TOWARD A BETTER UNDERSTANDING OF HEALTH-RELATED QUALITY-OF-LIFE - A COMPARISON OF THE MEDICAL OUTCOMES STUDY HIV HEALTH SURVEY (MOS-HIV) AND THE HIV OVERVIEW OF PROBLEMS-EVALUATION SYSTEM (HOPES)

Although enthusiasm for measuring health-related quality of life (HRQL ) in clinical trials exists, information is limited on the meaning of scores. We examined the relation between scores from the 34-item Medic al Outcomes Study HIV Health Survey (MOS-HIV) and the more detailed HI V Overview of Problems-Evaluation System (HOPES) using the responses o f 318 HIV-infected outpatients being treated in Los Angeles and Baltim ore. With the HOPES problem statements as independent variables, stati stically significant predictors of the variation in MOS-HIV scores for the Physical Function, Mental Health, and Energy/Fatigue scales were identified using stepwise regression. Approximately 60% to 70% of the variation in each of the scores was explained by five to seven differe nt HOPES problem statements, with a single item explaining 47% to 59% of the variation. We created illustrative profiles for each of the thr ee MOS-HIV scales using the HOPES items identified in the regressions. Independent of the scale, persons scoring in the top MOS-HIV quartile tended to report few if any problems, whereas a decline in score to t he next quartile was characterized by functional difficulties (e.g., ' 'HIV interferes with work''). The onset of specific problems might tri gger further evaluation and potential intervention from health care pr oviders to help maintain patient functioning.