The VR-12 is a brief, generic measure of overall physical and mental health. This page explains what the VR-12 is, what it measures, the items it contains, how it is scored, and how it is used.
What is the VR-12?
The VR-12 (Veterans RAND 12-Item Health Survey) is a twelve-item, self-reported measure of general health-related quality of life. It was developed from the Veterans RAND 36-Item Health Survey (VR-36), which itself derived from the RAND/Medical Outcomes Study SF-36. It is designed to reproduce much of the information of the longer survey with fewer questions and is used as a generic health measure across many conditions and populations.
What does the VR-12 measure?
The VR-12 summarizes health into two scores: a Physical Component Summary (PCS) and a Mental Component Summary (MCS). Its items map to eight health domains: general health perceptions, physical functioning, role limitations due to physical problems, role limitations due to emotional problems, bodily pain, energy/fatigue (vitality), social functioning, and mental health.
What questions are included in the VR-12?
The twelve items ask respondents to rate their general health; whether physical health limits moderate activities and stair climbing; whether physical health has caused them to accomplish less or be limited in the kind of work or activities they do; whether emotional problems have caused them to accomplish less or be less careful; how much pain has interfered with normal work; and how much of the time they have felt calm, had energy, or felt downhearted, as well as whether physical or emotional health has interfered with social activities. Most items use five-point response options.
How is the VR-12 scored?
Item responses are combined using published scoring algorithms into the PCS and MCS. Scores are standardized to a T-score metric in which the U.S. general population averages 50 on both the PCS and MCS, with a standard deviation of 10. Higher scores indicate better self-reported health, so a score of 60 is one standard deviation better than the population average. Because scoring uses weighted algorithms rather than a simple sum, it is typically calculated with a scoring program.
How is the VR-12 used in clinical practice?
The VR-12 is used to capture overall physical and mental health at baseline and over time, often alongside a condition-specific PROM, and it is used in registries and quality measurement. Its component scores can also be linked to other global-health metrics, and it has established reliability and validity in general and comorbid patient populations.
Strengths and limitations
Strengths include brevity, a standardized and comparable T-score metric, and a strong lineage from the widely used SF-36 family. Limitations include being generic rather than condition-specific, reduced sensitivity to small joint-specific changes, and reliance on a scoring algorithm rather than simple summation.
Frequently asked questions
What do the PCS and MCS mean? They are the Physical and Mental Component Summary scores; both are standardized so 50 is the U.S. population average.
Is higher better on the VR-12? Yes. Higher component scores indicate better self-reported health.
How is the VR-12 related to the SF-12? Both descend from the SF-36 family and produce PCS and MCS scores, but they use differently worded items and separate scoring algorithms.
References
- Kazis LE, Miller DR, Skinner KM, et al. Applications of methodologies of the Veterans Health Study in the VA healthcare system: conclusions and summary. Journal of Ambulatory Care Management. 2006;29(2):182-188.
- Selim AJ, Rogers W, Fleishman JA, et al. Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). Quality of Life Research. 2009;18(1):43-52.
- Ware JE, Kosinski M, Keller SD. A 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care. 1996;34(3):220-233.
