The left ventricular dysfunction questionnaire (LVD-36): reliability, validity, and responsiveness

Abstract

Objective: To examine the reliability, validity, and responsiveness of a new health status measure (LVD-36) for patients with left ventricular dysfunction which was designed with emphasis on content validity, clarity, brevity, and ease of use.

Design: At baseline, patients completed the LVD-36 and a range of measures reflecting general health and disease severity. The LVD-36 was repeated after one week. After six months, it was repeated again, along with a transition question to measure global changes in health.

Setting: Patients were recruited from the cardiology and general medical clinics at a south west London hospital.

Patients: 60 patients with chronic left ventricular dysfunction.

Interventions: None.

Main outcome measures: Short form 36 questionnaire (SF-36), Minnesota living with heart failure questionnaire (LIhFE), New York Heart Association criteria, and exercise performance and echocardiographic tests.

Results: The LVD-36 showed good internal consistency (kappa = 0.95) and repeatability (r(i) = 0.95). Its scores were significantly associated with SF-36 mental and physical component scores (r = -0. 48 and -0.75; p < 0.0001), with exercise capacity (r = -0.52; p < 0. 0001), and with systolic shortening fraction (r = -0.27; p < 0.05). Change in the LVD-36 over six months was associated with change in overall health (F = 5.7; p < 0.001). In tests of validity and responsiveness, the LVD-36 performed similarly to or marginally better than the LIhFE.

Conclusions: The LVD-36 showed a high level of reliability and validity, and appears to measure changes in health. It provides a short, simple, valid, and reliable measure of health status in patients with left ventricular dysfunction.

Figure 1

Histogram of LVD-36 and LIhFE scores.

Figure 2

Association between the patients' score for global change and change in scores for (A) LVD-36 and (B) LIhFE over six months. Error bars show 95% confidence intervals.