Sanjeewa Kularatna1, Donna Rowen2, Clara Mukuria2, Steven McPhail3,4, Gang Chen5, Brendan Mulhern6, Jennifer A Whitty7,8, Joshua Byrnes9, Paul Scuffham9, John Atherton10, Stefan Höfer11, William Parsonage3,10. 1. Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove Queensland 4156, Kelvin Grove, Australia. sanjeewa.kularatna@qut.edu.au. 2. School of Health and Related Research, the University of Sheffield, Sheffield, England. 3. Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove Queensland 4156, Kelvin Grove, Australia. 4. Clinical Informatics Directorate, Metro South Health, Eight Mile Plains, Australia. 5. Centre for Health Economics, Monash University, Clayton, Australia. 6. University of Technology Sydney, Ultimo, Australia. 7. Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK. 8. Applied Research Collaboration (ARC), National Institute for Health Research (NIHR), East of England, UK. 9. Centre for Applied Health Economics, Griffith University, Nathan, Australia. 10. Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Herston, Australia. 11. Medical University Innsbruck, Innsbruck, Austria.
Abstract
PURPOSE: The MacNew Heart Disease Health-Related Quality of Life Instrument (MacNew) is a validated, clinically sensitive, 27-item disease-specific questionnaire. This study aimed to develop a new heart disease-specific classification system for the MacNew amenable for use in health state valuation. METHODS: Patients with heart disease attending outpatient clinics and inpatient wards in Brisbane, Australia, completed MacNew. The development of the new disease-specific classification system included three stages. First, a principal component analysis (PCA) established dimensionality. Second, Rasch analysis was used to select items for each dimension. Third, Rasch analysis was used to explore response-level reduction. In addition, clinician and patient judgement informed item selection. RESULTS: Participants included 685 patients (acute coronary 6%, stable coronary 41%, chronic heart failure 20%). The PCA identified 4 dimensions (restriction, emotion, perception of others, and symptoms). The restriction dimension was divided into physical and social dimensions. One item was selected from each to be included in the classification system. Three items from the emotional dimension and two symptom items were also selected. The final classification system had seven dimensions with four severity levels in each: physical restriction; excluded from doing things with other people; worn out or low in energy; frustrated, impatient or angry; unsure and lacking in self-confidence; shortness of breath; and chest pain. CONCLUSION: This study generated a brief heart disease-specific classification system, consisting of seven dimensions with four severity levels in each. The classification system is amenable to valuation to enable the generation of utility value sets to be developed for use in economic evaluation.
PURPOSE: The MacNew Heart Disease Health-Related Quality of Life Instrument (MacNew) is a validated, clinically sensitive, 27-item disease-specific questionnaire. This study aimed to develop a new heart disease-specific classification system for the MacNew amenable for use in health state valuation. METHODS: Patients with heart disease attending outpatient clinics and inpatient wards in Brisbane, Australia, completed MacNew. The development of the new disease-specific classification system included three stages. First, a principal component analysis (PCA) established dimensionality. Second, Rasch analysis was used to select items for each dimension. Third, Rasch analysis was used to explore response-level reduction. In addition, clinician and patient judgement informed item selection. RESULTS: Participants included 685 patients (acute coronary 6%, stable coronary 41%, chronic heart failure 20%). The PCA identified 4 dimensions (restriction, emotion, perception of others, and symptoms). The restriction dimension was divided into physical and social dimensions. One item was selected from each to be included in the classification system. Three items from the emotional dimension and two symptom items were also selected. The final classification system had seven dimensions with four severity levels in each: physical restriction; excluded from doing things with other people; worn out or low in energy; frustrated, impatient or angry; unsure and lacking in self-confidence; shortness of breath; and chest pain. CONCLUSION: This study generated a brief heart disease-specific classification system, consisting of seven dimensions with four severity levels in each. The classification system is amenable to valuation to enable the generation of utility value sets to be developed for use in economic evaluation.
Authors: Sanjeewa Kularatna; Joshua Byrnes; Yih Kai Chan; Melinda J Carrington; Simon Stewart; Paul A Scuffham Journal: Int J Cardiol Date: 2016-11-09 Impact factor: 4.164
Authors: Sanjeewa Kularatna; Jennifer A Whitty; Newell W Johnson; Ruwan Jayasinghe; Paul A Scuffham Journal: Qual Life Res Date: 2014-12-28 Impact factor: 4.147