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SF-6D
The SF-6D provides a method for estimating health state utility values from data obtained from patients using the SF-36 (or SF-12) health status questionnaires. The SF-6D has two parts. First, patients who have completed the SF-36 are assigned to a health state classification (i.e., SF-6D). This classification describes health on six multilevel dimensions: physical functioning, role limitations, social functioning, pain, mental health, and vitality. Second, there are algorithms for scoring each state based on values obtained from general population surveys using the standard gamble (SG). These health state utility values can be used to calculate quality-adjusted life years (QALYs) for cost-effectiveness analysis. There are two versions of the SF-6D, one for use with the SF-36 and the other for the SF-12.
Derivation of the SF-6D from SF-36
The SF-36 is the most widely used generic measure of health status in the world. It yields scores across eight dimensions and two summary scores. The SF-36 is useful for assessing changes in self-perceived health status or health-related quality of life across these eight dimensions. However, these dimension scores are derived by either simply summing responses to the SF-36 items or by the use of weights from factor analysis; as neither of these is likely to reflect people's preferences for the health states, they cannot be used in economic evaluation. Furthermore, there is no means of combining across the dimensions or combining with survival for cost-effectiveness analysis. The SF-6D was developed to estimate health state utility values from the large number of data sets collected using the SF-36.
The development of the SF-6D involved three stages. The first was the development of the SF-6D health state classification from the SF-36. The second was a valuation survey to value a sample of states defined by the SF-6D. The third stage was the econometric analysis of the health state valuation data to estimate an algorithm for scoring all states defined by the SF-6D. The first version of the SF-6D was reported in 1998, but this was substantially revised in the publication of 2002 and again in 2004. This entry only reports the latter.
SF-6D Health State Classification
The SF-6D was constructed from a selection of 11 items drawn from the SF-36. These items were selected from the SF-36 to minimize the information loss within the constraint that the resultant health state classification must be amenable to valuation. The item selection process was undertaken using evidence of the psychometric properties of the items and the factor analyses undertaken by John Ware and his colleagues in developing the SF-12.
The SF-6D has six multilevel dimensions: physical functioning, role limitation, social functioning, pain, mental health, and vitality (Table 1). The number of levels per dimension is between four and six levels of functioning or well-being, depending on the response choice categories of the original items from the SF-36. The SF-36 version of the SF-6D defines 18,000 states. The version of the SF-6D derived from the SF-12 has the same six dimensions and only differs in having just three levels for physical functioning and five for pain, which in all define 7,500 states. The SF-12 version of the SF-6D (i.e., SF-6D (12)) uses 7 items of the SF-12 (a subset of the 11 used in SF-6D (36)). Both versions of the SF-6D can be used with Versions 1 and 2 of the SF-36 and SF-12.
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- Basis for Making the Decision
- Acceptability Curves and Confidence Ellipses
- Beneficence
- Bioethics
- Choice Theories
- Construction of Values
- Cost-Benefit Analysis
- Cost-Comparison Analysis
- Cost-Consequence Analysis
- Cost-Effectiveness Analysis
- Cost-Minimization Analysis
- Cost-Utility Analysis
- Decision Quality
- Distributive Justice
- Dominance
- Equity
- Evaluating Consequences
- Expected Utility Theory
- Expected Value of Perfect Information
- Extended Dominance
- Health Production Function
- League Tables for Incremental Cost-Effectivenes: Ratios
- Marginal or Incremental Analysis, Cost-Effectiveness Ratio
- Monetary Value
- Moral Choice and Public Policy
- Net Benefit Regression
- Net Monetary Benefit
- Nonexpected Utility Theories
- Pharmacoeconomics
- Protected Values
- Rank-Dependent Utility Theory
- Return on Investment
- Risk-Benefit Trade-Off
- Subjective Expected Utility Theory
- Toss-Ups and Close Calls
- Value-Based Insurance Design
- Welfare, Welfarism, and Extrawelfarism
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- Measures of Frequency and Summary
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- Meta-Analysis and Literature Review
- Mixed and Indirect Comparisons
- Multivariate Analysis of Variance (MANOVA)
- Nomograms
- Number Needed to Treat
- Odds and Odds Ratio, Risk Ratio
- Ordinary Least Squares Regression
- Parametric Survival Analysis
- Poisson and Negative Binomial Regression
- Positivity Criterion and Cutoff Values
- Prediction Rules and Modeling
- Probability
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- Recurrent Events
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- Regression to the Mean
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- Statistical Testing: Overview
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- Subset Analysis: Insights and Pitfalls
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- Weighted Least Squares
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- Applied Decision Analysis
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- SF-36 and SF-12 Health Surveys
- SF-6D
- Sickness Impact Profile
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- Impact or Weight or Utility of the Possible Outcomes
- Certainty Equivalent
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- Conjoint Analysis
- Contingent Valuation
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- Disability-Adjusted Life Years (DALYs)
- Discounting
- Discrete Choice
- Disutility
- EuroQol (EQ-5D)
- Health Utilities Index Mark 2 and 3 (HUI2, HUI3)
- Healthy Years Equivalents
- Holistic Measurement
- Multi-Attribute Utility Theory
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- Quality of Well-Being Scale
- Quality-Adjusted Life Years (QALYs)
- Quality-Adjusted Time Without Symptoms or Toxicity (Q-TWiST)
- SMARTS and SMARTER
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- Judgment
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- Learning and Memory in Medical Training
- Lens Model
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- Preference Reversals
- Probability Errors
- Probability, Verbal Expressions of
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- Prospect Theory
- Range-Frequency Theory
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- Scaling
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- Social Judgment Theory
- Stigma Susceptibility
- Support Theory
- Uncertainty in Medical Decisions
- Unreliability of Memory
- Value Functions in Domains of Gains and Losses
- Worldviews
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