PMID- 17125512
OWN - NLM
STAT- MEDLINE
DCOM- 20061206
LR  - 20191210
IS  - 1477-7525 (Electronic)
IS  - 1477-7525 (Linking)
VI  - 4
DP  - 2006 Nov 24
TI  - Assessing responsiveness of generic and specific health related quality of life 
      measures in heart failure.
PG  - 89
AB  - BACKGROUND: Responsiveness, or sensitivity to clinical change, is an important 
      consideration in selection of a health-related quality of life (HRQL) measure for 
      trials or clinical applications. Many approaches can be used to assess 
      responsiveness, which may affect the interpretation of study results. We compared 
      the relative responsiveness of generic and heart failure specific HRQL 
      instruments, as measured both by common psychometric indices and by external 
      clinical criteria. METHODS: We analyzed data collected at baseline and 6-weeks in 
      298 subjects with heart failure on the following HRQL measures: EQ-5D (US, UK, 
      and VAS Scoring), Kansas City Cardiomyopathy Questionnaire (KCCQ) (Clinical and 
      Overall Summary Score), and RAND12 (Physical and Mental Component Summaries). 
      Three external indicators of clinical change were used to classify subjects as 
      improved, deteriorated, or unchanged: 6-minute walk test, New York Heart 
      Association (NYHA) class, and physician global rating of change. Four 
      responsiveness statistics (T-test, effect size, Guyatt's responsiveness 
      statistic, and standardized response mean) were used to evaluate the 
      responsiveness of the select measures. The median rank of each HRQL measure 
      across responsiveness indices and clinical criteria was then determined. RESULTS: 
      Average age of subjects was 60 years, 75 percent were male, and had moderate to 
      severe heart failure symptoms. Overall, the KCCQ Summary Scores had the highest 
      relative ranking, irrespective of the responsiveness index or external criterion 
      used. Importantly, we observed that the relative ranking of responsiveness of the 
      generic measures (i.e. EQ-5D, RAND12) was influenced by both the responsive 
      indices and external criterion used. CONCLUSION: The disease specific KCCQ was 
      the most responsive HRQL measure assessing change over a 6-week period, although 
      generic measures provide information for which the KCCQ is not suitable. The 
      responsiveness of generic HRQL measures may be affected by the index used, as 
      well as the external criterion to classify patients who have clinically change or 
      remained stable.
FAU - Eurich, Dean T
AU  - Eurich DT
AD  - Institute of Health Economics, Edmonton, Alberta, Canada. deurich@ualberta.ca
FAU - Johnson, Jeffrey A
AU  - Johnson JA
FAU - Reid, Kimberly J
AU  - Reid KJ
FAU - Spertus, John A
AU  - Spertus JA
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20061124
PL  - England
TA  - Health Qual Life Outcomes
JT  - Health and quality of life outcomes
JID - 101153626
SB  - IM
MH  - Adult
MH  - Aged
MH  - Canada
MH  - Cardiac Output, Low/*physiopathology
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/*physiopathology/psychology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Psychometrics/*instrumentation
MH  - *Quality of Life
MH  - *Sickness Impact Profile
MH  - Surveys and Questionnaires
MH  - United States
MH  - Ventricular Dysfunction, Left/physiopathology
MH  - Ventricular Dysfunction, Right/physiopathology
PMC - PMC1675990
EDAT- 2006/11/28 09:00
MHDA- 2006/12/09 09:00
PMCR- 2006/11/24
CRDT- 2006/11/28 09:00
PHST- 2006/08/16 00:00 [received]
PHST- 2006/11/24 00:00 [accepted]
PHST- 2006/11/28 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/11/28 09:00 [entrez]
PHST- 2006/11/24 00:00 [pmc-release]
AID - 1477-7525-4-89 [pii]
AID - 10.1186/1477-7525-4-89 [doi]
PST - epublish
SO  - Health Qual Life Outcomes. 2006 Nov 24;4:89. doi: 10.1186/1477-7525-4-89.