Heartqol Questionnaire: a new Patient-reported Outcome in Cardiology

Abstract

Background: Patient-reported outcomes such as health-related quality of life (HRQL) improve patient care quality. Methods: The HeartQoL Project, designed to develop and validate a core ischemic heart disease (IHD) HRQL questionnaire, enrolled 6,384 patients (33.1% angina; 36.8% myocardial infarction; 30.1% heart failure) speaking 15 languages in 22 countries. Findings: The 14-item HeartQoL questionnaire, developed using Mokken scaling and scored from 0 (poor HRQL) to 3 (good HRQL), has a global scale with 10-item physical and 4-item emotional subscales. Mean global score (2.2±0.5) in the total group) differed by diagnosis (p<0.001). Cronbach’s alpha was consistently =0.80; convergent validity between similar HeartQoL and SF-36 subscales was confirmed (r=0.60, p<0.001) as was discriminative validity with SF-36 health transition, HADS anxiety and depression, and functional status. HeartQoL score changes were significant (p<0.001) with effect sizes from 0.37 to 0.51 with invasive intervention and 0.47 to 0.64 with cardiac rehabilitation. Discussion: The HeartQoL questionnaire is reliable, valid, and responsive to change in an international cohort of patients with angina, myocardial infarction, or heart failure allowing clinicians and researchers to assess, compare, and evaluate HRQL with a single IHD HRQL instrument that still needs language-specific validation.