Translation and validation of two Chinese health-related quality of life instruments in patients with coronary heart disease.

1. The Chinese version of the 27-item MacNew health-related quality of life (HRQL) questionnaire is a valid, reliable and responsive core coronary heart disease (CHD)-specific HRQL measure. It can be used to compare the health outcomes, burdens of illness, and treatment effectiveness in pure or mixed populations of patients with myocardial infarction, angina, or heart failure in clinical trials and in routine clinical practice. 2. The Chinese version of the 35-item Myocardial Infarction Dimensional Assessment Scale (MIDAS) did not perform as well. Although four of the seven subscales, which cover the physical and psychosocial aspects of HRQL, are psychometrically sound when used to evaluate HRQL among CHD patients with different cardiac diagnostic categories, the remaining three subscales covering treatment-related aspects are not. The latter had only weak validity and responsiveness, which may be due to cultural differences. 3. To improve the overall performance of the Chinese version of the MIDAS, further effort is required to clarify the treatment-related impact of CHD on well-being from the patient's perspective.