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. 2019 Feb 14;17(1):36.
doi: 10.1186/s12955-019-1104-2.

Responsiveness and minimal clinically important difference of the Minnesota living with heart failure questionnaire

M Gonzalez-Saenz de Tejada  1   2 , A Bilbao  3   4 , L Ansola  3 , R Quirós  4   5 , L García-Perez  4   6 , G Navarro  7 , A Escobar  3   4
Affiliations

Responsiveness and minimal clinically important difference of the Minnesota living with heart failure questionnaire

M Gonzalez-Saenz de Tejada et al. Health Qual Life Outcomes. .

Abstract

Background: The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most widely used health-related quality of life questionnaires for patients with heart failure (HF). The objective of the present study was to explore the responsiveness of the MLHFQ by estimating the minimal detectable change (MDC) and the minimal clinically important difference (MCID) in Spain.

Methods: Patients hospitalized for HF in the participating hospitals completed the MLHFQ at baseline and 6 months, plus anchor questions at 6 months. To study responsiveness, patients were classified as having "improved", remained "the same" or "worsened", using anchor questions. We used the standardized effect size (SES), and standardized response mean (SRM) to measure the magnitude of the changes scores and calculate the MDC and MCID.

Results: Overall, 1211 patients completed the baseline and follow-up questionnaires 6 months after discharge. The mean changes in all MLHFQ domains followed a trend (P < 0.0001) with larger gains in quality of life among patients classified as "improved", smaller gains among those classified as "the same", and losses among those classified as "worsened". The SES and SRM responsiveness parameters in the "improved" group were ≥ 0.80 on nearly all scales. Among patients classified as "worsened", effect sizes were < 0.40, while among patients classified as "the same", the values ranged from 0.24 to 0.52. The MDC ranged from 7.27 to 16.96. The MCID based on patients whose response to the anchor question was "somewhat better", ranged from 3.59 to 19.14 points.

Conclusions: All of these results suggest that all domains of the MLHFQ have a good sensitivity to change in the population studied.

Keywords: Health-related quality of life; Heart failure; Minimal clinically important difference; Minnesota living with heart failure questionnaire; Psychometric properties; Responsiveness.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study received the approval of the following Ethics Committees for Clinical Research: Hospital Universitario de Basurto (22.08), Hospital Costa del Sol, Hospital Universitar Parc Taulí, and Hospital Universitario Nuestra Señora de Candelaria (09/09).

Consent to participate was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200. doi: 10.1093/eurheartj/ehw128. - DOI - PubMed
    1. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322. - PubMed
    1. Juenger J, Schellberg D, Kraemer S, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart. 2002;87:235–241. doi: 10.1136/heart.87.3.235. - DOI - PMC - PubMed
    1. Kilgore M, Patel HK, Kielhorn A, Maya JF, Sharma P. Economic burden of hospitalizations of Medicare beneficiaries with heart failure. Risk Manag Healthc Policy. 2017;10:63–70. doi: 10.2147/RMHP.S130341. - DOI - PMC - PubMed
    1. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245. - PMC - PubMed

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