|
Author:
|
Garín, Olatz; Ferrer, Montse; Pont, Àngels; Rué i Monné, Montserrat; Kotzeva, Anna; Wiklund, Ingela; Van Ganse, Eric; Alonso, Jordi
|
|
Notes:
|
Background Heart failure (HF) is an increasingly common
condition affecting patients’ health-related quality of
life (HRQL). However, there is little literature comparing
HF-specific instruments. Our aim was to evaluate
and compare data on the conceptual model and metric
properties (reliability, validity and responsiveness) of
HF-specific HRQL instruments, by performing a systematic
review with meta-analyses.
Methods and results Of 2,541 articles initially identified,
421were full-text reviewed. Ninety-four reported data on five
questionnaires: Minnesota Living with Heart Failure Questionnaire
(MLHFQ), Chronic Heart Failure Questionnaire
(CHFQ), Quality of Life Questionnaire for Severe
Heart Failure (QLQ-SHF), Kansas City Cardiomyopathy
Questionnaire (KCCQ) and Left Ventricular Dysfunction
(LVD-36) questionnaire. Metric properties (reliability,
validity and responsiveness) were summarised using metaanalysis
for pools above five estimates. Cronbach’s alpha
coefficientswere generally high (0.83–0.95) for overall scores
and scales measuring physical health. Associations with four
validity criteria (New York Heart Association [NYHA] class,
six-minute walk test [6MWT] and short form-36 [SF-36]
‘Physical’ and ‘Social Functioning’) were moderate to strong
(0.41–0.84), except for those between two CHFQ domains
(fatigue and dyspnoea) and theNYHA(0.19 and 0.22). Pooled
estimates of change from eight meta-analyses showed the
MLHFQ to be highly responsive, with changes in overall
score ranging from-9.6 (95%confidence interval [CI]:-4.1;
-15.2) for placebo to -17.7 (95% CI: -15.3; -20.2) for pacing devices. The CHFQ and KCCQ also showed good
sensitivity to change.
Conclusions Most of the questionnaires studied met
minimum psychometric criteria, though current evidence
would primarily support the use of the MLHFQ, followed
by the KCCQ and CHFQ.
This study has been supported by the European Union (QLRI-CT-2000-00551), the CIRIT-Comisio Interdepartamental (2001 Sol licitud Grups de Recerca 00405), and the Instituto de Salud Carlos III (SAF2002-11009-E). |
