Published in:
Open Access 01-12-2003 | Commentary
Commentary on using the SF-36 or MOS-HIV in studies of persons with HIV disease
Published in: Health and Quality of Life Outcomes | Issue 1/2003
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The purpose
was to compare and comment on use of the SF-36 and MOS-HIV instruments
in studies of persons with HIV disease. Three medical information
databases were searched to identify examples of HIV studies that
included the MOS-HIV or SF-36. Thirty-nine and 14 published articles
were identified for illustration in comparing the use of the MOS-HIV
and SF-36 in HIV disease, respectively. Support for the reliability
and construct validity of the MOS-HIV and SF-36 was found. Ceiling
and floor effects were reported for both the MOS-HIV and SF-36;
however, ceiling effects were more common for the MOS-HIV, in part
due to fewer items in the physical, social, and role functioning
domains. The MOS-HIV measures three domains hypothesized to be associated
with the health deterioration of HIV disease not measured by the
SF-36; however, these domains may not assess aspects of HIV disease
that typify the majority of the persons with HIV disease today.
National norms for the U.S. adult population (and other nations)
are available for the SF-36. In addition, the SF-36 has been used
in a wide variety of patient populations, enabling comparisons of
HIV-infected persons with persons with other health conditions.
No national norms for the MOS-HIV are available. We conclude that
there is currently insufficient evidence in the literature to recommend
the use of the MOS-HIV over the SF-36 in HIV-infected persons. Although
the SF-36 is not targeted at HIV, it may be preferable to use the
SF-36 over the MOS-HIV due to fewer ceiling effects, availability
of national norms, and the vast amount of data for other populations
in the U.S. and around the world. Head-to-head comparisons demonstrating
the unique value of the MOS-HIV over the SF-36 are clearly needed.
More importantly, additional work needs to be directed at comparing
the MOS-HIV and other putatively HIV-targeted instruments to one
another to help demarcate aspects of HRQOL that are truly generic
versus specific to HIV disease. Using both a generic and targeted
HRQOL measure is a good general strategy, but this has not been
a typical practice in studies of HIV because the MOS-HIV is so similar
in content to the SF-36.