Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure

Abstract Background Heart failure is a worldwide health problem that significantly affects patients’ physical function and health state. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a disease-specific patient-reported outcome measure commonly used for the assessment of health states of pat...

Full description

Bibliographic Details
Main Authors: Emi Watanabe-Fujinuma, Hideki Origasa, Luke Bamber, Lothar Roessig, Tetsumi Toyoda, Yuri Haga, Chad Gwaltney, Burkert Pieske
Format: Article
Language:English
Published: BMC 2020-07-01
Series:Health and Quality of Life Outcomes
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12955-020-01483-0
_version_ 1818962134342565888
author Emi Watanabe-Fujinuma
Hideki Origasa
Luke Bamber
Lothar Roessig
Tetsumi Toyoda
Yuri Haga
Chad Gwaltney
Burkert Pieske
author_facet Emi Watanabe-Fujinuma
Hideki Origasa
Luke Bamber
Lothar Roessig
Tetsumi Toyoda
Yuri Haga
Chad Gwaltney
Burkert Pieske
author_sort Emi Watanabe-Fujinuma
collection DOAJ
description Abstract Background Heart failure is a worldwide health problem that significantly affects patients’ physical function and health state. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a disease-specific patient-reported outcome measure commonly used for the assessment of health states of patients with heart failure. This study aimed to evaluate the psychometric properties of the Japanese version of the KCCQ. Methods Using pooled data of 141 Japanese patients with chronic heart failure from three clinical trials, the Japanese version of the KCCQ was evaluated for validity and reliability, with a focus on the clinical summary score (CSS) and its component domains. For construct validity, the associations of baseline KCCQ scores with New York Heart Association (NYHA) class and the EuroQol five-dimension, three-level (EQ-5D-3L) scores at baseline were analyzed. For reliability, internal consistency was assessed using Cronbach’s α, and test–retest reliability (reproducibility) was assessed among stable patients. Responsiveness to changes in patients’ clinical status was assessed by analyzing score changes between two timepoints among patients whose health states improved. Results Among 141 patients (mean age, 73.7 ± 10.9 years), 76.6% were NYHA class II at baseline. For CSS and its component domains (physical limitations, symptom frequency, and symptom severity), baseline scores were all significantly lower in patients with a higher NYHA class (p <  0.001 for all, Jonckheere-Terpstra test). The physical limitations domain and CSS showed a moderate correlation (Spearman’s ρ = − 0.40 to − 0.54) with three functional status-related EQ-5D dimensions (mobility, self-care, and usual activities). The Cronbach’s standardized α was high (> 0.70) for all KCCQ domain/summary scores. In the test–retest analysis among 58 stable patients, all domain/summary scores minimally changed by 0.3–4.2 points with intraclass correlation coefficients of 0.65–0.84, demonstrating moderate to good reproducibility, except for the symptom stability domain. Among 44 patients with improved health states, all domain/summary scores except for the symptom stability and self-efficacy domains substantially improved from baseline with a medium to large effect size of 0.62–0.88. Conclusions The Japanese version of the KCCQ was demonstrated to be a valid and reliable tool for the assessment of symptoms and physical function of Japanese patients with chronic heart failure.
first_indexed 2024-12-20T12:24:30Z
format Article
id doaj.art-dca9ff708c7745ce9a7ee01dff2919c5
institution Directory Open Access Journal
issn 1477-7525
language English
last_indexed 2024-12-20T12:24:30Z
publishDate 2020-07-01
publisher BMC
record_format Article
series Health and Quality of Life Outcomes
spelling doaj.art-dca9ff708c7745ce9a7ee01dff2919c52022-12-21T19:40:53ZengBMCHealth and Quality of Life Outcomes1477-75252020-07-0118111110.1186/s12955-020-01483-0Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failureEmi Watanabe-Fujinuma0Hideki Origasa1Luke Bamber2Lothar Roessig3Tetsumi Toyoda4Yuri Haga5Chad Gwaltney6Burkert Pieske7Health Economics and Outcomes Research, Market Access, Bayer Yakuhin, Ltd.Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical SciencesBayer AGBayer AGClinical Study Support, IncClinical Study Support, IncGwaltney ConsultingDepartment of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine BerlinAbstract Background Heart failure is a worldwide health problem that significantly affects patients’ physical function and health state. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a disease-specific patient-reported outcome measure commonly used for the assessment of health states of patients with heart failure. This study aimed to evaluate the psychometric properties of the Japanese version of the KCCQ. Methods Using pooled data of 141 Japanese patients with chronic heart failure from three clinical trials, the Japanese version of the KCCQ was evaluated for validity and reliability, with a focus on the clinical summary score (CSS) and its component domains. For construct validity, the associations of baseline KCCQ scores with New York Heart Association (NYHA) class and the EuroQol five-dimension, three-level (EQ-5D-3L) scores at baseline were analyzed. For reliability, internal consistency was assessed using Cronbach’s α, and test–retest reliability (reproducibility) was assessed among stable patients. Responsiveness to changes in patients’ clinical status was assessed by analyzing score changes between two timepoints among patients whose health states improved. Results Among 141 patients (mean age, 73.7 ± 10.9 years), 76.6% were NYHA class II at baseline. For CSS and its component domains (physical limitations, symptom frequency, and symptom severity), baseline scores were all significantly lower in patients with a higher NYHA class (p <  0.001 for all, Jonckheere-Terpstra test). The physical limitations domain and CSS showed a moderate correlation (Spearman’s ρ = − 0.40 to − 0.54) with three functional status-related EQ-5D dimensions (mobility, self-care, and usual activities). The Cronbach’s standardized α was high (> 0.70) for all KCCQ domain/summary scores. In the test–retest analysis among 58 stable patients, all domain/summary scores minimally changed by 0.3–4.2 points with intraclass correlation coefficients of 0.65–0.84, demonstrating moderate to good reproducibility, except for the symptom stability domain. Among 44 patients with improved health states, all domain/summary scores except for the symptom stability and self-efficacy domains substantially improved from baseline with a medium to large effect size of 0.62–0.88. Conclusions The Japanese version of the KCCQ was demonstrated to be a valid and reliable tool for the assessment of symptoms and physical function of Japanese patients with chronic heart failure.http://link.springer.com/article/10.1186/s12955-020-01483-0Kansas City Cardiomyopathy QuestionnairePsychometric propertiesHeart failureJapaneseFunctional status
spellingShingle Emi Watanabe-Fujinuma
Hideki Origasa
Luke Bamber
Lothar Roessig
Tetsumi Toyoda
Yuri Haga
Chad Gwaltney
Burkert Pieske
Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
Health and Quality of Life Outcomes
Kansas City Cardiomyopathy Questionnaire
Psychometric properties
Heart failure
Japanese
Functional status
title Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
title_full Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
title_fullStr Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
title_full_unstemmed Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
title_short Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure
title_sort psychometric properties of the japanese version of the kansas city cardiomyopathy questionnaire in japanese patients with chronic heart failure
topic Kansas City Cardiomyopathy Questionnaire
Psychometric properties
Heart failure
Japanese
Functional status
url http://link.springer.com/article/10.1186/s12955-020-01483-0
work_keys_str_mv AT emiwatanabefujinuma psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT hidekiorigasa psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT lukebamber psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT lotharroessig psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT tetsumitoyoda psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT yurihaga psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT chadgwaltney psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure
AT burkertpieske psychometricpropertiesofthejapaneseversionofthekansascitycardiomyopathyquestionnaireinjapanesepatientswithchronicheartfailure