Performance of health-related quality-of-life instruments in a spinal cordinjured population

Objective: General health-related quality-of-life (HRQoL) surveys have not been well tested in populations with spinal cord injury (SCI), This study e valuated the performance of 5 such instruments, Design: A cross-sectional survey with instruments administered in random or der during computer-assisted interviews. Setting: A midwestern US veteran SCI program. Subjects: One hundred eighty-three veterans with SCI ranging in age from 21 to 81 yrs (mean = 50.5). Measures: The Behavioral Risk Factor Surveillance System (BRFSS) HRQoL modu les, the Quality of Well-Being scale (QWB), the Medical Outcomes Study Shor t-Form 36 and Short-Form 12 (SF-36, SF-12), and instrumental activities of daily living (IADL). Results: Construct validity was supported by scores from the QWB, IADL, and physical health measures of the BRFSS and SF-36 showing greater impairment for quadriplegia than paraplegia, Similar constructs on the SF-36 and BRFS S were more strongly correlated than between the IADL and QWB; eg, correlat ion between the SF-36 Vitality scale and the BRFSS "Days full of energy" qu estion was r = .789 (p < .01), whereas correlation between the IADL and QWB was r = -.454 (p < .01), Longer surveys (SF-36, QWB) were rated lower in s ubject acceptability. Conclusions: These instruments have potential for research use among patien ts with SCI, More studies are needed to explore the best use of instruments with apparently different domains. (C) 1999 by the American Congress of Re habilitation Medicine and the American Academy of Physical Medicine and Reh abilitation.