Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study

Abstract

Objective We compare the reliability and validity of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12) in adolescence, the period of life when a child develops into an adult, i.e., the period from puberty to maturity terminating legally at the age of majority (10–19 years), thus supplying evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China. Methods Stratified cluster random sampling was adopted according to geographical location, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach’s alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factors for the items of the SF-36 and SF-12, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for the items of the SF-36 and SF-12. Results 19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). Reliability of each domain of the SF-36 was better than for the corresponding domain of the SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of some domains of the SF-36 were a little higher in some corresponding dimensions of the SF-12, except for PCS. The convergence validities of the SF-12 were higher than the SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in the SF-12 had acceptable discrimination of items that were higher than in the SF-36. The items’ average amounts of information on BP, VT, SF, RE, and MH in the SF-36 and SF-12 were poor. Conclusion Two component (PCS and MCS) measurements of the SF-12 appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of the 8 domains of the SF-36 were better than those of the SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need to be studied further.

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“…Before initiating the formal study, we first consulted psychologists working at our institution. The final questionnaire included an assessment of demographics (such as sex, age, education level, current position, marital status, children), the General Health Questionnaire (GHQ-12) ( 14 – 16 ), Myers-Briggs Type Indicator questionnaire (MBTI) ( 17 – 19 ), Depression, Anxiety, and Stress Scales (DASS-21) ( 20 – 23 ), and the 12-item Short Form Health Survey (SF-12) ( 24 – 27 ). This study was approved by the Ethics Committee of Third People's Hospital of Chengdu ( 2021 -S-51), and all responders provided written informed consent before participating in this study.…”

“…The SF-12 has been used to investigate the quality of life ( 24 , 25 ) and includes the Physical Component Summary (PCS) and Mental Component Summary (MCS) ( 26 ). The SF-12 physical (PCS-12) and mental (MCS-12) component summary scales were scored with reference to a formula ( 27 ).…”

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“…Standardized 0-100 scores were converted after calculating the raw scores of each subscale. The PCS and MCS scores were calculated according to the general formula (23). A Mandarin Chinese version of SF-36 was used, which was confirmed as valid and reliable in the Chinese general population.…”

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“…The Hong Kong version [38][39][40][41] of the SF-36 42,43 was used to measure the participants' health-related quality of life in the physical and mental domains. The scale has been adapted to and validated for over 40 countries 51 and commonly used in adolescent populations, [52][53][54] with norm reference criteria available from 14 countries, 51 including Hong Kong. 39,40 The SF-36 consists of 35 questions that are summarized into eight multi-item scales under two domains, and one self-reported question which is related to health transition as compared to one year ago.…”