Measuring the health related quality of life of people with ischaemic heart disease

Objectives-To inform researchers and clinicians about the most appropriate generic and disease specific measures of health related quality of life for use among people with ischaemic heart disease. Methods-MEDLINE and BIDS were searched for research papers which contained a report of at least one of the three most common generic instruments or at least one of the five disease specific instruments used with ischaemic hea rt disease patients. Evidence for the validity, reliability, and sensitivit y of these instruments was critically appraised. Results-Of the three generic measures-the Nottingham health profile, sickne ss impact profile, and short form 36 (SF-36)-the SF-36 appears to offer the most reliable, valid, and sensitive assessment of quality of life. However , a few of the SF-36 subscales lack a sufficient degree of sensitivity to d etect change in a patient's clinical condition. According to the best avail able evidence, the quality of life after myocardial infarction questionnair e should be preferred to the Seattle angina questionnaire, the quality of l ife index cardiac version, the angina pectoris quality of life questionnair e, and the summary index. Overall, research on disease specific measures is sparse compared to the number of studies which have investigated generic m easures. Conclusions-An assessment of the quality of life of people with ischaemic h eart disease should comprise a disease specific measure in addition to a ge neric measure. The SF-36 and the quality of life after myocardial infarctio n questionnaire (version 2) are the most appropriate currently available ge neric and disease specific measures of health related quality of life, resp ectively. Further research into the measurement of health related quality o f life of people with ischaemic heart disease is required in order to addre ss the problems (such as lack of sensitivity to detect change) identified b y the review.