ABSTRACT
INTRODUCTION AND OBJECTIVES: To evaluate the applicability, internal consistency and validity of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) when used in primary care, compared with the Short Form-36 (SF-36) health survey. METHODS: The two questionnaires were administered to 589 patients with chronic heart failure who were registered with 97 primary care physicians. The applicability, internal consistency and validity of the MLHFQ were evaluated and comparisons were made with the SF-36. RESULTS: More than 90% of patients completed the questionnaires. The percentage of uncompleted items was low. Cronbach's alpha ranged from 0.79 to 0.94 for the various MLHFQ dimensions. Exploratory factorial analysis identified two factors that explained 65.8% of the variance. Moderate to good correlations were observed between similar dimensions of the MLHFQ and SF-36 (correlation coefficient -0.43 to -0.73). There were significant associations between scores on the MLHFQ and clinical measures of disease severity. CONCLUSIONS: When used in primary care, the MLHFQ had a high level of acceptability and good psychometric properties compared with the SF-36. Consequently, it would be useful for assessing health-related quality of life in patients with chronic heart failure.
Subject(s)
Heart Failure/psychology , Primary Health Care , Surveys and Questionnaires , Adult , Aged , Chronic Disease , Cross-Sectional Studies , Factor Analysis, Statistical , Female , Heart Failure/complications , Humans , Male , Middle Aged , Physicians, Primary Care , Psychometrics , Quality of Life , Reproducibility of ResultsABSTRACT
Introducción y objetivos. Evaluar la aplicabilidad, la consistencia interna y la validez del Minnesota Living with Heart Failure Questionnaire (MLHFQ) en atención primaria, comparándolo con el Short-Form Health Survey (SF-36). Métodos. Se aplicaron ambos cuestionarios a 589 pacientes con insuficiencia cardiaca crónica documentada atendidos por médicos de atención primaria. Analizamos la factibilidad, la consistencia interna y la validez del MLHFQ comparado con el SF-36. Resultados. Respondió los cuestionarios más del 90% de la muestra. El porcentaje de ítems no respondido es bajo. El coeficiente alfa de Cronbach oscila entre 0,79 y 0,94 para las dimensiones del MLHFQ. Del análisis factorial exploratorio, se extraen dos factores que explican una varianza total del 65,8%. Los coeficientes de correlación entre dimensiones similares del MLHFQ y el SF-36 fueron de moderados a altos (0,43 a 0,73). Las puntuaciones del MLHFQ se asocian significativamente con variables clínicas de gravedad. Conclusiones. En atención primaria el MLHFQ, comparado con el SF-36, muestra buena aceptabilidad y buenas propiedades psicométricas que lo hacen útil para medir la calidad de vida relacionada con la salud en pacientes con insuficiencia cardiaca crónica (AU)
Introduction and objectives. To evaluate the applicability, internal consistency and validity of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) when used in primary care, compared with the Short Form-36 (SF-36) health survey. Methods. The two questionnaires were administered to 589 patients with chronic heart failure who were registered with 97 primary care physicians. The applicability, internal consistency and validity of the MLHFQ were evaluated and comparisons were made with the SF-36. Results. More than 90% of patients completed the questionnaires. The percentage of uncompleted items was low. Cronbachs alpha ranged from 0.79 to 0.94 for the various MLHFQ dimensions. Exploratory factorial analysis identified two factors that explained 65.8% of the variance. Moderate to good correlations were observed between similar dimensions of the MLHFQ and SF- 36 (correlation coefficient 0.43 to 0.73). There were significant associations between scores on the MLHFQ and clinical measures of disease severity. Conclusions. When used in primary care, the MLHFQ had a high level of acceptability and good psychometric properties compared with the SF-36. Consequently, it would be useful for assessing health-related quality of life in patients with chronic heart failure (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Validation Studies as Topic , Heart Failure/epidemiology , Echocardiography/methods , Surveys and Questionnaires , Primary Health Care/methods , Psychometrics/methods , Quality of Life , Radiography, Thoracic/methods , 28599 , Confidence Intervals , Analysis of Variance , Factor Analysis, Statistical , Discriminant AnalysisABSTRACT
Objetivo: La tomografía computarizada multicorte (TCMC) permite la visualización de las arterias coronarias, y por tanto la detección de lesiones arterioscleróticas estenóticas. El objetivo del presente trabajo fue analizar la capacidad diagnóstica de la TCMC para la detección de lesiones estenóticas coronarias. Material y métodos: Se realizó un metaanálisis mediante búsqueda en las bases de datos MEDLINE y EMBASE de los trabajos que analizaran la sensibilidad y especificidad de la TCMC para el diagnóstico de enfermedad coronaria, mediante una división del árbol coronario por segmentos. Se incluyeron finalmente 10 estudios, con un total de 498 pacientes y 5.332 segmentos coronarios. Resultados: El porcentaje de segmentos correctamente visualizados osciló entre el 70 y el 96%. Tras la agrupación de la información proporcionada por los estudios individuales, la estimación global de la sensibilidad fue del 0,79 (intervalo de confianza [IC] del 95%, 0,77-0,81) y de la especificidad del 0,95 (IC del 95%, 0,94-0,96). Se demuestra la presencia de heterogeneidad significativa entre estudios y una curva ROC-resumen asimétrica, que corta a la diagonal para valores bajos de especificidad (8%). El área bajo la curva ROC-resumen oscila entre 0,82 y 0,89. Conclusiones: La TCMC es una prueba excelente para la detección de lesiones coronarias estenóticas en segmentos bien visualizados. Sin embargo, la curva ROC-resumen es asimétrica y existe significativa heterogeneidad entre estudios, por lo que es necesario profundizar más en la rentabilidad diagnóstica de la prueba antes de trasladar la información que proporciona a la práctica clínica diaria
Objective: The multislice computed tomography (MSCT) permits visualization of the coronary arteries and thus the detection of stenotic arteriosclerotic lesions. This present study aimed to analyze the diagnostic capacity of the MSCT to detect stenotic coronary lesions. Material and methods: A metaanalysis was conducted through the search in the MEDLINE and EMBASE data bases of the works that analyzed sensitivity and specificity of MSCT for the diagnosis of coronary disease, using a division of the coronary tree by segments. Finally 10 studies were included, with a total of 498 patients and 5322 coronary segments. Results: The percentage of the correctly visualized segments ranged from 70% to 96%. After grouping the information provided by the individual studies, global estimation of sensitivity was 0.79 (95% CI: 0.77-0.81) and specificity 0.95 (95% CI: 0.94-0.96). The presence of significant heterogeneity was demonstrated between studies and an asymmetric summary ROC curve, that cuts the diagonal line for low specificity values (8%). The area under the curve-summary ROC curve-ranges from 0.82 to 0.89. Conclusions: The MSCT is an excellent test to detect stenotic coronary lesions in well visualized segments. However, the summary ROC curve is asymmetric and there is significant heterogeneity between studies, so that it is necessary to study diagnostic profitability of the test in greater depth before transferring the information it provides to the daily clinical practice
