Health status of cardiac genetic disease patients and their at-risk relatives

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The SF36 Version 2: critical analyses of population weights, scoring algorithms and population norms.

Anne Winifred Taylor, Graeme Hawthorne, J Sansoni … (2007)

The SF36 Version 2 (SF36V2) is a revision of the SF36 Version 1, and is a widely used health status measure. It is important that guidelines for interpreting scores are available. A population sample of Australians (n = 3015) weighted to achieve representativeness was administered the SF36V2. Comparisons between published US weights and sample derived weights were made, and Australian population norms computed and presented. Significant differences were observed on 7/8 scales and on the mental health summary scale. Possible causes of these findings may include different sampling and data collection procedures, demographic characteristics, differences in data collection time (1998 vs. 2004), differences in health status or differences in cultural perception of the meaning of health. Australian population norms by age cohort, gender and health status are reported by T-score as recommended by the instrument developers. Additionally, the proportions of cases within T-score deciles are presented and show there are important data distribution issues. The procedures reported here may be used by other researchers where local effects are suspected. The population norms presented may be of interest. There are statistical artefacts associated with T-scores that have implications for how SF36V2 data are analysed and interpreted.

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Quality of life in patients with chronic heart failure and their carers: a 3-year follow-up study assessing hospitalization and mortality.

Javaid Iqbal, Loraine Francis, Janet Reid … (2010)

Chronic heart failure (CHF) due to left ventricular systolic dysfunction is associated with poor quality of life (QoL). This study aimed to assess factors affecting health-related QoL in CHF patients and their carers and the impact of QoL on clinical outcomes. Demographic, social, and clinical data were collected for consecutive CHF patients in an academic hospital setting. All patients (n = 179) and informal carers (n = 131) completed a generic QoL questionnaire (EQ-5D) and patients also completed a CHF-specific QoL questionnaire (Minnesota Living with Heart Failure Questionnaire, MLHFQ). Patients were then followed up for 3 years to assess subsequent hospitalizations and mortality. Minnesota Living with Heart Failure Questionnaire score was independently predicted by NYHA class, socioeconomic deprivation and lack of an informal carer. Severity of heart failure, anaemia, and cancer co-morbidity in CHF patients were associated with poor QoL in carers. Chronic heart failure patients with poor baseline QoL (MLHFQ > median) were at increased risk of hospital admissions [hazard ratios (HR) 7.3, P < 0.001] and death (HR 1.5, P = 0.09). Mortality was also independently associated with repeat hospitalization (HR 6.0, P < 0.001) and lack of beta-blocker therapy (HR 1.8, P = 0.03). Severe heart failure, poor socioeconomic status and lack of social support results in poor QoL in CHF patients which in turn leads to an increased risk of hospital admissions and death. Quality of life in carers is lower in female carers, those with socioeconomic deprivation and those caring for patients with higher NYHA class or having a cancer. Quality of life assessment may complement clinical prognostic markers to identify CHF patients at high risk of adverse events.

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The SF-36 in an Australian sample: validating a new, generic health status measure.

John McCallum (1995)

The SF-36 is a self-reported, 36-item, generic measure of health status that has been validated for adult age groups in the United States, the United Kingdom and in some non-English-speaking countries. The Australian Bureau of Statistics used it in the 1995 National Health Survey and it has been used in health status measurement, in monitoring health outcomes and in clinical trials. The validity of the SF-36 was examined in the National Centre for Epidemiology and Population Health Record Linkage Study using a sample of 555 respondents to the National Heart Foundation Risk Factor Prevalence Survey in 1989; they were followed up in 1992. Items chosen for the scale had been used in health status assessment and had stood the test of time. The health concepts measured demonstrated good internal consistency. The eight scales of the SF-36 formed factors as predicted in the general health dimensions of physical and mental health. The component scales of the SF-36 demonstrated good discrimination between people with and without health conditions, including those with medical and those with psychiatric types of conditions. Although the SF-36 was a valid measure of general health status among Australian respondents, further work is needed to establish clinical validity and to produce population norms for Australia. Use of the SF-36 will allow Australian and international comparison of health status from the point of view of the users of health services.