Abstract
Purpose. Quality of life in multiple sclerosis has been often measured through the SF-36 questionnaire. In this study, validation of the SF-36 summary scores, its 'physical' component, and its 'mental' component was attempted by exploring the joint predictive power of disability (EDSS score), of anxiety and depression (HADS-A and -D scores, respectively), and of disease duration, progression type, age, gender and marital status. Method. The sample consisted of 75 patients suffering from multiple sclerosis admitted to an inpatient rehabilitation unit. The interplay between potential predictors was assessed through a particular regression model (classification and regression tree, CART). Two main advantages of this technique are its robustness with respect to distributional assumptions (rarely met by scores coming in from questionnaires) and its sensitivity to high-order interactions, between independent variables, difficult to detect through conventional multiple regression. Results. Predictive variables for physical component of the SF-36 were EDSS and HADS-D (36.8% variance explanation). The only predictive variable for mental component of SF-36 was HADS-D (39.1% variance explanation). Conclusion. Results confirm previous findings showing that in patients with multiple sclerosis quality of life is heavily determined by person's mood, whatever his/her neurological or functional severity. The usefulness and validity of the SF-36 as an index representative of quality of life is debatable, as long as depression explains much of its variance. Further refinement of quality of life definition and measurement is worth further psychometric and statistical research.
| Original language | English |
|---|---|
| Pages (from-to) | 307-314 |
| Number of pages | 8 |
| Journal | Disability and Rehabilitation |
| Volume | 28 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Mar 2006 |
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Keywords
- CART
- Depression
- EDSS
- Measure
- Multiple sclerosis
- Quality of life
- SF-36
ASJC Scopus subject areas
- Rehabilitation
- Health Professions(all)
Cite this
Depression is the main determinant of quality of life in multiple sclerosis : A classification-regression (CART) study. / D'Alisa, S.; Miscio, G.; Baudo, S.; Simone, A.; Tesio, L.; Mauro, A.
In: Disability and Rehabilitation, Vol. 28, No. 5, 03.2006, p. 307-314.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Depression is the main determinant of quality of life in multiple sclerosis
T2 - A classification-regression (CART) study
AU - D'Alisa, S.
AU - Miscio, G.
AU - Baudo, S.
AU - Simone, A.
AU - Tesio, L.
AU - Mauro, A.
PY - 2006/3
Y1 - 2006/3
N2 - Purpose. Quality of life in multiple sclerosis has been often measured through the SF-36 questionnaire. In this study, validation of the SF-36 summary scores, its 'physical' component, and its 'mental' component was attempted by exploring the joint predictive power of disability (EDSS score), of anxiety and depression (HADS-A and -D scores, respectively), and of disease duration, progression type, age, gender and marital status. Method. The sample consisted of 75 patients suffering from multiple sclerosis admitted to an inpatient rehabilitation unit. The interplay between potential predictors was assessed through a particular regression model (classification and regression tree, CART). Two main advantages of this technique are its robustness with respect to distributional assumptions (rarely met by scores coming in from questionnaires) and its sensitivity to high-order interactions, between independent variables, difficult to detect through conventional multiple regression. Results. Predictive variables for physical component of the SF-36 were EDSS and HADS-D (36.8% variance explanation). The only predictive variable for mental component of SF-36 was HADS-D (39.1% variance explanation). Conclusion. Results confirm previous findings showing that in patients with multiple sclerosis quality of life is heavily determined by person's mood, whatever his/her neurological or functional severity. The usefulness and validity of the SF-36 as an index representative of quality of life is debatable, as long as depression explains much of its variance. Further refinement of quality of life definition and measurement is worth further psychometric and statistical research.
AB - Purpose. Quality of life in multiple sclerosis has been often measured through the SF-36 questionnaire. In this study, validation of the SF-36 summary scores, its 'physical' component, and its 'mental' component was attempted by exploring the joint predictive power of disability (EDSS score), of anxiety and depression (HADS-A and -D scores, respectively), and of disease duration, progression type, age, gender and marital status. Method. The sample consisted of 75 patients suffering from multiple sclerosis admitted to an inpatient rehabilitation unit. The interplay between potential predictors was assessed through a particular regression model (classification and regression tree, CART). Two main advantages of this technique are its robustness with respect to distributional assumptions (rarely met by scores coming in from questionnaires) and its sensitivity to high-order interactions, between independent variables, difficult to detect through conventional multiple regression. Results. Predictive variables for physical component of the SF-36 were EDSS and HADS-D (36.8% variance explanation). The only predictive variable for mental component of SF-36 was HADS-D (39.1% variance explanation). Conclusion. Results confirm previous findings showing that in patients with multiple sclerosis quality of life is heavily determined by person's mood, whatever his/her neurological or functional severity. The usefulness and validity of the SF-36 as an index representative of quality of life is debatable, as long as depression explains much of its variance. Further refinement of quality of life definition and measurement is worth further psychometric and statistical research.
KW - CART
KW - Depression
KW - EDSS
KW - Measure
KW - Multiple sclerosis
KW - Quality of life
KW - SF-36
UR - http://www.scopus.com/inward/record.url?scp=33644583206&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33644583206&partnerID=8YFLogxK
U2 - 10.1080/09638280500191753
DO - 10.1080/09638280500191753
M3 - Article
C2 - 16492625
AN - SCOPUS:33644583206
VL - 28
SP - 307
EP - 314
JO - Disability and Rehabilitation
JF - Disability and Rehabilitation
SN - 0963-8288
IS - 5
ER -