Abstract 1175: Developing a Core Ischemic Heart Disease Health-related Quality of Life Questionnaire: The HeartQoL Project
Objectives: There is little consensus on assessment tools for health-related quality of life (HRQL) across cardiovascular conditions. We used validated MI-, angina- and heart failure-specific HRQL instruments to develop a single new core ischemic heart disease specific HRQL questionnaire which would allow between-diagnosis comparisons of outcomes.
Methods: Patients with a diagnosis of MI, angina or heart failure who had not been hospitalized in the previous six weeks were recruited in 21 countries (18 European countries plus Australia, Canada, USA). The referring physician provided diagnostic and co-morbidity details. All patients completed the MacNew, the Seattle Angina and the Minnesota Living With Heart Failure questionnaires. The Medical Outcomes Study SF-36 Health Survey and the Hospital Anxiety and Depression Scale were completed for validation purposes.
Results: A total of 6,017 patients were recruited (2,259 MI, 2,002 angina, 1,756 heart failure). Based on the clinical impact method score and clinical relevance, a candidate set of 49 items was identified from all the items in the condition-specific HRQL instruments. The number of items was reduced and further analyzed, substantiated and allocated to subscales using both Latent Variable analysis to identify groups of related variables and Mokken analysis to form subscales from the item pools. Using data from all patients, we identified a core set of 13 HRQL items which fall into three subscales with six physical, three emotional and four social function items with strong H coefficients of >0.5.
Conclusions: A 13-item core heart disease specific HRQL questionnaire for patients with MI, angina or heart failure has been developed with three subscales reflecting physical, emotional and social function. The HeartQoL questionnaire has the potential to increase the efficiency of clinical service providers and researchers. It is acknowledged that the brief HeartQoL heart disease specific instrument may not cover all possible HRQL domains and that the instrument will need further psychometric evaluation to document responsiveness and to establish interpretable scores for comparing the effectiveness of interventions in patients with MI, angina or heart failure.