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Measuring health of patients with cervical spinal disorder: Is SF-12 health survey a valid alternative for SF-36?

C. Ellen Lee, PhD, PT, Division of Physical Therapy & Dept of Orthopedics, School of Medicine, PO Box 9226, Morgantown, WV 26506-9226 and Dina L. Jones, PhD, PT, Department of Orthopedics, School of Medicine, PO Box 9196, Morgantown, WV 26506-9196.

The Medical Outcome Study Short-Form 12 version 2 (SF-12) is an abbreviated version of the widely used Short-Form 36 version 2 (SF-36). However, few studies have examined the extent to which SF-12 scores correspond to SF-36 scores in patients with cervical spinal disorders. Therefore, the purpose of this study was to determine the convergent validity of the SF-12 with the SF-36 in patients with cervical spinal disorders. This cross-sectional study comprised 24 elective cervical spine surgical patients who completed the SF-36 as part of their initial assessment. A summary physical component score (PCS), a mental component score (MCS) and eight scale scores that include physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health of the SF-12 and SF-36 were calculated and converted to norm-based scores. Pearson product moment correlation was used to examine the relationship of the corresponding scores between the SF-12 and SF-36. Stepwise multiple regressions were used to determine additional factors that might further explain the variances of SF-36 scores. Most of the corresponding scale scores (r=0.81–0.99), PCS scores (r=0.88), and MCS scores (r=0.97) between the SF-12- and SF-36 were strongly correlated, with the exception of general health scale score (r=0.76). Comorbidity index was found to be the only significant factor (regression coefficient -0.60; p=0.012) that could further explain the variances of the general health scale score of SF-36, in addition to that of the SF-12 (regression coefficient 0.60; p<0.0005). The results suggest that SF-12 is a practical and valid alternative for SF-36 in measuring health of patients with cervical spinal disorders, with strong convergent validity for the summary scores and most scale scores. The validity of the interpretation of the SF-12 general health scale score is further improved when comorbidity index is taken into consideration in this population.