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All studies underwent IRB approval before their conduct, and each patient signed informed consent to participate. EPHESUS indicates Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival; EVEREST, Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan; and KCCQ, Kansas City Cardiomyopathy Questionnaire. EPHESUS indicates Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival; EVEREST, Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan; and KCCQ, Kansas City Cardiomyopathy Questionnaire.In deriving the short KCCQ, we first restricted consideration to domains that directly measure patients’ current health status: physical limitation, symptom frequency, quality of life, and social limitation.To evaluate construct validity, we first compared each short KCCQ domain scores with their respective score from the full KCCQ.Means and standard deviations of scores, as well as mean and standard deviation of differences and concordance coefficients, as described earlier, were calculated and reported.For each subset of items, we then calculated a short-version domain score following the KCCQ scoring methodology and examined how closely the short score tracked with the corresponding full-version score.We used Lin’s concordance correlation coefficient, which measures the agreement between 2 variables; concordance values range from −1 (perfect negative agreement) to 1 (perfect positive agreement), with 0 denoting no agreement.For each of the 3 remaining domains, we sought to select items that would maximize comparability between the short and full versions of their domain score.
The 23-item KCCQ quantifies 7 domains of patients’ HF-related health status: Physical Limitation (6 items), Symptom Stability (1 item), Symptom Frequency (4 items), Symptom Burden (3 items), Self-Efficacy (2 items), Quality of Life (3 items), and Social Limitations (4 items).
However, its use has been limited, in part, by its length.
We sought to develop a shortened version of the instrument that maintains the psychometric properties of the full KCCQ.
We did not include the single-item symptom change scale because this could not be reduced further, is not incorporated into any of the summary scores, and could always be added to the short version of the KCCQ in clinical settings where a more responsive assessment of recent changes in patients’ symptoms was desired.
We excluded the self-efficacy scale because it measures a distinctly different concept than the ways in which HF impacts patients’ health status.Item responses are coded sequentially (1, 2, 3, etc.) from worst to best status.