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Validity, reliability, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients.

Spertus JA, Jones PG, Kim J, Globe D - Qual Life Res (2007)

Bottom Line: The internal consistency (Cronbach's alpha = 0.92 and 0.93 for anemic and non-anemic patients, respectively) and test-retest reliability (mean 3-month change scores in stable patients = -2.8 [SD = 1.4] and -0.5 [SD = 0.8], P = 0.14) were similar.Estimates of responsiveness were also similar.This study provides empirical evidence that the psychometric properties of the KCCQ are similar in patients with or without anemia, a potentially confounding clinical condition in patients with heart failure.

View Article: PubMed Central - PubMed

Affiliation: Mid America Heart Institute, 4401 Wornall Road, Kansas City, MO 64111, USA. spertusj@umkc.edu

ABSTRACT

Background: While generic health status measures quantify the impact of all patients' diseases on their health-related quality of life, disease specific measures focus on only one of the many conditions that a patient may have. If a patient has two diseases with similar clinical manifestations, they may respond differently to a disease-specific instrument if one of their conditions improves while the other worsens or remains stable, thus undermining the instruments in that patient population. We sought empirical evidence of the reliability and validity (including responsiveness) of the Kansas City Cardiomyopathy Questionnaire (KCCQ), a disease-specific measure for heart failure (HF), among HF patients with and without anemia, a condition that has similar symptoms to HF.

Methods: This work used a prospective cohort study of 811 HF outpatients from 58 U.S. centers with a baseline assessment of anemia of whom 698 were followed for 3 months with serial health status measures.

Results: Among participants, 268 (33%) were anemic. The construct validity of the KCCQ was supported by showing similar correlations with the New York Heart Association (NYHA) classification in patients with and without anemia (P value for interaction = 0.38). The internal consistency (Cronbach's alpha = 0.92 and 0.93 for anemic and non-anemic patients, respectively) and test-retest reliability (mean 3-month change scores in stable patients = -2.8 [SD = 1.4] and -0.5 [SD = 0.8], P = 0.14) were similar. Estimates of responsiveness were also similar.

Conclusion: This study provides empirical evidence that the psychometric properties of the KCCQ are similar in patients with or without anemia, a potentially confounding clinical condition in patients with heart failure.

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Related in: MedlinePlus

Three-month KCCQ change by reported health change and anemia status
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Fig2: Three-month KCCQ change by reported health change and anemia status

Mentions: To compare the sensitivity of the KCCQ to patients’ perceptions of change, the mean change in KCCQ scores across each category of change were compared in anemic and nonanemic patients. Figure 2 describes the means and 95% confidence intervals of change in KCCQ scores across crude categories of improved (mild to marked), no change, and worsening (mild to marked) of their overall clinical status during the first 3 months of the study. No significant differences by anemia status were detected within any of the three categories of reported health change. In regression analysis, mean 3-month KCCQ change was found to be linearly related to reported health change, with a slope of −2.7 points (95% CI = [−3.6, −1.9]) per 1 step down on the Likert-scale response. Nonlinearity was tested using cubic splines and was found to be nonsignificant (P = 0.68). The association was consistent in both anemic and nonanemic patients (slope estimates = −3.4 [95% CI = (−5.0, −1.8)] vs. −2.5 [95% CI = (−3.4, −1.6)], P-value = 0.33).Fig. 2


Validity, reliability, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients.

Spertus JA, Jones PG, Kim J, Globe D - Qual Life Res (2007)

Three-month KCCQ change by reported health change and anemia status
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2238779&req=5

Fig2: Three-month KCCQ change by reported health change and anemia status
Mentions: To compare the sensitivity of the KCCQ to patients’ perceptions of change, the mean change in KCCQ scores across each category of change were compared in anemic and nonanemic patients. Figure 2 describes the means and 95% confidence intervals of change in KCCQ scores across crude categories of improved (mild to marked), no change, and worsening (mild to marked) of their overall clinical status during the first 3 months of the study. No significant differences by anemia status were detected within any of the three categories of reported health change. In regression analysis, mean 3-month KCCQ change was found to be linearly related to reported health change, with a slope of −2.7 points (95% CI = [−3.6, −1.9]) per 1 step down on the Likert-scale response. Nonlinearity was tested using cubic splines and was found to be nonsignificant (P = 0.68). The association was consistent in both anemic and nonanemic patients (slope estimates = −3.4 [95% CI = (−5.0, −1.8)] vs. −2.5 [95% CI = (−3.4, −1.6)], P-value = 0.33).Fig. 2

Bottom Line: The internal consistency (Cronbach's alpha = 0.92 and 0.93 for anemic and non-anemic patients, respectively) and test-retest reliability (mean 3-month change scores in stable patients = -2.8 [SD = 1.4] and -0.5 [SD = 0.8], P = 0.14) were similar.Estimates of responsiveness were also similar.This study provides empirical evidence that the psychometric properties of the KCCQ are similar in patients with or without anemia, a potentially confounding clinical condition in patients with heart failure.

View Article: PubMed Central - PubMed

Affiliation: Mid America Heart Institute, 4401 Wornall Road, Kansas City, MO 64111, USA. spertusj@umkc.edu

ABSTRACT

Background: While generic health status measures quantify the impact of all patients' diseases on their health-related quality of life, disease specific measures focus on only one of the many conditions that a patient may have. If a patient has two diseases with similar clinical manifestations, they may respond differently to a disease-specific instrument if one of their conditions improves while the other worsens or remains stable, thus undermining the instruments in that patient population. We sought empirical evidence of the reliability and validity (including responsiveness) of the Kansas City Cardiomyopathy Questionnaire (KCCQ), a disease-specific measure for heart failure (HF), among HF patients with and without anemia, a condition that has similar symptoms to HF.

Methods: This work used a prospective cohort study of 811 HF outpatients from 58 U.S. centers with a baseline assessment of anemia of whom 698 were followed for 3 months with serial health status measures.

Results: Among participants, 268 (33%) were anemic. The construct validity of the KCCQ was supported by showing similar correlations with the New York Heart Association (NYHA) classification in patients with and without anemia (P value for interaction = 0.38). The internal consistency (Cronbach's alpha = 0.92 and 0.93 for anemic and non-anemic patients, respectively) and test-retest reliability (mean 3-month change scores in stable patients = -2.8 [SD = 1.4] and -0.5 [SD = 0.8], P = 0.14) were similar. Estimates of responsiveness were also similar.

Conclusion: This study provides empirical evidence that the psychometric properties of the KCCQ are similar in patients with or without anemia, a potentially confounding clinical condition in patients with heart failure.

Show MeSH
Related in: MedlinePlus