title: Measuring quality of life in rural Uganda: reliability and validity of summary scores from the medical outcomes study HIV health survey (MOS-HIV).
abstract: OBJECTIVE
  Summary scores derived from the medical outcomes study HIV health survey (MOS-HIV) are used to assess treatment impacts among HIV-infected patients in Western settings, but have yet to be validated in rural, African settings. We examined the reliability, validity and responsiveness of scores among a prospective cohort of 947 HIV-1-infected adults initiating antiretroviral therapy between May 2003 and May 2004 in rural Uganda.
  
  
  METHODS
  Physical (PHS) and mental health (MHS) summary scores were developed from baseline MOS-HIV sub-domains using exploratory factor analysis. Construct and discriminant validity were established by comparing mean summary scores across known groups of sociodemographic, clinical and health status characteristics. Effect sizes were calculated to assess responsiveness to therapy.
  
  
  RESULTS
  Reliability of the PHS and MHS scores was 0.79 and 0.85, respectively. Mean baseline PHS and MHS scores varied significantly by CD4 cell count, HIV viral load, WHO stage of disease and Karnofsky performance status scores. By 12 months on antiretroviral therapy, PHS and MHS scores improved by 14.6 points (P < 0.001) and 13.9 points (P < 0.001), respectively.
  
  
  CONCLUSIONS
  PHS and MHS scores can be derived from the MOS-HIV and used to assess health status among cohorts of patients taking antiretroviral therapy in rural Uganda.
authors.affiliation: The Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. alstangl@gmail.com
authors.forename: Anne L
authors.initials: AL
authors.lastname: Stangl
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bunnell
authors.forename: Nafuna
authors.initials: N
authors.lastname: Wamai
authors.forename: Humphrey
authors.initials: H
authors.lastname: Masaba
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mermin
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D015497:HIV-1; D006306:Health Surveys; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008603:Mental Health; D025341:Principal Component Analysis; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012424:Rural Population; D013315:Stress, Psychological; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents