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Wiley InterScience | ||||||
  Value in HealthVolume 11 Issue 4, Pages 680 - 688 Published Online: 11 Jan 2008 © 2010 International Society for Pharmacoeconomics and Outcomes Research Published on behalf of the International Society for Pharmacoeconomics and Outcomes Research
Abstract | References | Full Text: HTML, PDF (Size: 132K) | Related Articles | Citation Tracking  Validity, Responsiveness, and Minimal Important Difference for the SF-6D Health Utility Scale in a Spinal Cord Injured Population Copyright © 2008 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) KEYWORDS health economics • health preference state • SF-6D • spinal cord injury • urinary tract infection • validity ABSTRACTObjective: To determine the feasibility, acceptability, discriminative validity, responsiveness, and minimal important difference (MID) of the SF-6D for people with spinal cord injury (SCI). Methods: A total of 305 people with SCI completed the SF-36 health status questionnaire at baseline and at subsequent occurrence of a urinary tract infection (UTI) or 6-month follow-up. Normative SF-36 data were obtained from the Australian Bureau of Statistics. SF-36 scores were transformed to SF-6D utility values using Brazier's algorithm. We used UTI as the external criterion of clinically important change to determine responsiveness and two categories of the SF-36 transition question ("somewhat worse" and "somewhat better") as the external criterion to determine the MID. Derived SF-12 responsiveness was also assessed. Results: The mean SF-6D values were: 0.68 (SD 0.21, n = 305) all patients; 0.66 (SD 0.19, n = 167) tetraplegia; 0.72 (SD 0.26, n = 138) paraplegia; 0.57 (SD 0.15, n = 138) with UTI. The Australian normative SF-6D mean value was 0.80 (SD 0.14, n = 18,005). The SF-6D was able to discriminate between SCI and the Australian normative sample (effect size [ES] = 0.86), tetraplegia–paraplegia (ES = 0.23), and it was responsive to UTI (ES = 0.86 SF-36 variant, ES = 0.92 SF-12 variant). The MID for respondents who reported being somewhat worse or somewhat better at follow-up was 0.03 (SD 0.17, n = 108/305), while the MID for only those who were somewhat worse was 0.10 (SD 0.14, n = 58). Conclusions: The content of the SF-6D is more appropriate than that of the SF-36 for this physically impaired population. The SF-6D has discriminative power and is responsive to clinically important change because of UTI. The MID is consistent with published estimates for other disease groups. | 
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