2010 review - Patient-Reported Outcomes Measurement - University ...

The PF subscale discriminated between patient groups and detected within-group change in a
study examining outcomes in patients with advanced CAD; patients undergoing CABG
experienced significantly greater improvement at two years than those who did not receive
surgery (Kandzari et al., 2001; MOSS study). All SF-36 domains except BP and MH
discriminated between treatment groups at four months in a trial of interventional versus
conservative treatment for patients with angina or NSTEMI (Kim et al., 2005, UK; RITA-3
trial); however, these differences remained significant at one year in only four of eight
dimensions (RP, SF, V, and GH) (Kim et al., 2005, UK). Similar results were reported in the
COURAGE trial which compared the use of optimal medical therapy (OMT) alone and OMT
with PCI support (Weintraub et al., 2008). SF-36 scores in five domains (PF, RP, V, BP, GH)
showed an advantage of PCI over OMT alone up to three months; by 12 months, however, no
advantage was apparent (Weintraub et al., 2008).
The SF-36 scores discriminated patient groups by demographic characteristics in several
studies. Five of eight SF-36 domains (PF, RF, SF, RE, MH) showed that Black patients had
significantly worse outcomes than Whites at six months post-revascularisation (Kaul et al.,
2005). All SF-36 domains except MH showed significant differences between age-groups in
the study by Bradshaw et al. (2006), with younger respondents generally reporting higher
HRQoL. Significant differences between men and women in SF-36 physical component
scores (BP, GH, PF, RP) were found at three time-points in a study examining gender
differences in patients’ experience of CABG surgery (Sawatzky & Naimark, 2009b). Lower
PCS and MCS scores were significantly associated with mortality in older (≤65), but not
younger, patients following CABG and/or valve surgery (p=0.01 for PCS and p=0.03 for
MCS) (Ho et al., 2005).
In a RCT assessing the QoL of individuals undergoing PTCA (Pocock et al., 2000, UK), the
SF-36 discriminated between grades of disease severity, for both the control and the
intervention group, in the PF, VT, and GH domains, with greater disease severity resulting in
lower scores for each of these three dimensions. In a prospective study of post-CABG
patients by Lindsay et al. (2000, UK), SF-36 detected different levels of health in individuals
at a single point in time.
The SF-36 also discriminated between patient sample and population norms in several
studies. The study by Worcester et al. (2007) reported scores significantly lower than norms
on all SF-36 subscales except GH at two, four, and 12 months. In the study by Hawkes et al.
(2003), patient scores on all subscales were significantly lower than for age-matched
population norms at baseline (p≤0.05); at six months, RP and BP subscales were significantly
lower (p