A Timely Evaluation of the Psychometric Properties of the KDQOL-36

Chong, Kelly; Myaskovsky, Larissa; Unruh, Mark

doi:10.1053/j.ajkd.2017.10.028

Cited by 5 publications

(14 citation statements)

References 11 publications

(10 reference statements)

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“…The absence of a clear treatment effect for the high-tertile group of log-on hours may be because of the lack of change in HRQoL features that were not directly targeted by our digital program-i.e., HRQoL components related to improvement in SF and engagement in activities of daily living. In support of this interpretation, it is interesting that features of the MCS 24,25 related to changes in mood and effect did improve in association with increased log-on hours, as demonstrated for the MCS-MH 24,25 subscale. In hindsight, our primary hypothesis about change in the MCS summary score 24,25 may not have been appropriately tailored to evaluate the digital counseling protocol that was administered with the ODYSSEE-KH program over a brief 4-month period.…”

Section: Discussionmentioning

confidence: 67%

“…Second, the 4-month outcome for the MCS can be interpreted as showing a protective effect for the low and high-usage groups against deterioration in MCS scores. It is interesting that the MCS 24,25 contains items regarding the influence of kidney disease on SF, daily activities, mood, and effect. The absence of a clear treatment effect for the high-tertile group of log-on hours may be because of the lack of change in HRQoL features that were not directly targeted by our digital program-i.e., HRQoL components related to improvement in SF and engagement in activities of daily living.…”

Section: Discussionmentioning

confidence: 99%

“…Table 2 indicates that the baseline-adjusted change scores on several secondary outcomes demonstrated a dose-response association. The high-tertile group for program engagement demonstrated significantly greater improvement on the MCS-MH 24,25 subscale as compared with both the moderate (P 5 0.004) and low (P 5 0.02) tertile groups. In addition, separate GLMs demonstrated that significant improvement on the KDQoL Summary Score 27,28 was observed for the high (P 5 0.03) versus low-tertile engagement groups.…”

Section: Secondary End Pointsmentioning

confidence: 92%

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Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

et al. 2023

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Background: In-person counselling programs promote self-care behaviour and health-related quality of life (HRQoL). ODYSSEE Kidney Health (ODYSSEE-KH) is an automated, scalable, digital counselling program for patients with CKD. This open-label, single-arm pilot study tested the efficacy potential of ODYSSEE-KH to improve HRQoL in patients with CKD. Methods: Adults with categories G3b to 5D CKD were recruited from nephrology clinics in Toronto, Canada. Patients (n=29) received access to ODYSSEE-KH in conjunction with usual care. Generalized linear models and pairwise comparisons of mean change scores were conducted to assess the primary outcome: Mental Component Score (MCS) of the Kidney Disease Quality of Life – Short Form (KDQoL-SF) instrument. Secondary outcomes included: MCS mental health scale, 36-item KDQoL-SF, Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire for depression (PHQ-9), Enhancing Recovery in Coronary Heart Disease Social Support Instrument (ESSI), and 3-item Revised UCLA Loneliness (RULS-3) scale. Results: Mean age was 53.5 years (SD=18.3); 35% women; 56% White; 93% completed ≥ post-secondary education; patients came from the Multi-Care Kidney Clinic (n=9), the Home Peritoneal Dialysis Unit (n=12), and the Home Hemodialysis Unit (n=8); and 24 participants completed the 4-month end of study questionnaires. Outcomes were assessed according to tertiles of program logon minutes: median (range) = 67 (62-108), 212 (119-355), and 500 (359-1573) minutes. Patients in the highest tertile of engagement showed significant improvements on the MCS vs. the moderate tertile group (p = 0.01). Significant dose-response associations were observed for MCS Mental Health (p<0.05), KDQoL Burden on Kidney Disease (p<0.01), KDQoL Effect of Kidney Disease on Everyday Life (p<0.01), aggregated KDQoL summary (p<0.05), GAD-7 (p<0.01), PHQ-9 (p<0.05), ENRICHD-SSI (p<0.01), and RULS-3 (p<0.01). Conclusion: ODYSSEE-KH demonstrated feasibility as an automated, scalable, digital self-care program for patients with CKD. There is evidence of efficacy potential to improve HRQoL. Further evaluation with a larger sample is warranted.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Secondary End Pointsmentioning

confidence: 92%

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Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

et al. 2023

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“…Each score ranges from 0 to 100, with higher scores indicating better HRQOL [60]. The reliability and validity of the KDQOL-36 have been affirmed in previous studies [58,61,62] and was selected because of its extensive use among patients on dialysis and KTR [57,[63][64][65][66][67][68][69][70][71][72][73]. We also included the SF-PCS and SF-MCS (part of KDQOL-36) as these subscales evaluate the physical or mental aspects of generic quality of life, respectively, to assess the mental and physical ESAS-r domain scores in our study sample.…”

Section: Legacy Measuresmentioning

confidence: 99%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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Summary We assessed the validity of the Edmonton Symptom Assessment System (ESAS‐r) in kidney transplant recipients (KTR). A cross‐sectional sample of 252 KTR was recruited. Individual ESAS‐r symptom scores and symptom domain scores were evaluated. Internal consistency, convergent validity, and construct validity were assessed with Cronbach’s α, Spearman’s rank correlations, and a priori‐defined risk group comparisons. Mean (SD) age was 51 (16), 58% were male, and 58% Caucasian. ESAS‐r Physical, Emotional, and Global Symptom Scores demonstrated good internal consistency (α > 0.8 for all). ESAS‐r Physical and Global Symptom Scores strongly correlated with PHQ‐9 scores (0.72, 95% CI: 0.64–0.78 and 0.74, 95% CI: 0.67–0.80). For a priori‐defined risk groups, individual ESAS‐r symptom score differed between groups with lower versus higher eGFR [pain: 1 (0–3) vs. 0 (0–2), delta = 0.18; tiredness: 3 (1–5) vs. 1.5 (0–4), delta = 0.21] and lower versus higher hemoglobin [tiredness: 3 (1–6) vs. 2 (0–4), delta = 0.27]. ESAS‐r Global and Physical Symptom Scores differed between groups with lower versus higher hemoglobin [13 (6–29) vs. 6.5 (0–18.5), delta = 0.3, and 9 (2–19) vs. 4 (0–13), delta = 0.24] and lower versus higher eGFR [11 (4–20) vs. 6.5 (2–13), delta = 0.21, and 7 (2–16) vs. 3 (0–9), delta = 0.26]. These data support reliability and construct validity of ESAS‐r in KTR. Future studies should explore its clinical utility for symptom assessment among KTR.

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“…There are disease-specific questionnaires developed for transplant patients or individuals with chronic renal failure, such as the Modified Transplant Symptom Occurrence and Symptom Distress scale derived from 59 items (MTSOSD-59R) ( Kim and Jang, 2020 ) or the Kidney Disease and Quality-of-Life (KDQOL-36) ( Chong et al, 2018 ). The implementation of such elicitation instruments in a routine QoL survey during follow-up (FU) visits remained difficult to achieve in larger scale, due to the number of items, language issues, and nuances between proposals in the questionnaires.…”

Section: Introductionmentioning

confidence: 99%

Immunosuppressant drugs and quality-of-life outcomes in kidney transplant recipients: An international cohort study (EU-TRAIN)

et al. 2023

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Introduction: Patient-Reported Outcomes (PRO) integrate a wide range of holistic dimensions that arenot captured within clinical outcomes. Particularly, from induction treatment to maintenance therapy, patient quality-of-life (QoL) of kidney transplant recipients have been sparsely investigated in international settings.Methods: In a prospective, multi-centric cohort study, including nine transplant centers in four countries, we explored the QoL during the year following transplantation using validated elicitation instruments (EQ-5D-3L index with VAS) in a population of kidney transplant patients receiving immunosuppressive therapies. Calcineurin inhibitors (tacrolimus and ciclosporin), IMPD inhibitor (mycophenolate mofetil), and mTOR inhibitors (everolimus and sirolimus) were the standard-of-care (SOC) medications, together with tapering glucocorticoid therapy. We used EQ-5D and VAS data as QoL measures alongside descriptive statistics at inclusion, per country and hospital center. We computed the proportions of patients with different immunosuppressive therapy patterns, and using bivariate and multivariate analyses, assessed the variations of EQ-5D and VAS between baseline (i.e., inclusion Month 0) and follow up visits (Month 12).Results: Among 542 kidney transplant patients included and followed from November 2018 to June 2021, 491 filled at least one QoL questionnaire at least at baseline (Month 0). The majority of patients in all countries received tacrolimus and mycophenolate mofetil, ranging from 90.0% in Switzerland and Spain to 95.8% in Germany. At M12, a significant proportion of patients switched immunosuppressive drugs, with proportion varying from 20% in Germany to 40% in Spain and Switzerland. At visit M12, patients who kept SOC therapy had higher EQ-5D (by 8 percentage points, p < 0.05) and VAS (by 4 percentage points, p < 0.1) scores than switchers. VAS scores were generally lower than EQ-5D (mean 0.68 [0.5–0.8] vs. 0.85 [0.8–1]).Discussion: Although overall a positive trend in QoL was observed, the formal analyses did not show any significant improvements in EQ-5D scores or VAS. Only when the effect of a therapy use was separated from the effect of switching, the VAS score was significantly worse for switchers during the follow up period, irrespective of the therapy type. If adjusted for patient characteristics and medical history (e.g., gender, BMI, eGRF, history of diabetes), VAS and EQ-5D delivered sound PRO measures for QoL assessments during the year following renal transplantation.

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A Timely Evaluation of the Psychometric Properties of the KDQOL-36

Abstract: The best measure of quality is not how well or how frequently a medical service is given, but how closely the result approaches the fundamental objectives of prolonging life, relieving distress, restoring function, and preventing disability.

Cited by 5 publications

References 11 publications

Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

Automated Digital Counseling Program (ODYSSEE-Kidney Health): A Pilot Study on Health-Related Quality of Life

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Immunosuppressant drugs and quality-of-life outcomes in kidney transplant recipients: An international cohort study (EU-TRAIN)

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