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Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations
Kristianstad University.
Kristianstad University.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar Cty Hospital ; Linköping University.ORCID iD: 0000-0002-0961-5250
2017 (English)In: Research in Nursing & Health, ISSN 0160-6891, E-ISSN 1098-240X, Vol. 40, no 4, 378-386 p.Article in journal (Refereed) Published
Abstract [en]

The 12-item Short Form Health Survey (SF-12) is a generic health rating scale developed to reproduce the Physical and Mental Component Summary scores (PCS and MCS, respectively) of a longer survey, the SF-36. The standard PCS/MCS scoring algorithm has been criticized because its expected dimensionality often lacks empirical support, scoring is based on the assumption that physical and mental health are uncorrelated, and because scores on physical health items influence MCS scores, and vice versa. In this paper, we review the standard PCS/MCS scoring algorithm for the SF-12 and consider alternative scoring procedures: the RAND-12 Health Status Inventory (HSI) and raw sum scores. We corroborate that the SF-12 reproduces SF-36 scores but also inherits its problems. In simulations, good physical health scores reduce mental health scores, and vice versa. This may explain results of clinical studies in which, for example, poor physical health scores result in good MCS scores despite compromised mental health. When applied to empirical data from people with Parkinson's disease (PD) and stroke, standard SF-12 scores suggest a weak correlation between physical and mental health (r(s). 16), whereas RAND-12 HSI and raw sum scores show a much stronger correlation (r(s). 67-.68). Furthermore, standard PCS scores yield a different statistical conclusion regarding the association between physical health and age than do RAND-12 HSI and raw sum scores. We recommend that the standard SF-12 scoring algorithm be abandoned in favor of alternatives that provide more valid representations of physical and mental health, of which raw sum scores appear the simplest.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017. Vol. 40, no 4, 378-386 p.
Keyword [en]
epidemiology, health status, instrument development and validation, quality of life
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-67501DOI: 10.1002/nur.21806ISI: 000406119100010PubMedID: 28732149OAI: oai:DiVA.org:lnu-67501DiVA: diva2:1137023
Available from: 2017-08-30 Created: 2017-08-30 Last updated: 2017-08-30Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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