The MacNew Heart Disease Health-Related Quality of Life Questionnaire: A Scandinavian Validation Study

Shan Alphin,Stig Slørdahl,Ann-Dorthe Olsen Zwisler,Stefan Höfer,Joep Perk,Neil Oldridge

doi:10.1007/s11205-014-0694-7

Abstract

The aim of this study is to validate the Danish, Norwegian and Swedish versions of the self-administered MacNew Heart Disease Health-related Quality of Life questionnaire in patients with ischemic heart disease. The MacNew questionnaire, the Short Form SF-36, and the Hospital Anxiety and Depression Scale were completed at baseline by 976 patients (Denmark n = 353, Norway n = 328, Sweden n = 295) with a diagnosis of angina (n = 335), myocardial infarction (n = 352), or heart failure (n = 289). Each language version of the MacNew satisfied reliability criteria with Cronbach’s α values for the total group data (0.90–0.94) as well as the diagnostic group data (0.91–0.96). The test–retest correlations exceeded the criteria for group comparison (r ≥ 0.70) in Danish and Norwegian patients. The multidimensionality of the MacNew was confirmed although the original three-factor solution did not fully meet the criteria for good fit. Convergent and discriminative validity were confirmed in each language and diagnosis group with the exception of discriminative validity in Swedish angina patients. The psychometric properties of the Danish, Norwegian, and Swedish versions of the MacNew are largely confirmed. The MacNew can be recommended as a specific instrument for assessing and evaluating HRQL in Danish, Norwegian, and Swedish patients with angina, MI, and heart failure. However, the MacNew factor structure needs to be revisited in future studies.

Highlights

Outcomes of existing and new therapies have been focused traditionally on mortality and morbidity
The objective of this study is to report on the psychometric properties of the MacNew in Danish, Norwegian, and Swedish patients with ischemic heart disease (IHD) and in each of the three major IHD diagnoses of angina, MI, or heart failure for the total group
The mean MacNew, SF-36, and Hospital Anxiety and Depression Scale (HADS) scores are given in Table 1 for the total group and in Table 2 for each diagnosis

Summary

Introduction

Outcomes of existing and new therapies have been focused traditionally on mortality and morbidity. Patient reported health status is an important cardiovascular health outcome that includes three domains: symptom burden, functional status, and health related quality of life (HRQL; Rumsfeld et al 2013). Agencies such as the European Agency for the Evaluation of Medicinal Products (2005) and the US Food and Drug Administration (2009) have recommended the use of patientreported treatment outcome measures such as HRQL in relevant research studies as well as in clinical care. Marked health-status deficits, including poor HRQL, are commonly seen in patients with ischemic heart disease (IHD) and treatments such as medications, invasive interventions, or rehabilitation, with common therapeutic goals that include symptom management and improvement of patient HRQL, are frequently used in patients with different IHD diagnoses (Krumholz et al 2005)

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