Health-related Quality Of Life In Clinical Practice Research Articles

Impaired health-related quality of life due to elevated risk of developing diabetes: A cross-sectional study in Indonesia.

This study investigated the association between elevated risk of developing diabetes and impaired health-related quality of life (HRQoL) in the Indonesian population. A cross-sectional study was conducted on 1,336 Indonesians from the general population who had no previous diagnosis of diabetes. Utility score to represent HRQoL was measured using the EuroQol 5-dimension, while the risk for developing diabetes was determined using the Finnish Diabetes Risk Score (FINDRISC) instrument. All participants underwent a blood glucose test after fasting for 8 hours. The association between FINDRISC score and HRQoL adjusted for covariates was analysed using multivariate Tobit regression models. Minimal clinically important differences were used to facilitate interpretation of minimal changes in utility score that could be observed. The median (interquartile range) of the overall FINDRISC score was 6 (7), while the mean (95% confidence intervals) of the EQ-5D utility score was 0.93 (0.93-0.94). Once adjusted for clinical parameters and socio-demographic characteristics, participants with a higher FINDRISC score showed a significantly lower HRQoL. No significant association was detected between fasting blood glucose level categories and HRQoL. A difference of 4-5 points in the FINDRISC score was considered to reflect meaningful change in HRQoL in clinical practice. An elevated risk of developing diabetes is associated with a lower HRQoL. Therefore, attention should be paid not only to patients who have already been diagnosed with diabetes, but also to members of the general population who demonstrate an elevated risk of developing diabetes. This approach will assist in preventing the onset of diabetes and any further deterioration of HRQoL in this segment of the Indonesian population.

Associations of health-related quality of life with major adverse cardiovascular and cerebrovascular events for individuals with ischaemic heart disease: systematic review, meta-analysis and evidence mapping

ObjectiveTo investigate the association between health-related quality of life (HRQoL) and major adverse cardiovascular and cerebrovascular events (MACCE) in individuals with ischaemic heart disease (IHD).MethodsMedline(R), Embase, APA PsycINFO and CINAHL...

The feasibility and value of assessing patient-reported outcomes in pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) is a progressive pulmonary vascular disease that negatively impacts health‐related quality of life (HRQOL). The PAH‐symptoms and impact (PAH‐SYMPACT) questionnaire is a validated disease‐specific patient‐reported outcome (PRO) instrument that assesses a patient's symptoms and the impact of PAH and its treatment on well‐being. We performed a single‐center prospective cohort study of patients with PAH to determine the feasibility of assessing PROs in clinical practice and to determine the association between PAH‐SYMPACT domains and clinical characteristics and outcomes. One hundred and ten patients completed the 1‐day version of the PAH‐SYMPACT questionnaire which consists of 22 Likert‐scale questions that assess HRQOL across four domains: cardiopulmonary (CP) symptoms, cardiovascular (CV) symptoms, physical impact (PI), and cognitive and emotional (CE) impact. Higher scores indicate worse HRQOL. Patients were predominantly female (n = 86, 78%) with a mean age of 57.8 ± 16.2 years. While several patient characteristics were associated with CP and PI domains, few were associated with CV and CE domains. PI and CE impact scores were associated with recent hospitalizations and mortality and CE impact score was independently associated with an increased risk of death after adjustment for disease severity (hazard ratio: 3.29, 95% confidence interval: 1.56–6.91, p = 0.002). In conclusion, the assessment of PROs in clinical practice using the PAH‐SYMPACT questionnaire is both feasible and valuable. PAH‐SYMPACT scores have independent prognostic value and are not adequately reflected by traditional measures of disease severity. These findings underscore the importance of assessing HRQOL in clinical practice.

The contribution of daytime sleepiness to impaired quality of life in NAFLD in an ethnically diverse population

Health-related quality of life (HRQoL) is lower in people with NAFLD compared to the general population. Sleep disturbance resulting in daytime sleepiness is common in patients with NAFLD, but the effect of daytime sleepiness on HRQoL in NAFLD is unclear. The prevalence and natural history of NAFLD vary in different ethnic groups, but there has been limited ethnic diversity in HrQoL studies to date. We aimed to assess whether daytime sleepiness is independently associated with reduced HRQoL in an ethnically diverse UK population. We conducted HRQoL assessments using SF-36 version 2 and Epworth Sleepiness Scale (ESS) questionnaires in 192 people with NAFLD. Multivariate linear regression was used to identify factors independently affecting HRQoL scales. People with NAFLD reported significantly reduced physical health-related SF-36 scores compared to the general UK population. South Asian NAFLD patients reported impairment in physical health, but not mental health, approximately a decade before White NAFLD patients. In multivariate linear regression, daytime sleepiness (ESS score > 10), was the most significant independent predictor of reduced physical health. Age, BMI and liver stiffness score were also significantly associated. HRQoL is impaired earlier in patients of South Asian ethnicity. ESS score > 10, indicative of excessive daytime sleepiness, is an independent predictor of reduced HRQoL in people with NAFLD regardless of ethnicity. Daytime sleepiness should be considered as a contributing factor to reduced HRQoL in clinical practice and when evaluating patient-related outcomes in clinical trials.

Management of lung cancer patients' quality of life in clinical practice: a Delphi study

BackgroundThe assessment of health-related quality of life (HRQoL) has seen exponential growth in oncology clinical trials. However, the measurement of HRQoL has yet to be optimised in routine clinical practice. This study aimed at exploring the operationalisation of HRQoL in clinical practice with the goal of reaching a consensus from a panel of physicians.Materials and methodsPhysicians involved in the management of lung cancer patients in France were recruited to participate in a Delphi study. The study involved three rounds of iterated queries to gain consensus on management aspects of HRQoL, including timing of discussion on HRQoL, which specific domains of HRQoL should be discussed, and what was the most appropriate method of assessment. The threshold adopted for consensus was at least 70% agreement among physicians. A scientific committee reviewed results following each round of the Delphi study.ResultsA representative panel of 60 physicians participated in this study. Consensus was obtained for HRQoL management at all time points in the patient care pathway. Panellists agreed that HRQoL discussions should occur during routine visits and hospitalisation. The involvement of patients' relatives was also recognised as important, except when discussing side-effects and involvement of a multidisciplinary team. There was a lack of consensus on a systematic assessment for all patients at each visit and no consensus on how HRQoL should be measured in clinical practice.ConclusionsHRQoL discussions are considered an integral part in the management of lung cancer patients, and are deemed key to success in patient–physician interaction. Further research is required to harmonise how best to implement HRQoL assessment.

Paediatric patients report lower health-related quality of life in daily clinical practice compared to new normative PedsQLTM data.

AimTo compare Health‐Related Quality of Life (HRQOL) of paediatric patients with newly collected HRQOL data of the general Dutch population, explore responses to individual items and investigate variables associated with HRQOL.MethodsChildren (8–12y) and adolescents (13–17y) from the general population (N = 966) and from a paediatric population (N = 1209) completed the Pediatric Quality of Life Inventory (PedsQLTM) online via the KLIK Patient‐Reported Outcome Measures portal. PedsQLTM scale scores were compared between groups with independent t tests, by age group and gender. Responses to PedsQLTM items were explored using descriptive analyses. Linear regression analyses were performed to determine which variables were associated with HRQOL.ResultsPaediatric patients reported worse HRQOL than the general population on all PedsQLTM scales (p ≤ .001, d = 0.20–1.03), except social functioning, and a high proportion reported problems on PedsQLTM items, for example, ‘I have trouble sleeping’. Younger age, female gender and school absence were negatively associated with HRQOL (β = −0.37–0.10, p ≤ .008).ConclusionPaediatric patients reported lower HRQOL than the general population, and school absence, female gender and younger age were associated with lower HRQOL. The results underline the importance to structurally monitor paediatric patients’ HRQOL in clinical practice to detect problems and offer the right help on time.

Quality of life status determinants in hypertrophic cardiomyopathy as evaluated by the Kansas City Cardiomyopathy Questionnaire

PurposeThe present study evaluated how heart failure (HF) negatively impacts health-related quality of life (HRQoL) in hypertrophic cardiomyopathy (HCM) patients and explored the major clinical determinants associated with HRQoL impairment in this population.MethodsThis was a cross-sectional single-center study of health-related HRQoL that included 91 consecutive patients with HCM. Evaluation was performed based on a comprehensive protocol that included the recommended diagnostic studies, as well as administration of the translated validated version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) (CV Outcomes Inc) as a health status measure.ResultsThe cohort included 52 (57%) males, median age 58 (20–85) years. The median global KCCQ score was 67 (12.5–100) corresponding to a moderate impairment in HRQoL. There was an inverse correlation between the median global KCCQ score and NYHA class (Kendall’s tau b coefficient r − 0.33, p = 0.001). Patients with pulmonary hypertension (PHT), defined as resting pulmonary artery systolic pressure of ≥ 45 mmHg, presented a significantly worse HRQoL as compared to those without PHT (median KCCQ score 56.2 vs 77.5, p = 0.013). The KCCQ score mildly correlated with age (r − 0.18, p = 0.014), history of syncope (r − 0.18, p = 0.045), estimated glomerular filtration rate (eGFR) (r 0.31, p < 0.001), plasmatic creatinine (r − 0.18, p = 0.017) and urea levels (r − 0.27, p < 0.001), left ventricular (LV) end-systolic dimensions (r − 0.18, p = 0.014), maximal provoked intraventricular gradient (r 0.20, p = 0.039), LV ejection fraction (r 0.15, p = 0.04), average E/e′ (r − 0.16, p = 0.039), pulmonary acceleration time (r 0.21, p = 0.007), pulmonary artery systolic pressure (r − 0.20, p = 0.016). In ordinal regression, the independent predictors of HRQoL were NYHA class and eGFR.ConclusionsPatients with HCM and HF present a moderate degree of alteration in HRQoL. This is especially true for patients with PHT and more severe functional impairment. Renal failure and NYHA class are potential markers of HRQoL in clinical practice.

Development and psychometric evaluation of the U.S. English Wound-QoL questionnaire to assess health-related quality of life in people with chronic wounds.

People with chronic wounds perceive an impaired health-related quality of life (HRQoL). For the assessment of HRQoL, valid instruments are needed. Therefore, the Wound-QoL questionnaire was originally developed and psychometrically validated for use in Germany. As the Wound-QoL is to be used in numerous countries, international versions are required. Therefore, this study aimed to psychometrically validate the U.S. English Wound-QoL version. Upon translation into U.S. English, psychometric testing was performed based on cross-sectional data deriving from the U.S. Wound Registry. Besides descriptive statistics, internal consistency and concurrent validity were tested. In addition, a graded response model was used. The sample consisted of 599 people with chronic wounds of different etiologies. Participants were between 18 and 95 years old, mean age was 63.7 (SD = 15.9) years. Gender was distributed almost equally, with 47.4% female patients. High internal consistency, low floor and ceiling effects of the subscales could be largely confirmed. The internal consistency of the global score was excellent, with α > .9. Concurrent validity between the Wound-QoL and pain, the surface area of the largest wound, total surface area, and total number of active wounds could be confirmed. In contrast, item response theory (IRT) analyses could not fully confirm the factorial model underlying the Wound-QoL subscales. Furthermore, the items regarding smell and discharge and the items on problems with hitting the wound against something, climbing stairs and feeling dependent on help from others showed a low item information in their belonging dimensions. In conclusion, the newly validated Wound-QoL is available for HRQoL measurement in people with chronic wounds in the United States. It showed good psychometric properties, demonstrating its reliability and validity. Therefore, the instrument may be used to assess HRQoL in clinical practice. However, IRT analyses showed that the instrument may benefit from future refinement.

Elicitation of disease concepts in patients with diabetic foot ulcers: a qualitative study.

To identify in-depth information directly from patients with diabetic foot ulcers (DFU) on DFU symptoms, impacts on functioning and effects on health-related quality of life (HRQoL). Semi-structured, qualitative concept elicitation interviews were conducted with patients with DFUs (Wagner grade 1 or 2) until saturation was reached. Qualitative analysis (using MAXQDA, VERBI GmbH, Germany) of interview transcripts was conducted to identify concepts relevant to patients with DFUs, based on the frequency of mentions, and elucidate themes regarding impacts on HRQoL. Of the 18 participants, most were male (n=14; 78%) and 10 (56%) presented with a Wagner grade of 1. Frequently reported symptoms were pain/discomfort (n=15; 83%), weeping/discharge (n=10; 56%), bleeding (n=10; 56%) and swelling (n=8; 44%). Overall, patients reported more impacts than symptoms-wound care/treatment burden (n=14; 78%), limitations on exercise/physical activity (n=13; 72%), mobility limitations (n=12; 67%), and offloading (n=12; 67%) were the most frequently mentioned. Based on findings from the patient interviews, a draft conceptual model was developed outlining interrelationships between DFU symptoms, impacts, and HRQoL from the patient perspective. Qualitative interviews captured the breadth of disease-related concepts of direct importance to patients. The draft conceptual model developed from the analysis can help identify measures or instruments for use in assessing patient-reported symptoms or HRQoL in clinical practice and may have wider research applicability, including evaluation of treatment benefits in patients with DFUs.

Oncologists’ consideration of health-related quality of life in clinical practice for immune-checkpoint inhibitors-treated patients: An online patients community research

Abstract Background Immune-Checkpoint Inhibitors (ICI) treatments have specific Health Related Quality of Life (HRQoL) profiles. While HRQoL is central in the oncology patient experience, its integration into current practice remains poorly documented. The study objective was to describe patients' experience and expectations regarding HRQoL, in particular in their relationship with oncologists. Methods This research was a cross-sectional study within a French online patients’ community. Patients treated with ICI for cancer were recruited between Sep-18 and Jan-19. They answered to a questionnaire developed to assess health care practitioners (HCP) involvement in HRQoL, times of discussion and dimensions discussed. Importance of nine HRQoL dimensions were measured with a visual analog scale (VAS; 0–10 [low–high]). Results Over 82 patients included (median age: 59 years; 56% male, 41% with lung cancer), two third (53) mentioned a HRQoL discussion at least once with an oncologist. Half of them (39) discussed of HRQoL with oncologists and were mostly satisfied of this interaction. When occurred, discussions were mainly occasional during follow-up visits (64%), adverse event occurrence (57%), treatment initiation (43%) and were mostly on patients’ initiative (64%). The most discussed HRQoL dimensions were symptoms (85%) and physical well-being (74%). In terms of expectations, two thirds of patients (54) considered oncologists were one of the most important HCP to discuss HRQoL with. Among them, 85% to 98% considered that HRQoL discussion was important at all times of care considered in the study from diagnosis to palliative care. The most important discussion for patients were symptoms (8.7 SD ± 2.0), physical well-being (8.6 ±1.8) daily activities (8.1 ±2.2), family and social life (8.0 ± 1.8), work and leisure (7.9 ±2.1), cognition (7.8 ±2.5) and emotional state (7.7 ±2.7). Conclusion According to patients, HRQoL consideration mostly relies on oncologists. Integration of HRQoL in clinical practice could be optimized by increasing frequency of dedicated interactions and by extending discussions to the less often addressed dimensions. Legal entity responsible for the study Carenity. Funding Bristol-Myers Squibb. Disclosure O. Wilczynski: Honoraria (institution): Bristol-Myers Squibb. A. Boisbouvier: Honoraria (institution), Full / Part-time employment: Bristol-Myers Squibb. L. Radoszycki: Honoraria (institution): Bristol-Myers Squibb. F-E. Cotte: Full / Part-time employment: Bristol-Myers Squibb. A-F. Gaudin: Full / Part-time employment: Bristol-Myers Squibb. H. Lemasson: Full / Part-time employment: Bristol-Myers Squibb.

The cross-cultural validation of the English version of RhinAsthma patient’s perspective (RAPP)

Objective: No validated instrument is currently available in English for use in daily practice to assess Health Related Quality of Life (HRQoL) in asthma and comorbid allergic rhinitis (AR). The aim of this study was to validate and assess the psychometric characteristics of an English language version of RhinAsthma Patient Perspective (RAPP).Methods: The study was performed in the Philippines. The RAPP was translated into English. Adult patients, diagnosed with asthma and AR, were recruited. Clinical and functional data were collected on two occasion with a 4-week interval between visits. At both visits patients completed the following questionnaires: RAPP, Short Form Heath Survey-12 (SF-12), asthma control test (ACT), and rhinitis symptom Visual Analog Scale (VAS). Scale dimensions, internal consistency and convergent validity, reliability, discriminant ability, responsiveness, and minimal important difference (MID) were evaluated.Results: About 150 patients (mean age 39.3 years) completed the study. Exploratory and confirmatory factor analysis identified a uni-dimensional structure of the questionnaire. Internal consistency was satisfactory (0.87 at visit 1; 0.89 at visit 2). The tool showed good discriminant and convergent validity at both visits (p < 0.01). High reliability was confirmed by an ICC of 0.97 and a CCC of 0.95. Responsiveness was shown by a significant association with VAS (r = 0.34, p < 0.01) and ACT (r = −0.35, p < 0.01). The MID value was 2.Conclusions: The English version of RAPP was shown to have good psychometric properties and is a valid tool for assessing asthma and AR HRQoL in clinical practice.

The clinical value of Coop/Wonca charts in assessment of HRQoL in a large cohort of relapsing-remitting multiple sclerosis patients: Results of a multicenter study

BackgroundMultiple sclerosis (MS) is a chronic neurological disease impacting patients’ health-related quality of life (HRQoL). Since MS specific HRQoL questionnaire are often time consuming; thus, simple, feasible and ease administering instruments are needed to assess MS HRQoL in clinical practice and clinical trials. Hence, aim of our study was to investigated the HRQoL in a large cohort of MS patients using the Coop/Wonca charts. MethodsThis was multicenter, independent, non-sponsored, observational study, including patients from 40 Italian MS centers. Inclusion criteria were Expanded Disability Status Scale score between 1.0 and 5.5; stable disease at enrolment. HRQoL was assessed, using six Coop/Wonca charts for physical fitness, feelings, daily activities, social activities, changes in health, health condition, and the Composites Scores of Multiple Sclerosis Quality of Life-54 (MSQoL-54), physical health composite summary (PHCS) and the mental health composite summary (MHCS). ResultsOut of 648, 593 relapsing-remitting MS patients, 415 (70%) women, mean age years, 417 (70%) were finally enrolled. We found a inter-rater agreement of 0.8, ranging from 0.64 to 0.91, as expressed by the alpha coefficient. Intra-rater agreement was 0.82, ranging from 0.78 to 0.96. Coop/Wonca charts were scored with a Likert method from one to five (corresponding to best and worst HRQoL respectively). According to this scoring, study population was stratified into three categories (score 1–2 corresponding to better HRQoL; score 3 corresponding to neutral profile; score 4–5 corresponding to worse HRQoL). Coop/Wonca charts resulted significantly correlated with PHCS and with MHCS.

A Brief Version of the Quality of Life in Short Stature Youth Questionnaire - the QoLISSY-Brief

The Quality of Life in Short Stature Youth (QoLISSY) questionnaire measures health-related quality of life (HrQoL) in short statured children (8–18 years) from patient and parent perspectives. To minimize respondent burden when assessing HrQoL in clinical practice, a brief version of the currently available 22-item QoLISSY is needed. The dataset of the European QoLISSY study (N = 268) was divided into two subdatasets at random, one to identify the items of the brief questionnaire and the other to test the operating characteristics (reliability and validity). Concept-based construction involved the selection of three items per Quality of Life (QoL)-dimension (physical, social, emotional) according to the highest corrected item-scale correlation. Psychometric properties were inspected in terms of reliability and validity supplemented by testing item fit statistics to examine item response theory (IRT) compliance. Cronbach’s alpha for the 9-item version was 0.89 for the patient- and the parent report. Pearson’s correlations with the generic KIDSCREEN questionnaire were low to moderate (children: r = 0.17–0.58; parents: r = 0.12–0.56). Shorter children reported significantly poorer QoL (mean difference 15.39 points; p < 0.001) than taller children, indicating known-groups validity. Results from IRT analysis showed an acceptable fit to Masters’ Partial Credit Model. The 9-item QoLISSY brief version has satisfactory operating characteristics and is an efficient alternative for use in research and practice.

Challenges With Health-related Quality of Life Assessment in Arthroplasty Patients: Problems and Solutions

Assessment of health-related quality of life (HRQOL) using patient-reported outcomes in arthroplasty has become popular because it provides a unique perspective on successful elective procedures. However, challenges exist in the assessment of HRQOL in clinical practice and in clinical research. Patient compliance with multiple and sometimes lengthy HRQOL assessments administered at multiple follow-up visits is problematic. Many well-validated HRQOL instruments are available, and progress has been made in defining the minimal clinically important difference in hip and knee arthroplasty that denotes the minimal change perceived to be important by patients. Challenges in understanding the literature are attributable to the use of various HRQOL scales, with different scoring ranges and scoring algorithms, different interpretations of highest score, and differences in the presentation of raw versus transformed scores.

Health-related quality of life measurement in cystic fibrosis: advances and limitations

Health-related quality of life (HRQoL) measurement in cystic fibrosis (CF) allows the inclusion of the patient's perspective in research and clinical practice. HRQoL scales have been used for many purposes and this review focuses on how HRQoL measurement has been implemented in CF research and care. Specifically, the review considers 1) the instruments used to measure HRQoL, 2) the factors that influence how people report HRQoL, 3) the monitoring of HRQoL in clinical practice, 4) HRQoL as an outcome measure in interventions and clinical trials and 5) whether HRQoL can predict survival. The challenge for the future is to use the available information to develop and evaluate psychological interventions that would be expected to improve HRQoL in children and adults with CF.

Translating the Science of Patient-Reported Outcomes Assessment Into Clinical Practice

Patient-reported outcomes (PROs) are based on direct reporting by patients without the intervention of an observer. They include the self-assessment of functional status, symptoms, and other concerns such as needs and satisfaction with care. Health-related quality of life (HRQOL) assessment is a form of PRO and often includes both functional status and symptoms. The science underlying the assessment of HRQOL in clinical practice requires an understanding of the relationships between symptoms, functional status, and HRQOL, as well as instrument selection, and analysis and interpretation of the data. A modification of the Wilson and Cleary model is proposed to show the likelihood of bidirectional relationships between symptoms, functions, and HRQOL. Instrument selection should be based on the measurement properties of the instruments and patient populations in which they will be used. Analyses of data that allow a calculation of the proportion of patients who benefit from an intervention are preferred to analyses that show only the mean change in scores from baseline. HRQOL assessment in clinical practice has been shown to lead to a better understanding of patients' concerns with improvement in counseling and referral for required services. Potentially, HRQOL assessment should also be used to monitor the progress of a patient's disease and benefit from treatment.

Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study

Validate the acromegaly quality of life (AcroQoL) questionnaire as a disease-generated questionnaire, which analyses physical and psychological domains, the latter subdivided into appearance and personal relationship sub-scales, to evaluate health-related quality of life (HRQoL) in acromegaly. Prospective, observational multicenter study. One hundred and six patients with acromegaly, 42 with active disease studied basally and 6 months after treatment ('sensitivity to change' group), and 64 with treated, stable disease, studied twice within 1 month ('reliability' group) were included. As controls, a reference Spanish population (n=12,245 for the EuroQoL questionnaire) and 157 obese patients (body mass index>30 kg/m2) were studied basally. Socio-demographic data, clinical activity, co-morbidity, GH, IGF-I, and HRQoL (overall perception of health state, EuroQoL and AcroQoL in the obese controls and acromegalic patients) were evaluated. Globally, AcroQoL scored worse in the 'sensitivity to change' group than in the 'reliability' group (56+/-20 vs 65+/-18, P<0.05), but did not discriminate between patients and obese controls. The psychological domain was worse in the 'sensitivity to change' group than obese controls (P<0.05). Appearance was the most affected sub-scale in acromegaly and significantly worse than in obese controls. The sub-scale personal relationships of AcroQoL were less affected in the 'reliability' group than in obese controls (P<0.05). Patients with acromegaly and obese controls showed more problems on the EuroQoL than general Spanish population. Significant correlations were observed globally and for each dimension between AcroQoL and the generic questionnaires. On re-testing, no change was observed in the 'reliability' group in any questionnaire, demonstrating good test-re-test reliability. In the 'sensitivity to change' group after 6 months of treatment, there was improvement in the generic questionnaires and in AcroQoL score (P<0.01). Internal consistency of AcroQoL was good (Cronbach's alpha>0.7). No correlation between AcroQoL and GH or IGF-I was observed. AcroQoL questionnaire is a valid tool for the assessment of HRQoL in clinical practice in patients with acromegaly.

Relationship between provider-based measures of physical function and self-reported health-related quality of life in patients admitted for elective coronary angiography

Improving health-related quality of life (HRQOL) is important for patients with coronary artery disease (CAD). However, few clinicians measure HRQOL in clinical practice. More commonly used are two provider-based measures of CAD, the Canadian Cardiovascular Society (CCS) and the New York Heart Association (NYHA). We explored the relationship of these two provider-based measures with two self-reported HRQOL questionnaires, the Seattle Angina Questionnaire (SAQ) and the Short Form 36 (SF-36). Included were 753 outpatients (74% were men) admitted for elective cardiac catheterization. HRQOL, CCS class, and NYHA status were measured. We found significant associations of CCS and NYHA with HRQOL concerning physical dimensions, but weaker associations for other important dimensions. We also observed weaker associations in women than men, not being previously reported. HRQOL instruments add broader information in patients with CAD and should supplement provider-based measures. Further research is needed on possible implications of the observed sex differences.