Psychometric evaluation of four HIV disease-specific quality-of-life instruments

OBJECTIVE: To provide a comparative evaluation of psychometric properties f or three or more HIV disease-specific quality-of-life (QoL) instruments. METHODS: Four instruments were selected using the following criteria: multi ple publications of instrument, focus of instrument on QoL, psychometric va lidation publication or comparison with previously validated questionnaire, stages of HIV/AIDS used or evaluated in the study, and inclusion of sample items or the instrument in at least one publication. The four HIV-specific QoL instruments were: HIV/AIDS-Targeted Quality of Life instrument, Medica l Outcomes Study HIV questionnaire (MOS-HIV), Functional Assessment of Huma n Immunodeficiency Virus Infection, and HIV Overview of Problems - Evaluati on System. These instruments were evaluated using combined criteria derived from McHomey and Tarlov and Shumaker et al. The criteria include: administ ration, content, depth, reliability, validity, and responsiveness. A letter grade scale (A, B, C, D) was used in rating the criteria. RESULTS: NO instrument demonstrated ideal psychometric properties. The MOS- HIV questionnaire was the only instrument that published results for seven of the eight categories. Therefore, a decision cannot be made about the bes t instrument to use for measuring QoL in an HIV-positive patient. CONCLUSIONS: Published data for these questionnaires had common limitations of sample size, study design, and population demographics. Hence, further testing of these questionnaires is recommended before use in any study to d etermine suitability, reliability, and validity.