Implementation of the Short-Form 36 (SF-36) in childhood cancer survivors: An analysis on measurement properties across 5 European countries
Bibliographic record
Abstract
ABSTRACT Purpose The Short Form-36 (SF-36) is widely used in many research contexts and cultures to assess health-related quality of life (HRQOL). We investigated the measurement properties of the SF-36 in a large cohort study among childhood cancer survivors living in 5 European countries. Methods The PanCareLIFE project includes adult survivors of childhood cancer living in the Czech Republic, France, Germany, The Netherlands, and Switzerland. We invited 19,268 survivors aged >18 years, and 10,077 (53%) returned questionnaires. Of these, 9,871 (98%) were included in the analyses. We assessed HRQOL with the SF-36 version 1 (V1) or version 2 (V2) and investigated its performance. We analysed data completeness, floor and ceiling effects, item-internal consistency, item-discriminant validity, reliability, and scaling assumptions focusing on country-and version-specific differences. Results Data completeness was high but differed between countries (90% in the Czech Republic to 96% in France). Floor effects were negligible, but ceiling effects in 5 out of 8 SF-36 scales were present (50-70%). V2 had slightly fewer ceiling effects than V1 in 2 scales. Item-internal consistency, item-discriminant validity, and reliability were good. Scaling assumptions were met, with 4 scales representing strong mental health content, and the other 4 representing strong physical health content. Conclusion The SF-36 (V1 and V2) provided robust measurement properties among childhood cancer survivors, and differences in study design across the 5 European countries did not affect measurement properties. Researchers need to take into account that ceiling effects exist which might limit sensitivity among participants who fared particularly well. PLAIN ENGLISH SUMMARY This study investigated how well the Short Form-36 (SF-36), a commonly used tool for assessing health-related quality of life, performs in childhood cancer survivors from five different European countries. We looked at the amount of survivors answering to all of the SF-36 questions, how many indicated the most positive or the most negative answer category, whether the questions were consistent within the different aspects of the questionnaire and how consistent and dependable it measured quality of life in the survivors. We found that overall, the SF-36 measured health-related quality of life well in all the countries. This is reassuring for researchers considering its use in studies involving multiple centers across Europe.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.038 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".