Okunrintemi et al.1 found that those who scored between 4 and 6 (“high risk” for depression) versus between 0 and 3 (“low risk” for depression) on the 2-item Patient Health Questionnaire depression had worse SF-12 PCS and MCS scores and worse reported self-rated general health (In general, would you say your health is: excellent, very good, good, fair, poor). In addition, those with a clinical diagnosis of depression (ICD-9-M Code of 311) had worse SF-12 PCS and MCS scores and self-rated health than those without depression. The finding that depressive symptoms and depression are associated with SF-12 MCS scores is circular because the SF-12 assesses mental health. While the standard scoring of the SF-12 forces the PCS and MCS to be uncorrelated, depression is correlated with physical health.2 In addition, the self-rated general health item is one of the SF-12 questions.
Moreover, the authors incorrectly state that the SF-12 PCS and MCS scores range from “0 to (worst health status possible) to 100 (best health status possible)” (p. 2429). The PCS and MCS are scored on a T-score metric with a mean of 50 and standard deviation of 10 in the US general population.
The authors refer to the excellent, very good, good, fair, and poor response scale as a “Likert scale.”2 Technically, a Likert scale uses an agree-disagree response scale. Not all polytomous response scales are Likert scales.3
The authors call the CAHPS overall rating of healthcare item a measure of patient satisfaction. No articles published by the CAHPS instrument developers are cited and there is no reference to the CAHPS website4 where it is noted that the “terms patient satisfaction and patient experience are often used interchangeably, but they are not the same thing.”
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Okunrintemi V, Valero-Elizondo Micos ED, Salami JA, et al. Association of depression risk with patient experience, healthcare experience, and health resource utilization among adults with atherosclerotic cardiovascular disease. J Gen Intern Med. 2019;34:2427–34. doi: 10.1007/s11606-019-05325-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Farivar SS, Cunningham WE, Hays RD. Correlated physical and mental health summary scores for the SF-36 and SF-12 health survey, V. 1. Health Qual Life Outcomes. 2007;5:54. [DOI] [PMC free article] [PubMed]
- 3.Uebersax JS. Likert Scales: Dispelling the Confusion. Available at: http://www.john-uebersax.com/stat/likert.htm. Accessed November 20, 2019.
- 4.Agency for Healthcare Research and Quality. What is Patient Experience? Available at: https://www.ahrq.gov/cahps/about-cahps/patient-experience/index.html. Accessed November 20, 2019.