Validity, reliability, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients.
Validity, reliability, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients.
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DOI：
10.1007/s11136-007-9302-5
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发表时间：
2008-03
影响因子：
3.5
通讯作者：
Globe, Denise
中科院分区：
文献类型：
--
作者：
Spertus, John A.;Jones, Philip G.;Kim, John;Globe, Denise
虽然通用的健康状况衡量标准量化了所有患者的疾病对他们与健康相关的生活质量的影响，但针对疾病的衡量标准只关注患者可能患有的多种疾病中的一种。如果患者有两种临床表现相似的疾病，如果其中一种病情改善，而另一种病情恶化或保持稳定，那么他们对特定疾病的仪器的反应可能会不同，从而破坏该患者群体中的仪器。我们在有和没有贫血的心衰患者中寻找堪萨斯城心肌病问卷(KCCQ)的可靠性和有效性(包括反应性)的经验证据，KCCQ是一种针对心力衰竭(HF)的疾病特异性测量指标，贫血的症状与HF相似。这项工作使用了一项前瞻性队列研究，对58个美国中心的811名心力衰竭门诊患者进行了基线评估，其中698人接受了为期3个月的系列健康状况评估。在参与者中，有268人(33%)患有贫血。KCCQ的结构效度与纽约心脏协会(NYHA)分类在患有和不患有贫血的患者中显示出类似的相关性(交互作用的P值=0.38)，从而支持了KCCQ的结构效度。内部一致性(贫血和非贫血患者的Cronbach‘sα系数分别为0.92和0.93)和重测信度(稳定患者的3个月平均变化分数−=2.8[SD=11.4]和−0.5[SD=0.08]，P=0.14)相似。对反应能力的估计也是相似的。这项研究提供了经验证据，表明KCCQ的心理测量学特性在患有或不患有贫血的患者中是相似的，贫血是心力衰竭患者的一种潜在的令人困惑的临床状况。
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. 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. 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. 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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