Cardiovascular medicine
Measuring the health related quality of life of people with
ischaemic heart disease
M Dempster, M Donnelly
Health and Social
Care Research Unit, The Queen's University of Belfast, Mulhouse
Building, Grosvenor Road, Belfast BT12 6BJ, UK
Correspondence to: Dr Dempster email: m.dempster{at}qub.ac.uk
Accepted 29 June 1999
OBJECTIVES
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.
METHODSMEDLINE 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.
RESULTSOf the three generic measuresthe 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.
CONCLUSIONSAn 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.
Keywords: quality of life; outcome measurement; ischaemic heart disease
© 2000 by Heart
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