Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: A new health status measure for heart failure

OBJECTIVE To create a valid, sensitive, disease-specific health status meas ure for patients with congestive heart failure (CHF). BACKGROUND Quantifying health status is becoming increasingly important for CHF. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a new, self-ad ministered, 23-item questionnaire that quantifies physical limitations, sym ptoms, self-efficacy, social interference and quality of life. METHODS To establish the performance characteristics of the KCCQ, two disti nct patient cohorts were recruited: 70 stable and 59 decompensated CHF pati ents with ejection fractions of <40. Upon entry into the study, patients we re administered the KCCQ, the Minnesota Living with Heart Failure Questionn aire and the Short Form-36 (SF-36). Questionnaires were repeated three mont hs later. RESULTS Convergent validity of each KCCQ domain was documented by compariso n with available criterion standards (r = 0.46 to 0.74; p < 0.001 for all). Among those with stable CHF who remained stable by predefined criteria (n = 39), minimal changes in KCCQ domains were detected over three months of o bservation (mean change = 0.8 to 4.0 points, p = NS for all). In contrast, large changes in score were observed among patients whose decompensated CHF improved three months later (n = 39; mean change = 15.4 to 40.4 points, p < 0.01 for all). The sensitivity of the KCCQ was substantially greater than that of the Minnesota Living with Heart Failure and the SF-36 questionnair es. CONCLUSIONS The KCCQ is a valid, reliable and responsive health status meas ure for patients with CHF and may serve as a clinically meaningful outcome in cardiovascular research, patient management and quality assessment. (J A m Coll Cardiol 2000;35:1245-55) (C) 2000 by the American College of Cardiol ogy.