Measuring the health related quality of life of people with ischaemic heart disease.
OBJECTIVE
To inform researchers and clinicians about the most appropriate generic and disease specific measures of health related quality of life for use among people with ischaemic heart disease.


METHODS
MEDLINE and BIDS were searched for research papers which contained a report of at least one of the three most common generic instruments or at least one of the five disease specific instruments used with ischaemic heart disease patients. Evidence for the validity, reliability, and sensitivity of these instruments was critically appraised.


RESULTS
Of the three generic measures-the Nottingham health profile, sickness impact profile, and short form 36 (SF-36)-the SF-36 appears to offer the most reliable, valid, and sensitive assessment of quality of life. However, a few of the SF-36 subscales lack a sufficient degree of sensitivity to detect change in a patient's clinical condition. According to the best available evidence, the quality of life after myocardial infarction questionnaire should be preferred to the Seattle angina questionnaire, the quality of life index cardiac version, the angina pectoris quality of life questionnaire, and the summary index. Overall, research on disease specific measures is sparse compared to the number of studies which have investigated generic measures.


CONCLUSIONS
An assessment of the quality of life of people with ischaemic heart disease should comprise a disease specific measure in addition to a generic measure. The SF-36 and the quality of life after myocardial infarction questionnaire (version 2) are the most appropriate currently available generic and disease specific measures of health related quality of life, respectively. Further research into the measurement of health related quality of life of people with ischaemic heart disease is required in order to address the problems (such as lack of sensitivity to detect change) identified by the review.
Dempster
M
M
Health and Social Care Research Unit, The Queen's University of Belfast, Mulhouse Building, Grosvenor Road, Belfast BT12 6BJ, UK. m.dempster@qub.ac.uk
Donnelly
M
M
D006305:Health Status Indicators; D006801:Humans; D017202:Myocardial Ischemia / Q000523:psychology*; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile; D016896:Treatment Outcome