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Are the modified "simple questions" a valid and reliable measure of health related quality of life after stroke?

86 citations0/0 files storedJournal of Neurology Neurosurgery & Psychiatry

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Health Systems, Economic Evaluations, Quality of Life Stroke Rehabilitation and Recovery Health Education and Validation

Abstract

OBJECTIVES: Two "simple questions" were developed as a minimalist measurement tool to assess outcome in large trials and epidemiological studies after stroke. A previous study of their validity had disclosed ambiguities in their wording. In this study, the clarity, validity, and reliability of a modified version of these simple questions were examined. The relation between patients' responses to these questions and two widely used generic measures of health related quality of life were also studied. METHODS: A hospital based stroke register cohort of 152 patients, who were all visited at home by a study nurse, was used to study validity. A cohort of 1753 patients derived from the International Stroke Trial was used to study the relation with measures of quality of life. The sensitivity, specificity, and accuracy with which responses to each question predicted the patients' outcome measured using standard instruments was assessed. The distribution of scores for the EuroQol and SF-36 was examined for patients classified as dependent, independent, and fully recovered by the combined use of the modified simple questions. RESULTS: The modified "dependency" question had excellent sensitivity (>85%), specificity (>79%), and accuracy (>82%) for identifying dependency after stroke. The "problems" question had good sensitivity (65-88%) and moderate specificity (36-72%) for the detection of problems in a broad range of domains. The combined use of the modified dependency and problems questions provided a valid, simple, and reliable overall indicator of health related quality of life after stroke. CONCLUSIONS: The modified simple questions have excellent face validity and good measurement properties for the assessment of outcome after stroke. They are particularly well suited for large epidemiological studies and randomised trials.

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References

1983The Hospital Anxiety and Depression Scale 1990EuroQol - a new facility for the measurement of health-related quality of life 1992Statistical methods for assessing observer variability in clinical measures.1997Is the EuroQol a Valid Measure of Health-Related Quality of Life After Stroke?1998Qualitative Comparison of the Reliability of Health Status Assessments With the EuroQol and SF-36 Questionnaires After Stroke 1997Are Proxy Assessments of Health Status After Stroke With the EuroQol Questionnaire Feasible, Accurate, and Unbiased?1997A randomised comparison of the EuroQol and Short Form-36 after stroke: Table 1 1999How Do Scores on the EuroQol Relate to Scores on the SF-36 After Stroke?

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