Psychometric evaluation of four HIV disease-specific quality-of-life instruments.

OBJECTIVE: To provide a comparative evaluation of psychometric properties for three or more HIV disease-specific quality-of-life (QoL) instruments.
METHODS: Four instruments were selected using the following criteria: multiple publiations of instrument, focus of instrument on QoL, psychometric validation publication or comparison with prevoiusly validated questionnaire, stages of HIV/AIDS used or evaluated in the study, and inclusion of sample items or the instrument in at least one publication. The four HIV-specific QoL instruments were: HIV/AIDS-Targeted Quality of Life Instrument, Medical Outcomes Study HIV questionnaire (MOS-HIV), Functional Assessment of Human Immunodeficiency Virus Infection, and HIV Overview of Problems -- Evaluation System. These instruments were evaluated using combined criteria derived from McHorney and Tarlov and Shumaker et al. The criteria include: administration, content, depth, reliability, validity, and responsiveness. A letter grade scale (A,B,C,D) was used in rating the criteria.
RESULTS: No instrument demonstrated ideal psychometric properties. The MOS-HIV questionnaire was the only instrument that published results for seven of the eight categories. Therefore, a decision cannot be made about the best instrument to use for measuring QoL in an HIV-positive patient.
CONCLUSIONS: Published data for these questionnaires had common limitations of sample size, study design, and population demograhpics, Hence, further testing of these questionnaires is recommended before use in any study to determine suitability, reliability and validity.