Do PRO Measures Function the Same Way for all Individuals With Heart Failure?

Coles, Theresa; Lin, Li; Weinfurt, Kevin P.; Reeve, Bryce B.; Spertus, John A.; Mentz, Robert J.; Piña, Ileana L.; Bocell, Fraser D.; Tarver, Michelle E.; Henke, Debra M.; Saha, Anindita; Caldwell, Brittany

doi:10.1016/j.cardfail.2022.05.017

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Psychometric properties of the KCCQ were compared by gender [ 13 ], showing that validity, reliability and sensitivity to change were similar by gender, but published quantitative DIF studies on the KCCQ are not available. Coles and colleagues have discussed the importance of evaluating DIF in measures used with this population [ 14 ]. Similar to the PROMIS + HF measure, the KCCQ includes domains with few items (anchors), limiting the ability to conduct quantitative DIF analyses on all domains.…”

Section: Introductionmentioning

confidence: 99%

Investigating gender-based differential item functioning on the Kansas City Cardiomyopathy Questionnaire (KCCQ) using qualitative content analysis

et al. 2022

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Purpose The purpose of this study is to evaluate potential gender-based differences in interpreting the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) and to explore if there are aspects of health-related quality of life (HRQOL) not captured by the KCCQ-23 that are important to assess in men and/or women with heart failure (HF). Methods Patients ≥ 22 years of age with clinician-diagnosed HF and left ventricular ejection fraction ≤ 40% were recruited from two academic medical centers to participate in semi-structured concept elicitation and cognitive debriefing interviews. Enrollment was stratified by patient-identified gender (half women/half men). All interviews were conducted over the phone/web and audio recorded. Interviews were transcribed and descriptive qualitative content analysis was used to summarize findings overall and by gender. Results Twenty-five adults (56% women) diagnosed with HF participated. The average age was 67 years (range: 25–88). Women attributed a wider variety of symptoms to HF than men. Some participants had difficulty differentiating whether their experiences were due to HF, side effects of their medications, or age. We found very little evidence that participants interpreted KCCQ-23 items differently based on gender. Conclusions Overall, our findings indicate that interpretation of the KCCQ-23 items were similar in men and women. However, some modifications to items may improve clarity of interpretation for a wide range of patients. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03276-y.

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Section: Introductionmentioning

confidence: 99%

Investigating gender-based differential item functioning on the Kansas City Cardiomyopathy Questionnaire (KCCQ) using qualitative content analysis

et al. 2022

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Investigating Potential Gender-Based Differential Item Functioning for Items in the Kansas City Cardiomyopathy Questionnaire (KCCQ) Physical Limitations Domain

Coles

Lin

Weinfurt

et al. 2023

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Background: Women with heart failure report worse health-related quality of life, on average, than men.Whether this is due to true differences in care or that women and men interpret and respond to survey questions differently is unknown. In this study, we investigate potential gender-based differential item functioning (DIF) on the Kansas City Cardiomyopathy Questionnaire (KCCQ) Physical Limitations (PL) domain.Methods: Using data from Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION), a multicenter, randomized controlled trial of exercise training in patients with chronic heart failure with reduced ejection fraction (1670 men, 661 women), we assessed gender DIF using item response theory (IRT)-based Wald test and ordinal logistic regression. Both methods evaluated how men and women responded to each KCCQ item after adjusting for their physical limitation status.Results: A 5-item version of the KCCQ PL domain was evaluated to satisfy statistical assumptions of DIF methodology. No KCCQ items exhibited statistically signi cant DIF using the IRT-based Wald method, and two items exhibited DIF using the ordinal logistic regression method (KCCQ1e: Climbing a ight of stairs without stopping; KCCQ1f: Hurrying or jogging) (p<0.01), but the magnitude of DIF was negligible.Conclusions: To accurately measure patient-reported outcomes, it is important to evaluate potential biases that may in uence the ability to compare patient subgroups. The magnitude of DIF on the 5-item KCCQ PL domain was negligible.

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Do PRO Measures Function the Same Way for all Individuals With Heart Failure?

Cited by 2 publications

References 40 publications

Investigating gender-based differential item functioning on the Kansas City Cardiomyopathy Questionnaire (KCCQ) using qualitative content analysis

Investigating gender-based differential item functioning on the Kansas City Cardiomyopathy Questionnaire (KCCQ) using qualitative content analysis

Investigating Potential Gender-Based Differential Item Functioning for Items in the Kansas City Cardiomyopathy Questionnaire (KCCQ) Physical Limitations Domain

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