The use of the 12-item short-form health status instrument in a longitudinal study of patients with stroke and transient ischaemic attack

The 36-item short-form health survey (SF-36) is one of the most commonly used health status instruments in patients with cerebrovascular disease. However, responsiveness to change in health-related quality of life (HRQoL) has not yet been assessed for the SF-36 and its shortened version, the SF-12. The main objective of the present study was to determine responsiveness to change of the SF-12 in patients with cerebrovascular disease. Patients with stroke/transient ischaemic attack (TIA) were included at admission to one of four participating hospitals. HRQoL was assessed with the Physical (PCS-12) and Mental (MCS-12) Component Summary scales at baseline ( referring to the status prior to the event) and after 12 months. Responsiveness to change was determined with the standardized response mean (SRM) and classified as small ( SRM 0.20 - 0.49), moderate (0.50 - 0.79) or large ( >= 0.80). A total of 558 patients were included [55% men, mean age 65 (SD, 13) years; 45% women, mean age 69 (SD, 14) years]. Indications for admission were stroke (74%) and TIA (26%). In patients with stroke, SRMs were small for the PCS-12 [SRM 0.49; absolute change - 5.9 ( SD, 12)] and moderate for the MCS-12 [ SRM 0.52; absolute change - 6.6 ( SD, 13)]. In patients with TIA, SRMs were below 0.2 for the PCS-12 [ absolute change - 0.7 ( SD, 11)] and small for the MCS-12 [ SRM 0.34; absolute change - 3.7 ( SD, 11)]. SRMs increased with stroke severity as indicated by the NIHSS score. The SF-12 summary scales showed a small to moderate responsiveness to change in patients after stroke. Responsiveness to change was higher in patients with increased symptom severity. Copyright (C) 2005 S. Karger AG, Basel.