Disease-specific health-related quality of life questionnaires for heart failure: a systematic review with meta-analyses |
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Authors: | Olatz Garin Montse Ferrer àngels Pont Montserrat Rué Anna Kotzeva Ingela Wiklund Eric Van Ganse Jordi Alonso |
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Institution: | 1. Health Services Research Unit, IMIM—Hospital del Mar, Doctor Aiguader 80, 08003, Barcelona, Spain 2. CIBER Epidemiología y Salud Pública (CIBERESP), Spain
http://www.ciberesp.es/ 3. Universitat Autónoma de Barcelona, Barcelona, Spain 4. Universitat de Lleida, Lleida, Spain 5. Agència d’Avaluació de Tecnologia i Recerca Mèdiques (AATRM), Catalan Agency for Health Technology Assessment and Research (CAHTAR), C/ Roc Boronat 81-95, 08005, Barcelona, Spain 6. Behavioral Medicine, Astra H?ssle Research Laboratories, M?lndal, Sweden 7. Global Health Outcomes GlaxoSmithKline, Stockley Park West, Uxbridge, UK 8. Unité de Pharmacoépidémiologie, Centre Hospitalier Lyon-Sud, Pierre-Benite Cedex, France 9. Universitat Pompeu Fabra, Barcelona, Spain
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Abstract: | 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, 421 were 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 meta-analysis for pools
above five estimates. Cronbach’s alpha coefficients were 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 the NYHA (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.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. |
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Keywords: | Congestive heart failure Meta-analysis Psychometrics Quality of life Review (publication type) |
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