ARTICLE
Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure
C. Patrick Green, MD*,
Charles B. Porter, MD, FACC*  ,
Dennis R. Bresnahan, MD, FACC* and
John A. Spertus, MD, MPH, FACC*
* Section of Cardiology, Department of Medicine, University of Missouri—Kansas City, Kansas City, Missouri, USA
Mid America Heart Institute, Saint Luke’s Hospital, Kansas City, Missouri, USA
Manuscript received August 4, 1999;
accepted December 15, 1999.
Reprint requests and correspondence: Dr. John A. Spertus, Mid America Heart Institute/University of Missouri—Kansas City, 4401 Wornall Road, Kansas City, Missouri 64111
jspertus{at}cctr.umkc.edu
OBJECTIVES
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 KCCQ was substantially greater than that of the Minnesota Living with Heart Failure and the SF-36 questionnaires.
CONCLUSIONS
The KCCQ is 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.
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Abbreviations and Acronyms
| | CHF | = congestive heart failure | | EF | = ejection fraction | | HRQoL | = health-related quality of life | | KCCQ | = Kansas City Cardiomyopathy Questionnaire | | LiHFe | = Minnesota Living with Heart Failure Questionnaire | | NYHA | = New York Heart Association | | QoL | = quality of life | | SF-36 | = Short Form 36 | | 6 MWT | = 6 minute walk test |
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