Spertus John A, Jones Philip G
Circ Cardiovasc Qual Outcomes. 2015 Sep;8(5):469-76. doi: 10.1161/CIRCOUTCOMES.115.001958.
There is a growing demand to collect patients' experiences of their health status (their symptoms, function, and quality of life) in clinical trials, quality assessment initiatives, and in routine clinical care. In heart failure, the 23-item, disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) has been shown to be valid, reliable, sensitive to clinical change, and prognostic of both clinical events and costs. However, its use has been limited, in part, by its length. We sought to develop a shortened version of the instrument that maintains the psychometric properties of the full KCCQ.
Using data from 3 clinical studies incorporating 4168 patients, we derived and validated a 12-item KCCQ, the KCCQ-12, to capture symptom frequency, physical and social limitations, and quality of life impairment as a result of heart failure, as well as an overall summary score. The KCCQ-12 scores had high correlations with the original scales (>0.93 for all scales in all clinical settings), high test–retest reliability (>0.76 for all domains), high responsiveness (16–31 point improvements after discharge from hospitalization; standardized response mean =0.61–1.12), and comparable prognostic significance and interpretation of clinically important differences as compared with the full KCCQ.
The KCCQ-12 is a shorter version of the original 23-item instrument that should be more feasible to implement while preserving the psychometric properties of the full instrument.
在临床试验、质量评估项目以及日常临床护理中，收集患者健康状况（症状、功能和生活质量）体验的需求日益增长。在心力衰竭领域，23项特定疾病的堪萨斯城心肌病问卷（KCCQ）已被证明是有效的、可靠的，对临床变化敏感，并且对临床事件和成本具有预后价值。然而，其使用在一定程度上受到篇幅的限制。我们试图开发一个缩短版的该工具，同时保持完整KCCQ的心理测量特性。
利用来自3项纳入4168例患者的临床研究的数据，我们推导并验证了一个12项的KCCQ，即KCCQ - 12，以获取因心力衰竭导致的症状频率、身体和社会限制以及生活质量损害情况，以及一个总体汇总分数。KCCQ - 12评分与原始量表具有高度相关性（在所有临床环境中所有量表的相关性均>0.93），具有较高的重测信度（所有领域>0.76），具有较高的反应性（出院后改善16 - 31分；标准化反应均值 = 0.61 - 1.12），并且与完整的KCCQ相比，在临床重要差异的预后意义和解释方面具有可比性。
KCCQ - 12是原始23项工具的缩短版，在保留完整工具心理测量特性的同时，实施起来应该更可行。
