The Short Form—12 and the measurement of health status in patients with cerebral aneurysms: performance, validity, and reliability

Joseph T. King Jr. M.D., M.S.C.E.1, Michael B. Horowitz M.D.1, Amin B. Kassam M.D.1, Howard Yonas M.D.1, and Mark S. Roberts M.D., M.P.P.1
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  • 1 Section of Neurosurgery, Veterans Administration Connecticut Healthcare System, West Haven, Connecticut; Department of Neurosurgery, Yale University, New Haven, Connecticut; Department of Neurological Surgery, Section of Decision Sciences and Clinical Systems Modeling, Division of General Internal Medicine, Department of Medicine, Center for Research on Health Care, and Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Object. Cerebral aneurysms can affect a patient's health status by rupture and stroke, impingement on neural structures, treatment side effects, or psychological stress. The authors assessed the performance, validity, and reliability of the Short Form—12 (SF-12), a self-administered written survey instrument, to assess health status in patients with cerebral aneurysms.

Methods. A cohort of 170 patients with cerebral aneurysms who were seen at a neurosurgery clinic underwent structured interviews including measurement of their health statuses (SF-12 physical component summary [PCS] and mental component summary [MCS]), functional status (Glasgow Outcome Scale score, modified Rankin Scale score, and Barthel Index), and mental health (Hospital Anxiety and Depression Scale score). The SF-12 scores were compared with US population norms by performing t-tests with unequal variances. The validity of the SF-12 was assessed by comparing the PCS and MCS scores with each patient's functional status and mental health scores by using rank-order methods. Inter-item reliability was assessed using the Cronbach alpha statistic.

Patients with cerebral aneurysms had decreased health status PCS and MCS scores when compared with population norms (p < 0.001 for all). A history of subarachnoid hemorrhage (SAH) (p = 0.006) and previous surgical or endovascular treatment (p = 0.047) was associated with worse PCS scores. The validity of the SF-12 was supported by the relationship between the PCS and MCS scores and the patient's functional status and mental health (p < 0.001 for all). The reliability of the SF-12 was documented by the Cronbach alpha statistic (α = 0.76).

Conclusions. Patients with cerebral aneurysms have a diminished physical and mental health status as measured using the SF-12. The presence of SAH and aneurysm treatment are associated with a worse physical health status. The SF-12 is a valid and reliable instrument for measuring health status in patients with cerebral aneurysms.

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