Validity and reliability of the Italian translation of the MOS-HIV health survey in persons with AIDS

Objectives: To evaluate the validity and reliability of the Italian version of the 35-item Medical Outcome Study HIV Health Survey (MOS-HIV) when applied to persons with AIDS. Methods: The study population consisted of 185 adults with AIDS residing in Rome and participating in a randomised controlled trial on home-care. Diagnosis was made between 1 October 1994 and 1 April 1996, and enrollment took place within 2 months of diagnosis. The MOS-HIV, which measures 10 dimensions of health-related quality of life (QoL), was administered at baseline and every 3 months thereafter during the 1-year follow-up. Tests of convergent and concurrent construct validity were conducted for all scales. Results: Of the 185 trial participants, 146 responded to the questionnaire; 82 responded at least twice (including baseline collection) during follow-up. For the role functioning, general health, and vitality scales, the distribution of scale scores was concentrated at the lower half of the range. Internal consistency reliability was adequate (>0.80) for all scales. Baseline scores tended to increase with decreasing AIDS severity and with increasing age. There were improvements over time in the role functioning, vitality, and health distress scales. Conclusions: The MOS-HIV had good reliability among persons with AIDS. There was a moderate floor effect for some of the subscales. Tests of convergent and construct validity were generally confirmed. Additional studies are needed to evaluate the responsiveness to changes over time.     

ISSQoL: A New Questionnaire for Evaluating the Quality of Life of People Living with HIV in the HAART Era*

Objective: To design a Health-related Quality of Life (HRQoL) instrument for HIV-infected people in the era of highly active antiretroviral therapy (HAART). Methods: The self-administered questionnaire was developed by an Italian network including researchers, physicians, people living with HIV, national institutions and community-based organizations (CBO) through several steps: (1) review of existing HRQoL literature and questionnaires for HIV-infected people; (2) selection of relevant domains measuring HRQoL in HIV-infected people, and identification of new domains related to new aspects of HRQoL concerning HAART-treated individuals; (3) conduction of two pre-test analyses in independent groups of Italian HIV-positive people (n≌100) distributed throughout the country. The objectives of the first pre-test were to verify the usefulness of the questionnaire, to construct a form easily understandable by everyone, to define the domains and their significance; the second pre-test aimed at evaluating and reshaping the questionnaire based on a statistical analysis of the outcomes of first pre-test; (4) validation analysis. A large cohort of people with HIV infection was recruited for the last step.Results: The internal consistence reliability (Cronbach’s α) was ≥0.70 for all domains. Most domains had Cronbach’s coefficient >0.80. All domains demonstrated convergent and discriminant validity. The final version of ISSQoL includes two sections: HRQoL Core Evaluation Form (9 domains) and Additional Important Areas for HRQoL (6 domains). The ISSQoL was administered together with two additional forms: a Daily Impact of Symptoms Form and a Demographic Information Form. The Additional Important Areas for HRQoL include social support, interaction with medical staff, treatment impact, body changes, life planning, and motherhood/fatherhood.Conclusion: The data reported in the present paper provide preliminary evidence of the reliability and validity of the ISSQoL questionnaire for the measurement of HRQoL in HIV-infected people. The direct involvement of HIV-positive people in all the phases of the project was a key aspect of our work. All the authors of this paper belong to ISSQoL Group.     

Reliability and validity of Thai versions of the MOS-HIV and SF-12 quality of life questionnaires in people living with HIV/AIDS

Background/Aim  

As Thai people living with HIV/AIDS gain increasing access to antiretroviral (ARV) therapy, it is important to evaluate the impact this has not only on clinical outcomes, but also on patients' functional status and well-being. In this study, we translated, culturally adapted and tested the reliability and validity of two widely-used health-related quality of life questionnaires - the MOS-HIV Health Survey and the SF-12 - in people living with HIV/AIDS in Northern Thailand. Methods: Questionnaires were administered to 100 patients at community hospital outpatient ARV clinics in northern Thailand. Reliability was estimated using Cronbach's alpha, while evidence for validity was tested using known-groups comparison based on CD4 group, symptom distress score, bed days and days of reduced activity in the past three months.     

Validation of a Chinese version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) among Chinese people living with HIV/AIDS in Hong Kong

Objectives: To evaluate the Chinese version of the 35-item Medical Outcomes Study HIV Health Survey (MOS-HIV) in Chinese people living with HIV/AIDS (PLWHA). Methods: A cross-sectional survey of 242 ethnic Chinese PLWHA in Hong Kong was conducted. Results: Cronbach’s αs of the eight multi-item scales of the MOS-HIV ranged from 0.78 to 0.90. Item-total and inter-scale correlation coefficients were acceptable. Factor analysis of the MOS-HIV identified two factors (Mental Health Summary scores and Physical Health Summary scores, or MHS and PHS), accounting for 63% total variance. The PHS and MHS correlated significantly with the WHOQOL-BREF(HK) and the three sub-scales of Profile of Mood States used in this study. Both PHS and MHS were significantly associated with self-perceived change in health status. PHS but not MHS was associated with Karnofsky Performance Status scores. PHS was also associated with disease stage. The MOS-HIV however, did not distinguish between groups of different CD4 cell counts. It is likely that the quality of life of these PLWHA of different disease stages was good in general. Conclusions: There is a large demand for evaluating treatments and services programs offered to PLWHA in China. The validated Chinese MOS-HIV would facilitate such research activities.     

Validation of the McCoy Female Sexuality Questionnaire in an Italian Sample

This article presents the result of a study that translated into Italian and validated the McCoy Female Sexuality Questionnaire (MFSQ) on an Italian sample. The questionnaire was first administered to a sample of 240 Italian women (age range, 18–65 years) recruited from a gynecology clinic. A principal component analysis identified 2 factors: sexuality (9 items) and partnership (5 items). Both factors showed an adequate inter-item reliability (Cronbach's α of .88 and .75, respectively). The validity of the Italian MFSQ was then tested by administering the questionnaire to a sample of 16 women with sexual dysfunction and 46 control women. Sexual dysfunction diagnoses were assessed through a semi-standardized interview based on the DSM-IV-TR diagnoses for Female Sexual Arousal Disorder, Female Orgasmic Disorder, Dyspareunia, and Hypoactive Sexual Desire Disorder. A discriminant validity test showed significant differences between women with and without female sexual dysfunction. These results indicate that the translated version of the MFSQ is a reliable and valid measure of sexual dysfunction among Italian women. The results also indicated a difference in factor structure between the Italian and the original version of the MFSQ, which warrants further investigation.     

Validation of a Specific Questionnaire on Psychological and Social Repercussions of the Lipodystrophy Syndrome in HIV-infected Patients

Objective: To validate a questionnaire to identify psychosocial repercussions of the lipodystrophy syndrome (LD) in HIV-infected patients. Methods: A questionnaire containing 35 items in 6 subscales [body image, anxiety, depression, social support, social distress, quality of life (QoL)] was consecutively administered to 128 patients with LD, 25 naïve patients or on therapy without LD, and to 15 HIV negative patients from January to July ’04. Reliability was assessed using Cronbach’s alpha and the intraclass correlation coefficient (ICC). The area under the curve (AUC) was used for discrimination between patients and control groups, and the scores were compared according to the severity of the LD. Results: In all the subscales, the relationship between higher scores and LD severity was statistically significant (0.37–0.64, p<0.01), whereas the control groups had significantly lower scores. The internal consistency showed Cronbach’s alpha coefficients ranging from 0.64 to 0.93. Test–retest reliability after 15 days in 30 patients showed ICC values of 0.8–0.94. AUC values for the different subscales were higher than 0.7 with the exception of QoL score, and construct validity showed a significant correlation with the Beck Depression Inventory and the MOS-HIV scores (0.49 and 0.51, respectively, p<0.01). Conclusions: Our questionnaire shows satisfactory psychometric properties for identifying psychosocial repercussions of the LD in HIV-infected patients.     

Quality of life among people living with HIV/AIDS in northern Thailand: MOS-HIV Health Survey

OBJECTIVES: Translation and psychometric evaluation of a Thai version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) in Thailand. METHODS: A cross-sectional survey in Chiang Mai province, northern Thailand, with data collected in face-to-face interviews using a structured questionnaire designed to measure 10 scales of quality of life (QOL). We recruited 200 people with HIV/AIDS attending self-help groups in the municipal area. Standard guidelines were followed for questionnaire translation and psychometric evaluations. RESULTS: Item-level internal consistency and discriminant validity were reasonably established. Success rates were 93.8 and 97.4%, respectively. Scale-level internal consistency reliability of multi-item scales was satisfactory, ranging from 0.74 to 0.88, with all exceeding inter-scale correlations. Principal components analysis of item and scale scores identified two hypothesized dimensions of the MOS-HIV. The mental health component was strongly loaded by health distress, mental health, vitality and cognitive function scales, and physical health by role, physical and social functions, and pain scales. Respondents manifesting symptoms or reporting worsening health status scored significantly lower on all scales. CONCLUSIONS: These preliminary studies have shown the Thai version of the MOS-HIV to have psychometric properties comparable with those reported in previous surveys. Further testing and modification should make it useful as an HIV-specific QOL measure in Thailand.     

The EORTC Quality of Life Questionnaire-Head and Neck 35 in Italian Laryngectomized Patients

The aim of this study was to test the validity and reliability of the European organization for research and treatment of cancer (EORTC) quality of life questionnaire (QLQ)-head and neck (H&N) 35 in Italian laryngeal cancer patients. The original questionnaire was developed by the EORTC quality of life (QoL) study group and tested in H&N cancer patients from Norway, Sweden, and the Netherlands. The Italian translation of the questionnaire used in this study was made by a team of the CRO, National Cancer Institute, using a double-back translation method between independent translators. The translated EORTC QLQ-H&N35 was given to 99 patients with H&N cancer who had undergone total laryngectomy 1–26 years before and had been then treated with radiotherapy and, in some cases, chemotherapy. The questionnaire was re-administrated to 33 patients after 1 month to test its stability over time. It was structurally made up of seven scales (pain, swallowing, sense, speech, social eating, social contact, and sexuality) and 11 single items that considered the most important clinical aspects characterizing the QoL in H&N cancer patients. The statistical analysis of the indexes of validity and reliability confirmed the results obtained with other linguistic versions of the questionnaire. Our Italian version of the EORTC QLQ-H&N35 proved to be a statistically valid instrument to assess QoL in laryngectomized patients. This revised version was published online in June 2006 with corrections to the Cover Date.     

Assessment of validity and clinical application of an Italian version of the Rotterdam Symptom Checklist

An Italian version of the Rotterdam Symptom Checklist (RSCL) has been validated in a sample of 147 healthy women and 61 breast cancer outpatients. The structure of the RSCL has been analysed by factor analysis reproducing results of the English version, and the psychological and physical subscales showed a good internal reliability (Chronbach's alpha 0.91; 0.87). The State-Trait Anxiety Inventory questionnaire and the RSCL were compared in the healthy women sample. A Pearson correlation coefficient (PCC) of 0.74 (p<0.01) was found between the trait anxiety and RSCL psychological scores. Psychological (mean: 17.5; SD: ±5.4) and physical (mean: 37.8; SD: ±8.6) subscale scores were correlated in general wellbeing item (PCC: 0.44; p<0.01). The breast cancer outpatients showed scores for psychological and physical subscales similar to those in the healthy women sample. The Italian version of the RSCL seems comparable to the English version and could be useful in clinical research. Its use in longitudinal studies should be tested.This study was supported by the Italian Association Against Cancer (AIRC).     

The use of two measures of health-related quality of life in HIV-infected individuals: a cross-sectional comparison

Two measures of health-related quality of life in 65 HIV-infected individuals were compared in a cross-sectional design. The Quality of Well-Being Scale (QWB) results in a single score ranging from death to perfect health. The MOS-HIV Health Survey (MOS-HIV, 34-item version) gives scores in 11 dimensions. The QWB score distinguished subjects with AIDS from those who were asymptomatic (p=0.027). For the seven multi-item scales of the MOS-HIV, Cronbach's alpha ranged from 0.85–0.95, indicating good internal consistency reliability. Clinical HIV-infection status was significantly associated with the dimensions of Overall Health (p=0.002), Role Function (p=0.022), Social Function (p=0.037), Energy/Fatigue (p=0.027) and Health Distress (p=0.025). All eleven dimensions of the MOS-HIV were significantly correlated with the QWB score (Spearman's coefficient = 0.405–0.670; for all, p<0.01) and the QWB score could be predicted from the MOS-HIV dimension scores using multiple regression. The QWB and the MOS-HIV may be useful in assessing health-related quality of life in patients infected with HIV.Funding support for this study provided by the Center for Pharmaceutical Economics of the University of Arizona.     

US and UK versions of the EQ-5D preference weights: Does choice of preference weights make a difference?

Background Most US studies that estimate EQ-5D index score generally apply the UK preference weights. We compared the validity of a newly-developed US weights to the UK weights for use of EQ-5D as a measure of health-related quality of life. Methods Data were collected from a randomized clinical trial for patients with HIV (n = 1,126) in the US. Convergent validity was examined by comparing Pearson correlations of EQ-5D index scores with the MOS-HIV Health Survey scale scores and Physical and Mental Health Summary (PHS, MHS) scores using the US and UK weights. Known-groups validity of EQ-5D US versus UK index scores was compared using clinical variables (CD4+ cell count and HIV viral load), and the MOS-HIV PHS and MHS. Score changes in the EQ-5D index from baseline to week 50 were examined using effect size (ES) estimates. Results The mean EQ-5D index scores was slightly higher using US weights than UK weights (0.87 vs. 0.84, respectively). The correlation coefficient for EQ-5D utilities using the US and UK weights was 0.98. The correlations of EQ-5D index scores with the MOS-HIV scores were moderate and similar using the US and UK weights. The EQ-5D index scores discriminated equally well for both versions between levels of CD4+ count, HIV viral load, and PHS and MHS scores (P < 0.05), suggesting equivalent known-groups validity. The changes in EQ-5D index scores from baseline to week 50 were similar for both versions (ES: 0.21 vs. 0.22 for US and UK, respectively), suggesting equivalent responsiveness to score changes. Conclusions EQ-5D index scores generated using UK and US preference weights showed equivalent psychometric properties. For assessing treatment benefit in a single population, the use of either the UK or US weights as a measure of HRQOL will not change inferences. However, for comparisons across US and UK populations, the choice between these two weights should be based on their relevance to the study population.     

A Chinese Mandarin translation and validation of the Myocardial Infarction Dimensional Assessment Scale (MIDAS)

Aims: To evaluate the validity, reliability, and cultural relevance of the Chinese Mandarin version of Myocardial Infarction Dimensional Assessment Scale (MIDAS) as a disease-specific quality of life measure. Methods: The cultural relevance and content validity of the Chinese Mandarin version of the MIDAS (CM-MIDAS) was evaluated by an expert panel. Measurement performance was tested on 180 randomly selected Chinese MI patents. Thirty participants from the primary group completed the CM-MIDAS for test–retest reliability after 2 weeks. Reliability, validity and discriminatory power of the CM-MIDAS were calculated. Results: Two items were modified as suggested by the expert panel. The overall CM-MIDAS had acceptable internal consistency with Cronbach’s α coefficient 0.93 for the scale and 0.71–0.94 for the seven domains. Test–retest reliability by intraclass correlations was 0.85 for the overall scale and 0.74–0.94 for the seven domains. There was acceptable concurrent validity with significant (p < 0.05) correlations between the CM-MDAS and the Chinese Version of the Short Form 36. The principal components analysis extracted seven factors that explained 67.18% of the variance with high factor loading indicating good construct validity. Conclusion: Empirical data support CM-MIDAS as a valid and reliable disease-specific quality of life measure for Chinese Mandarin speaking patients with myocardial infarction.     

Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV)

The Medical Outcomes Study HIV Health Survey (MOS-HIV) is a brief, comprehensive measure of health-related quality of life (HRQoL) used extensively in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The 35-item questionnaire includes ten dimensions (health perceptions, pain, physical, role, social and cognitive functioning, mental health, energy, health distress and quality of life (QoL)) and takes approximately 5 minutes to complete. Subscales are scored on a 0–100 scale (a higher score indicates better health) and physical and mental health summary scores can be generated. The MOS-HIV has been shown to be internally consistent, correlate with concurrent measures of health, discriminate between distinct groups, predict future outcomes and be responsive to changes over time. Limited experience suggests acceptable reliability and validity in women, injecting drug users and African–American and lower socioeconomic status patients. The MOS-HIV is available in 14 languages and has been included as a secondary outcome measure in numerous clinical trials for all stages of disease. In several studies it has detected significant differences between treatments; in some cases concordant with conventional end-points and, in others, discordant. The interpretation of scores is facilitated by an explanation in terms meaningful to the intended audience. Research is needed to compare the MOS-HIV to other strategies for HRQoL assessment in early HIV disease.     

Validation of the Italian version of the EUROPEP instrument for patient evaluation of general practice care

Objective: To describe the validity and reliability of the Italian version of the EUROPEP instrument for patient evaluation of general practice care. Methods: A survey was performed among patients who visited a general practice (n=983), using the 23-item EUROPEP questionnaire. The scores are aggregated in two dimensions: “clinical behaviour” and “organization of care”. The cultural adaptation of the questionnaire into Italian has been performed by using the formal translation procedures applied in other European countries. Data were analysed with respect to item response rate, item–scale correlation, internal consistency reliability and construct validity of the instrument. Results: The item response rate was good for 17 items, acceptable for four items and problematic for one item. The item–scale correlation largely exceeded a value of 0.40 for all items in both scales. The internal consistency of the aggregated scores was also very good, the reliability coefficients being 0.95 for “clinical behaviour” and 0.90 for “organization of care”. As expected, older age and better health status were associated with more positive evaluation of care.

Conclusion: Our study confirms that, even in its Italian version, the EUROPEP is a valid and easy-to-use instrument for gathering information on patients’ experience with and evaluation of general practice care.     

Reliability, validity and responsiveness of the German Short Musculoskeletal Function Assessment Questionnaire in patients undergoing surgical or conservative inpatient treatment

Objective: The patient-based evaluation of outcome is gaining increased importance. The aim of the study was to demonstrate the reliability, validity and responsiveness of the German version of the Short Musculoskeletal Function Assessment Questionnaire (SMFA-D) in patients undergoing surgical or conservative treatment. Methods: Three hundred and thirty-two patients suffering from osteoarthritis of the hip or knee, rheumatoid arthritis or rotator cuff tear undergoing surgical or medical inpatient treatment were followed up for 12 month. Patients underwent both SMFA-D and other assessments and clinical as well as radiological examinations. Reliability, validity and responsiveness of the SMFA-D were evaluated. Results: Values of the SMFA-D subscales, Function index (M 22–49, SD 12–20, range 0–96) and Bother index (M 29–52, SD 15–23, range 0–100), showed a normal distribution. Internal consistency (0.88–0.97) and retest reliability (0.71–0.96) coefficients were satisfactory to excellent. In most cases, the SMFA-D correlated significantly with function tests, physicians’ function ratings, patients’ pain ratings and other quality-of-life questionnaires in all patient subgroups. The results support both the construct and criterion validity of the measure. Different patient groups and subgroups could be discriminated with the SMFA-D scales. The standardized response means of SMFA-D subscales were in surgical patients better than in conservatively treated patients and comparable to those of the SF-36 Physical Component Summary scale. Conclusions: The German version of SMFA is a reliable, valid and responsive questionnaire in patients with osteoarthritis of the hip or knee, rheumatoid arthritis or rotator cuff tear undergoing surgical or medical inpatient treatment. Thus, the use of the SMFA-D in these patients can be recommended.     

Validity and Reliability of the Italian Version of the Quality of Life,Enjoyment and Satisfaction Questionnaire

The Quality of Life, Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is increasingly used in psychiatry because it gives emphasis to the subjective perspective of patients on physical, psychological and social domains. This paper reports on the validation of the Italian version of the Q-LES-Q in a large multicenter study (EQUIP) conducted at five Italian sites on outpatients in treatment for anxiety disorders. Study participants underwent a broad assessment of psychopathology including the MINI-International Neuropsychiatric Interview, the Symptom Checklist (SCL-90) and the Clinical Global Impression (CGI). Cronbach’s alpha was used to determine the internal consistency of the Q-LES-Q areas and Pearson’s r was used to analyze the correlation between the areas of Q-LES-Q and those of the other instruments. The internal consistency of the Q-LES-Q proved to be substantial (>0.80 in each of the areas) as well as the test–retest reliability. The convergent validity of the Q-LES-Q vs. the Work and Social Adjustment Scale was examined. High correlations were found between scales measuring similar constructs in the two instruments and lower correlation between scales measuring different constructs. In conclusion, the Italian version of the Q-LES-Q proved to be as valid and reliable as the original English version.     

The concurrent validity and responsiveness of the health utilities index (HUI 3) among patients with advanced HIV/AIDS

Objectives  To assess the concurrent validity and responsiveness of the Health Utility Index 3 (HUI3) in patients with advanced HIV/AIDS, and to determine the responsiveness of this measure, the MOS-HIV and EQ-5D to HIV-related clinical events. Methods  Data from the OPTIMA (OPTions In Management with Antiretrovirals) trial was analyzed. Two aspects of the validity of the HUI3 were considered: concurrent validity was evaluated using Spearman correlations with MOS-HIV component and summary scores. Responsiveness to AIDS-defining events (ADE) and all adverse events (our external change criterion) was assessed using area under the receiver operating characteristic (AUROC) curves. Results  The study enrolled 368 patients (mean follow-up: 3.66 years); 82% had at least one severe adverse event and 27% had at least one ADE. The HUI3 scale and items showed good concurrent validity, with 85% of the expected relationships with the MOS-HIV subscales verified. The HUI3 was responsive to both adverse events (AUROC [95%CI]: 0.68 [0.57, 0.80]) and ADEs (0.62 [0.51, 0.74]). The EQ-5D was responsive to ADEs (0.66 [0.56, 0.76]), but not responsive to adverse events (0.56 [0.46, 0.68]). Conclusion  The HUI3 is a valid and responsive measure of the change in HRQoL associated with clinical events in an advanced HIV/AIDS population.     

A validation of the MOS-HIV quality of life measure in HIV-infected patients in Mexico]

OBJECTIVE: To validate the Medical Outcomes Study HIV Health Survey (MOS-HIV) quality of life instrument for its application in clinical research in Mexico. METHODS: The data for this study were collected between April, 2002, and February, 2004. An expert committee combined two Spanish-language translations of the MOS-HIV questionnaire. The new questionnaire's feasibility was assessed in a group of 32 HIV-infected persons by measuring how long they took to complete the questionnaire and the numbers of items they left unanswered. The questionnaire was then applied to a group of 120 HIV-positive patients and to a control group of 102 HIV-negative individuals. The following questionnaire characteristics were evaluated: (1) internal reliability (Cronbach alpha coefficient), (2) discriminant validity (the receiver operating characteristic (ROC) curves derived from the scores of the two groups), and (3) convergent validity (the Spearman correlation coefficients for the scores of the HIV-positive patients on the 11 MOS-HIV dimensions and their scores on the analog visual scale of the European Quality of Life 5-Dimensional format (EQ-5D) questionnaire, a list of symptoms, the viral load, and the CD4 cell count). RESULTS: The mean response time with the questionnaire was 10 minutes and 22 seconds, and the mean number of unanswered items was 0.62. With each of the 11 dimensions of the questionnaire, the Cronbach alpha coefficient was at least 0.75. The mean scores obtained by the two groups were different for 9 of the 11 dimensions, and the 95% confidence intervals of the areas under the ROC curves did not include the value of 0.5 for 8 of the dimensions. The absolute value of the Spearman correlation coefficient was less than 0.3 for the CD4 cell count and for the viral load, and it was greater than 0.3 for each dimension and the scores on the list of symptoms and on the analog visual scale of the EQ-5D questionnaire. CONCLUSIONS: The MOS-HIV measure is valid for use in clinical research among HIV-infected persons in Mexico.     

Measuring quality of life in rural Uganda: reliability and validity of summary scores from the Medical Outcomes Study HIV Health Survey (MOS-HIV)

Purpose

Summary scores derived from the Medical Outcomes Study HIV Health Survey (MOS-HIV) are used to assess treatment impacts among HIV-infected patients in Western settings, but have yet to be validated in rural, African settings. We examined the reliability, validity and responsiveness of scores among a prospective cohort of 947 HIV-1-infected adults initiating antiretroviral therapy between May 2003 and May 2004 in rural Uganda.

Methods

Physical (PHS) and mental health (MHS) summary scores were developed from baseline MOS-HIV sub-domains using exploratory factor analysis. Construct and discriminant validity were established by comparing mean summary scores across known groups of sociodemographic, clinical and health status characteristics. Effect sizes were calculated to assess responsiveness to therapy.

Results

Reliability of the PHS and MHS scores was 0.79 and 0.85, respectively. Mean baseline PHS and MHS scores varied significantly by CD4 cell count, HIV viral load, WHO stage of disease and Karnofsky performance status scores. By 12?months on antiretroviral therapy, PHS and MHS scores improved by 14.6 points (P?P?Conclusions PHS and MHS scores can be derived from the MOS-HIV and used to assess health status among cohorts of patients taking antiretroviral therapy in rural Uganda.