A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors

Qual Life Res. 2015 Feb;24(2):339-62. doi: 10.1007/s11136-014-0785-6. Epub 2014 Aug 20.


Purpose: A systematic review of the validity, reliability and sensitivity of the Short Form (SF) health survey measures among breast cancer survivors.

Methods: We searched a number of databases for peer-reviewed papers. The methodological quality of the papers was assessed using the COnsenus-based Standards for the selection of health Measurement INstruments (COSMIN).

Results: The review identified seven papers that assessed the psychometric properties of the SF-36 (n = 5), partial SF-36 (n = 1) and SF-12 (n = 1) among breast cancer survivors. Internal consistency scores for the SF measures ranged from acceptable to good across a range of language and ethnic sub-groups. The SF-36 demonstrated good convergent validity with respective subscales of the Functional Assessment of Cancer Treatment-General scale and two lymphedema-specific measures. Divergent validity between the SF-36 and Lymph-ICF was modest. The SF-36 demonstrated good factor structure in the total breast cancer survivor study samples. However, the factor structure appeared to differ between specific language and ethnic sub-groups. The SF-36 discriminated between survivors who reported or did not report symptoms on the Breast Cancer Prevention Trial Symptom Checklist and SF-36 physical sub-scales, but not mental sub-scales, discriminated between survivors with or without lymphedema. Methodological quality scores varied between and within papers.

Conclusion: Short Form measures appear to provide a reliable and valid indication of general health status among breast cancer survivors though the limited data suggests that particular caution is required when interpreting scores provided by non-English language groups. Further research is required to test the sensitivity or responsiveness of the measure.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms*
  • Female
  • Health Status
  • Health Surveys*
  • Humans
  • Middle Aged
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Survivors / psychology*