Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure.
OBJECTIVE
To create a valid, sensitive, disease-specific health status measure for patients with congestive heart failure (CHF).


BACKGROUND
Quantifying health status is becoming increasingly important for CHF. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a new, self-administered, 23-item questionnaire that quantifies physical limitations, symptoms, self-efficacy, social interference and quality of life.


METHODS
To establish the performance characteristics of the KCCQ, two distinct patient cohorts were recruited: 70 stable and 59 decompensated CHF patients with ejection fractions of <40. Upon entry into the study, patients were administered the KCCQ, the Minnesota Living with Heart Failure Questionnaire and the Short Form-36 (SF-36). Questionnaires were repeated three months later.


RESULTS
Convergent validity of each KCCQ domain was documented by comparison with available criterion standards (r = 0.46 to 0.74; p < 0.001 for all). Among those with stable CHF who remained stable by predefined criteria (n = 39), minimal changes in KCCQ domains were detected over three months of observation (mean change = 0.8 to 4.0 points, p = NS for all). In contrast, large changes in score were observed among patients whose decompensated CHF improved three months later (n = 39; mean change = 15.4 to 40.4 points, p < 0.01 for all). The sensitivity of the KCCQwas substantially greater than that of the Minnesota Living with Heart Failure and the SF-36 questionnaires.


CONCLUSIONS
The KCCQis a valid, reliable and responsive health status measure for patients with CHF and may serve as a clinically meaningful outcome in cardiovascular research, patient management and quality assessment.
Green
C P
CP
Department of Medicine, University of Missouri-Kansas City 6411, USA.
Porter
C B
CB
Bresnahan
D R
DR
Spertus
J A
JA
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006333:Heart Failure / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors