoL) of patients with neuromuscular disease. We conducted this study to translate and validate the Japanese version of the INQoL in patients with myotonic dystrophy. METHODS Forward and backward translation, patient testing, and psychometric validation were performed. We used the 36-Item Short Form Health Survey (SF-36) and the modified Rankin scale for concurrent validation. RESULTS The Japanese INQoL was administered to 90 adult patients. The coefficients for internal consistency and test-retest reliability were adequately high in most domains (Cronbach α 0.88-0.96 and intraclass coefficient 0.64-0.99). INQoL domains were moderately to strongly associated with relevant SF-36 subscales (Spearman's ρ -0.23 to -0.74). Symptom severity, disease duration, employment status, and use of a ventilator influenced overall QoL. DISCUSSION The INQoL is a reliable and validated measure of QoL for Japanese patients with myotonic dystrophy. Muscle Nerve, 2018.
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Affiliation(s)
- Haruo Fujino
- Department of Special Needs Education, Oita University, 700 Dannoharu, Oita, Japan, 870-1192
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Toshio Saito
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
| | - Masanori P Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization Aomori National Hospital, Aomori, Japan
| | | | - Katsuhisa Ogata
- Department of Neurology, National Hospital Organization Higashisaitama Hospital, Hasuda, Saitama, Japan
| | - Michael R Rose
- Department of Neurology, King's College Hospital, London, United Kingdom
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan
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Kelly A, Rush J, Shafonsky E, Hayashi A, Votova K, Hall C, Piccinin AM, Weber J, Rast P, Hofer SM. Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey. Health Qual Life Outcomes 2015; 13:199. [PMID: 26690802 PMCID: PMC4687353 DOI: 10.1186/s12955-015-0395-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 12/07/2015] [Indexed: 01/13/2023] Open
Abstract
Background A major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions. Methods To distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (N = 122, Mage = 66.28 years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions. Results Multilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability. Conclusions Many of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary.
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Affiliation(s)
- Amanda Kelly
- Department of Psychology, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
| | - Jonathan Rush
- Department of Psychology, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
| | - Eric Shafonsky
- Family Physician, 2020 Richmond Road, Victoria, BC, V8R 6R5, Canada.
| | - Allen Hayashi
- Pediatric and General Surgery, Island Health, 1952 Bay Street, Victoria, BC, V8R 1J8, Canada.
| | - Kristine Votova
- Department of Research, Island Health, Victoria, BC, Canada.
| | - Christine Hall
- Emergency Department, Island Health, Victoria, BC, Canada.
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
| | - Jens Weber
- Department of Computer Science, University of Victoria, Victoria, BC, Canada.
| | - Philippe Rast
- Department of Psychology, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
| | - Scott M Hofer
- Department of Psychology, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.
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Stull DE, Wasiak R, Kreif N, Raluy M, Colligs A, Seitz C, Gerlinger C. Validation of the SF-36 in patients with endometriosis. Qual Life Res 2013; 23:103-17. [PMID: 23851974 PMCID: PMC3929048 DOI: 10.1007/s11136-013-0442-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2013] [Indexed: 01/24/2023]
Abstract
Objectives Endometriosis presents with significant pain as the most common symptom. Generic health measures can allow comparisons across diseases or populations. However, the Medical Outcomes Study Short Form 36 (SF-36) has not been validated for this disease. The goal of this study was to validate the SF-36 (version 2) for endometriosis. Methods Using data from two clinical trials (N = 252 and 198) of treatment for endometriosis, a full complement of psychometric analyses was performed. Additional instruments included a pain visual analog scale (VAS); a physician-completed questionnaire based on patient interview (modified Biberoglu and Behrman—B&B); clinical global impression of change (CGI-C); and patient satisfaction with treatment. Results Bodily pain (BP) and the Physical Component Summary Score (PCS) were correlated with the pain VAS at baseline and over time and the B&B at baseline and end of study. In addition, those who had the greatest change in BP and PCS also reported the greatest change on CGI-C and patient satisfaction with treatment. Other subscales showed smaller, but significant, correlations with change in the pain VAS, CGI-C, and patient satisfaction with treatment. Conclusions The SF-36—particularly BP and the PCS—appears to be a valid and responsive measure for endometriosis and its treatment.
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Affiliation(s)
| | - Radek Wasiak
- United BioSource Corporation, 26-28 Hammersmith Grove, London, UK
| | - Noemi Kreif
- United BioSource Corporation, 26-28 Hammersmith Grove, London, UK
| | - Mireia Raluy
- United BioSource Corporation, 26-28 Hammersmith Grove, London, UK
| | | | | | - Christoph Gerlinger
- Bayer Pharma AG, Berlin, Germany
- Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saar Germany
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Measurement bias of the SF-36 Health Survey in older adults with chronic conditions. Qual Life Res 2013; 22:2359-69. [PMID: 23463018 DOI: 10.1007/s11136-013-0373-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2013] [Indexed: 12/15/2022]
Abstract
PURPOSE The objectives of this study were to investigate the psychometric properties of the SF-36 in a sample of older adults with chronic conditions and to test whether measurement bias exists based on the levels of comorbidity. METHODS Participants included were 979 cognitively intact older adults with comorbidities who were interviewed at their homes. We examined the psychometric properties of the SF-36 and conducted confirmatory factor analysis (CFA) to investigate the assumption of measurement invariance by the levels of comorbidity. RESULTS Overall data quality was high and scaling assumptions were generally met with few exceptions. Floor and ceiling effects were present for the role-physical and role-emotional subscales. Using CFA, we found that a three-factor measurement model fits the data well. We identified two violations of measurement invariance. Results showed that participants with high comorbidity level place more emphasis on social functioning (SF) and bodily pain (BP) in relation to physical health-related quality of life (HRQoL) than those with low comorbidity level. CONCLUSIONS Measurement bias was present for the SF and BP components of the SF-36 physical HRQoL measure. Researchers should be cautious when considering the use of SF-36 in clinical studies among older adults with comorbidities.
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