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5.8.5 – Health-related Quality of Life

Measure (Authors, Year) Generic vs Specific, Purpose Administration, Number of Items, Number of Domains Measurement Properties

Functional Assessment of HIV Infection (FAHI)39

HIV-specific

Descriptive and Evaluative

Self-reported questionnaire

47 items

5 domains

Reliability: Internal consistency reliability (>0.73 Cronbach's alpha for all domains)

Validity: Convergent and discriminant validity among adults living with HIV. Responsiveness to change among adults living with HIV.40

Medical Outcomes Study Short Form (SF-36) Questionnaire19,20

Generic

Descriptive

Self-reported questionnaire

36 items

8 domains and 2 summary scores (physical component and mental component)

Demonstrated reliability and validity among people living with HIV.

Reliability: Good internal consistency reliability among people living with HIV (all Cronbach alpha values typically > 0.80) and good test-retest reliability.

Validity: Demonstrated content validity, criterion validity, construct validity with people living with HIV.41,42

Medical Outcomes Study-HIV Health Survey (MOS-HIV)43,44,45

HIV-specific

Descriptive

Self-reported questionnaire

35 items

10 domains and 2 summary scores (Mental Component Summary (MCS) and Physical Component Summary (PCS) scores)

Reliability: Good internal consistency (>0.75 Cronbach's alpha) for all dimensions for people living with HIV. 

Validity: Convergent and discriminant construct validity with people living with HIV.44,46

Multidimensional QOL Questionnaire for HIV/AIDS (MQoL-HIV)47

HIV-specific

Descriptive and Evaluative

Self-reported questionnaire

40 items

10 domains

Reliability: Good internal consistency reliability (>0.70 Cronbach's alpha for 8 out of 10 domains) and test-retest reliability (correlation coefficient >0.70 for all domains except cognitive functioning) among people with asymptomatic and symptomatic HIV infection.

Validity: Discriminative construct validity among people with asymptomatic and symptomatic HIV infection.

Responsiveness: Responsive to change in number of symptoms, viral load and CD4 count during a 3 month period for people living with HIV starting or changing an antiretroviral therapy regimen.46

WHO QOL-HIV48,49

HIV-specific

Descriptive

Self-reported questionnaire

120 items

6 domains

Reliability: Good internal consistency reliability for all domains with Cronbach's alpha between 0.70 and 0.90 among people living with HIV from seven culturally diverse centres.

Validity: Good discriminant validity among people living with HIV in diverse cultural settings.49,50

Patient Reported Outcomes Quality of Life-HIV (PROQOL-HIV) Questionnaire51,52

HIV-specific

Descriptive

Self-reported questionnaire

43 items

8 domains and 1 global health item

Reliability: Good internal consistency reliability with Cronbach alphas on domains ranging from 0.77–0.89. Test–retest reliability demonstrated consistency of the measure over time (intraclass correlation coefficient = 0.86).

Validity: Good convergent and discriminant validity. Correlations with EQ-5D and Medical Outcomes Study–HIV questionnaires complied with concurrent validity expectations; as well as correlations with self-reported symptom and depression questionnaires.

19Ware JE Jr. SF-36 health survey update. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3130-9. Review. PubMed PMID: 11124729. http://www.ncbi.nlm.nih.gov/pubmed/11124729.

20Ware JE Jr, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998  Nov;51(11):903-12. PubMed PMID: 9817107. http://www.ncbi.nlm.nih.gov/pubmed/9817107.

40Peterman AH, Cella D, Mo F, McCain N. Psychometric validation of the revised Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Qual Life Res. 1997 Aug;6(6):572-84. PubMed PMID: 9330556. http://www.ncbi.nlm.nih.gov/pubmed/9330556.

41McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993 Mar;31(3):247-63. Pub Med PMID8450681. http://www.ncbi.nlm.nih.gov/pubmed/8450681.

42McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994 Jan; 32(1):40-66. Pub Med PMID: 8277801. http://www.ncbi.nlm.nih.gov/pubmed/8277801 .

43Wu AW, Hays RD, Kelly S, Malitz F, Bozzette SA. Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS. Qual Life Res. 1997a Aug;6(6):531-54. Review. PubMed PMID: 9330553. http://www.ncbi.nlm.nih.gov/pubmed/9330553.

44Wu AW, Revicki DA, Jacobson D, Malitz FE. Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Qual Life Res. 1997b Aug;6(6):481-93. Review. PubMed PMID: 9330549. http://www.ncbi.nlm.nih.gov/pubmed/9330549.

45Wu AW, Rubin HR, Mathews WC, Ware JE Jr, Brysk LT, Hardy WD, Bozzette SA, Spector SA, Richman DD. A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection. Med Care. 1991 Aug;29(8):786-98. PubMed PMID: 1875745. http://www.ncbi.nlm.nih.gov/pubmed/1875745.

46Badia X, Podzamczer D, Casado A, Lopez-Lavid C, Garcia M. Evaluating changes in health status in HIV-infected patients: Medical Outcomes Study-HIV and Multidimensional Quality of Life-HIV quality of life questionnaires. Spanish MOS-HIV and MQOL-HIV Validation Group. AIDS. 2000 Jul 7;14(10):1439-47. PubMed PMID: 10930160. http://www.ncbi.nlm.nih.gov/pubmed/10930160.

47Avis NE. Development of the MQoL-HIV: the multi-dimensional quality of life questionnaire with HIV/AIDS. Quality of Life Newsletter, 17: 3-4.  http://www.pro-newsletter.com/images/PDF/qol17_0.pdf. Accessed July 17, 2013.

48O'Connell K, Skevington S, Saxena S; WHOQOL HIV Group. Preliminary development of the World Health Organsiation's Quality of Life HIV instrument (WHOQOL-HIV): analysis of the pilot version. Soc Sci Med. 2003 Oct;57(7):1259-75. PubMed PMID:12899909. http://www.ncbi.nlm.nih.gov/pubmed/12899909.

49World Health Organization's Quality of Life Instrument HIV Group. WHOQOL-HIV for quality of life assessment among people living with HIV and AIDS: results from the field test. AIDS Care. 2004 Oct;16(7):882-9. PubMed PMID: 15385243. http://www.ncbi.nlm.nih.gov/pubmed/15385243.

50Fang CT, Hsiung PC, Yu CF, Chen MY, Wang JD. Validation of the World Health Organization quality of life instrument in patients with HIV infection. Qual Life Res. 2002 Dec;11(8):753-62. PubMed PMID: 12482159. http://www.ncbi.nlm.nih.gov/pubmed/12482159.

51Duracinsky M, Herrmann S, Berzins B, Armstrong AR, Kohli R, Le Coeur S, Diouf A, Fournier I, Schechter M, Chassany O. The development of PROQOL-HIV: an international instrument to assess the health-related quality of life of persons living with HIV/AIDS. J Acquir Immune Defic Syndr. 2012 Apr 15;59(5):498-505. doi: 10.1097/QAI.0b013e318245cafe. PubMed PMID: 22205438. http://www.ncbi.nlm.nih.gov/pubmed/22205438.

52Duracinsky M, Lalanne C, Le Coeur S, Herrmann S, Berzins B, Armstrong AR, Lau JT, Fournier I, Chassany O. Psychometric validation of the PROQOL-HIVquestionnaire, a new health-related quality of life instrument-specific to HIV disease. J Acquir Immune Defic Syndr. 2012 Apr 15;59(5):506-15. doi: 10.1097/QAI.0b013e31824be3f2. PubMed PMID: 22293550. http://www.ncbi.nlm.nih.gov/pubmed/22293550.