Validity and Reliability of the Quality of Life with a Left Ventricular Assist Device (QOLVAD) Questionnaire.
Sandau KE, Lee CS, Faulkner KM, Eckman P, Garberich R, Pozehl B, Jurgens CY, Weaver CE, Joseph S, Hall SA, Carey S, Cowger JA, Chaudhry SP, Schroeder SE, Hoffman RO, Feldman D, Conway G, Birati E, Soni M, Marble J, Kunz MS, Storey KM, and Hoglund BA. Validity and Reliability of the Quality of Life with a Left Ventricular Assist Device (QOLVAD) Questionnaire. J Heart Lung Transplant 2019; 38(4Suppl):S261
J Heart Lung Transplant
Purpose: A valid and reliable quality of life (QOL) measure designed for left ventricular assist device (LVAD) patients has not been established. We report second stage preliminary psychometrics for the QOLVAD Questionnaire. Methods: Prospective, cross-sectional study at 7 sites. QOLVAD construct validity (overall, physical, emotional, social, cognitive and meaning/spiritual QOL) was tested using confirmatory factor analysis. Convergent validity was tested using correlations between QOLVAD scores and well-established measures of subjective health status (KCCQ12), depressive symptoms (PHQ9) anxiety (PROMIS), meaning/peace and faith (FACIT). Reliability was quantified using Cronbach's alpha (for domain scores) and factor determinacy score (multidimensional reliability). Test re-test reliability was quantified using correlations and Bland-Altman tests (enrollment vs. 1 week later). Results: There were 186 LVAD patients in the overall sample: 58.5±13.8 years; 82.7% male, 77.3% white, 50% bridge to transplant. Surveys were completed at median time (25th, 75th percentile) of 44 weeks (17.5±115.5) post-VAD. The five domains of the QOLVAD had good construct validity (RMSEA = 0.07, Comparative and Tucker Lewis fit indices = 0.90, weighted and standardized root mean square residual = 1.348 and 0.09, respectively). QOLVAD scores were standardized to range from 0-100 with higher values indicating better QOL. The overall and domain specific scores were significant correlated with the various other tools to which they were compared (Table). Additionally, with the exception of the cognitive domain (α=0.60), reliability was high among all areas (range 0.79 to 0.93) as was test re-test reliability (range 0.71 to 0.94; p<0.001 for all). Conclusion: While a subsequent version will focus on strengthening reliability of the cognitive domain, the existing QOLVAD is a valid, reliable measure of overall QOL with an LVAD and of physical, emotional, social and meaning/spiritual domains.