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6/9/2014 Psychometric Properties of Quality of Life and Health Related Quality of Life Assessments in People with Multiple Sclerosis Learmonth, Y. C., Hubbard, E. A., McAuley, E. Motl, R. W. Department of Kinesiology and Community Health,

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6/9/2014 1

Psychometric Properties of Quality of Life and Health‐Related Quality of Life Assessments in People with Multiple Sclerosis

Learmonth, Y. C., Hubbard, E. A., McAuley, E. Motl, R. W.

Department of Kinesiology and Community Health, University of Illinois at Urbana‐Champaign, Urbana, IL, USA

Quality of life defined

  • Quality of life (QOL)

ality of life (QOL)

– Subjective w bjective well-being ll-being or

  • r Satisfaction with

tisfaction with life life1, 2

1, 2

  • Health r

alth related-QOL (HR lated-QOL (HRQOL) QOL)

– Physical & psy Physical & psychological hological aspects of evaluating aspects of evaluating

  • ne
  • ne’s health status

s health status3,4

3,4

  • Both ar

Both are lo e lower in MS r in MS

– Compar Compared with healthier population ed with healthier population5 – Compar Compared with other ed with other disease population disease population6-8

6-8

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6/9/2014 2

  • 9

9, 10

Measurement of QOL & HRQOL

  • Ge

Gene neric sc scales

– 12-item 12-item Shor

  • rt F

t Form rm Health S alth Survey (SF-12) ey (SF-12)11

11

– Satisfaction tisfaction With Life Scale (SWLS th Life Scale (SWLS)2,

)2,

  • MS scales

MS scales

– Leeds M Leeds Multiple Sclerosis Q ltiple Sclerosis Quality ality of Life

  • f Life (LMSQOL)

(LMSQOL)12

12

– 29-item 29-item Multiple Sclerosis I ltiple Sclerosis Impact pact Scale Scale (MSIS-29 (MSIS-29)13,

)13,

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6/9/2014 3

Measurement of Psychometric properties

  • Test-r

st-retest r etest reliability; liability;

– Temporal stability mporal stability

  • Phenomenon

Phenomenon (i.e., QOL and HR (i.e., QOL and HRQOL) QOL)

  • Measur

asurement ement (i.e., SF-12 and SWLS) (i.e., SF-12 and SWLS)

Reliability Measurement error

  • All measur

All measures ar es are vulnerable e vulnerable to err to error

– Standar andard error error of

  • f measur

measurement ement (SEM) (SEM) – Coefficient of Coefficient of variation (CV variation (CV)

Interpretability

  • Smallest detectable change (SDC)

allest detectable change (SDC)

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6/9/2014 4

Is the change meaningful?

No change SEM or SDC Maximal CV change

≥SDC Change statistically significant and MAY be important <SEM/CV Change cannot be distinguished from measurement error ≥SEM/CV Change statistically significant, but NOT important

Study Purpose

  • Determine the test-r

termine the test-retest etest reliability liability, measur measurement err ement error, and interpr and interpretability of tability of QOL (i.e., SWLS QOL (i.e., SWLS and LMSQOL) and LMSQOL) and and HR HRQOL (i.e., SF-12 and MSIS-29) QOL (i.e., SF-12 and MSIS-29) measur measures es

  • ver six months

er six months in people with in people with MS. MS.

  • Interpr

terpret the r t the results sults of inter

  • f intervention

ention effectiv effectiveness eness

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6/9/2014 5

Participants

Initial interest 511

  • 124 lost interest

with initial explanation

387 screened

  • 27 did not meet inclusion
  • 16 lost interest

344 Sent demographic, QOL and HRQOL questionnaires

  • 44 did not return

baseline documents

  • 8 discontinued

participation

292 at baseline

  • 18 did not return

documents at 6 month follow‐up

Final analysis 274

Outcomes

  • SWLS

SWLS

– 5 items, 7-point scale. H 5 items, 7-point scale. Higher gher scor scores = higher es = higher QOL. QOL.

  • LMSQOL

LMSQOL

– 8 items, 4 point 8 items, 4 point scale. H

  • scale. Higher scor

gher scores es = worse QOL = worse QOL

  • SF12

SF12

– 12 12 items, composite point items, composite point scale. P

  • scale. Physical

ysical composite composite (PCS) & (PCS) & Mental composite ntal composite (MCS). H (MCS). Higher scor gher scores es = = higher higher HR HRQOL QOL

  • MSIS-29

MSIS-29

– 29 29 items, 4 point items, 4 point scale. P

  • scale. Physical

ysical and and psy psychological hological

  • components. H
  • components. Higher

gher scor scores = worse es = worse HR HRQOL QOL

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Data analysis

  • Reliability

liability

– ICC CC analys analyses es (2,1 (2,1 mix mixed model) d model) ≥0.6=moderate reliability ≥0.8=good reliability

  • Measur

asurement err ement error

– SEM = SEM = SD SDba

basel seline ne x √(1-I

x √(1-ICC) CC) (SD-of each (SD-of each outcome)

  • utcome)

– CV CV = = dividing s dividing sample SD mple SD of the diffe

  • f the difference

rence betw between the een the two time-points two time-points, by by the the mean mean difference betw difference between the een the time time points points x100 x100

  • Interpr

terpretability tability

– SDC =1.96 SDC =1.96 x √(2) x √(2) x SEM x SEM – SDC % SDC % = % = % of

  • f baseline

baseline mean mean

  • Va

Validity

– Spearman corr earman correl elat ations ions

  • ≥0.5=good v

≥0.5=good validity lidity

Results; Sample description (n=274)

Variable Sex (N, % female) 229 (84) Age (years) Mean (SD) 48.0 (10.4) Range 20‐84 Type of MS Relapsing Remitting N (%) 222(81) Secondary Progressive N (%) 33(12) Primary Progressive N (%) 12(4) Benign 6(2) Disease duration (years) Mean (SD) 10.3 (7.8) Range 1‐37 PDDS score Median (IQR) 3 (3) Range 0‐6

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Change over time

Measure Baseline mean (SD, SE) Six month mean (SD, SE) Change p‐ value SWLS 21.8 (8.0, 0.5) 22.1 (8.2, 0.5) 1.38 .306 SF‐12 PCS SF‐12 MCS 41.9 (9.0, 0.5) 41.3 (9.5, 0.6) ‐1.43 .182 41.5 (9.2, 0.6) 43.3 (7.5, 0.5) 4.34 <.001 LMSQOL 19.3 (4.8, 0.3) 19.0 (4.9, 0.3) 1.55 .133 MSIS‐29 Physical MSIS‐29 Mental 39.9 (27.8, 1.7) 39.0 (29.3, 1.8) 2.26 .339 43.0 (29.85, 1.8) 39.5 (28.7, 1.7) 8.14 .004

Reliability

Measure ICC 95% CI ICC SWLS .772 .720‐.816 SF‐12 PCS .741 .682‐.790 SF‐12 MCS .669 .598‐.730 LMSQOL .812 .767‐.849 MSIS‐29 Physical .883 .853‐.906 MSIS‐29 Mental .768 .715‐.813 Moderate (≥0.6) & good (≥0.8) reliability

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Measurement Error

Measure SEM %SEM CV (%) SWLS 3.8 17.4 13.4 SF‐12 PCS SF‐12 MCS 4.6 11.1 9.3 5.3 12.5 9.7 LMSQOL 2.1 10.9 8.9 MSIS‐29 Physical MSIS‐29 Mental 9.5 24 28.7 13.2 30.7 31.2 Accuracy

Interpretability

Measure SDC95 % SDC95 SWLS 10.5 48.1 SF‐12 PCS SF‐12 MCS 12.7 30.6 14.7 34.7 LMSQOL 5.8 30.1 MSIS‐29 Physical MSIS‐29 Mental 26.4 67 36.7 89

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Validity

Measure SWLS SF‐12 PCS SF‐12 MCS LMSQOL MSIS‐29 Physical MSIS‐29 Mental PDDS SF‐12 PCS SF‐12 MCS .355** .410** .071 LMSQOL ‐.674** ‐.411** ‐.623** MSIS‐29 Physical MSIS‐29 Mental ‐.489** ‐.671** ‐.386** .571** ‐.561** ‐.326** ‐.581** .696** .669** PDDS ‐.309** ‐.681** ‐.107 .360** .704** .350** ‐ Convergent Validity Construct Validity Convergent Validity ≥0.5 good

In summary

  • Moderate

derate (to good) r (to good) reliability liability

  • Suppor

pport past past findings for LMSQOL findings for LMSQOL & MSIS- & MSIS- 29 2912,13.

12,13.

  • Novel r

l reliability r liability results sults for SWLS & SF-12 in for SWLS & SF-12 in MS MS

  • Stability o

ability over six er six months is months is impor important ant

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6/9/2014 10

Interpreting change (LMSQOL)

No change SEM or SDC Maximal CV change

≥30% Change statistically significant and MAY be important <10% Change cannot be distinguished from measurement error ≥10% Change statistically significant, but NOT important

10% 30%

Validity

  • First study r

rst study repor porting ing relationships betw lationships between een QOL and HR QOL and HRQOL in MS QOL in MS

  • Good
  • od validity of all four

lidity of all four measur measures es

– Constr Construct uct – Convergent Convergent

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6/9/2014 11

Discussion

  • Ov

Overall, our data suggest erall, our data suggest that the that the phenomenon phenomenon (HR (HRQOL & QOL) & all four QOL & QOL) & all four measur measures hav es have acceptable acceptable measur measurement ement stability stability, as indicated as indicated thr through the r ugh the reliability liability estimates. estimates.

  • Power calculations

r calculations

  • Interpr

terpret clinical et clinical scor scores es

  • Limitations

Limitations

  • Distribution & criterion method

stribution & criterion method recommended. commended.

Recommendations

  • Resear

search r ch recommendation commendation

– Consider all psy Consider all psychometric hometric proper properties ties

  • QOL r

QOL recommendation commendation

– LMSQOL LMSQOL

  • HR

HRQOL r QOL recommendation commendation

– SF-12 SF-12

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6/9/2014 12

Acknowledgements

  • Thank y

Thank you to all r u to all resear search staff and ch staff and par participants. icipants.

  • Thank y

Thank you to N u to National tional Institute of stitute of Neur urological D

  • logical Disor

sorders ers and and Stroke ke (NS054050). (NS054050).

References

  • 1. P
  • 1. Pavot

vot W, Die Diener E.

  • E. Revie

view of

  • f the sa

satisfa sfaction

  • n wit

with life life sca

  • scale. P

Psychol A l Asse

  • ssess. 1993;5:2.
  • ss. 1993;5:2.
  • 2. Die
  • 2. Diener ED,

ED, Em Emmons R RA, , La Larse rsen R RJ, Griffin , Griffin S. Th

  • S. The sa

satisfa sfaction

  • n wit

with life life sca

  • scale. J P

J Pers A rs Asse

  • ssess. 1985;49(
  • ss. 1985;49(1)

1):71–5. :71–5.

  • 3. W
  • 3. Ware

re JE, JE, Sh Sherbou bourne CD. Th . The MO MOS S 36- 36-Item Sh Short

  • rt-Form

rm H Health Su Surve rvey (SF-36) 36): I : I. C Conceptual Framework

  • rk and I

d Item Se Sele lect ction ion. Me Med C d Care re. . 1992 Ju 1992 Jun 1;30( 1;30(6) 6):473–83. :473–83.

  • 4. McH
  • 4. McHorn

rney CA, W , Ware re JE, R JE, Racze czek A AE. . Th The MO MOS 36- S 36-Item Sh Short

  • rt-Form

rm H Health Su Surve rvey (SF-36) 36): : II. Psychometric a ic and C d Clin inica ical Te Test sts s

  • f
  • f Validit

lidity in in Me Measurin ing P Physica ical and Me d Mental H Health Constructs. Me . Med d Care

  • re. 1993

. 1993 Ma Mar r 1;31( 1;31(3) 3):247–63. :247–63.

  • 5. Lobe
  • 5. Lobentanz

z IS, , Asenba baum S, V S, Vass ss K, Sa Sauter C, K Klösch ösch G, K G, Kolle llegger r H, et al. F . Fact ctors in

  • rs influ

fluencin ing qu qualit ity of life

  • f life in

in m mult ltiple iple sc sclerosis lerosis pa patients: : disa disabilit bility, de , depre pressive ssive m mood,

  • od, fa

fatigue and sle d sleep qu qualit

  • ity. Acta N

Neurol

  • l Sca

Scand.

  • d. 2004 Ju

2004 Jul;110( l;110(1) 1):6–13. :6–13.

  • 6. La
  • 6. Lankhorst

rst GJ, Je GJ, Jelle lles F s F, Sm Smit its R s RC, , Polm lman CH, , Kuik DJ, P DJ, Pfennings LE, e s LE, et al. Q . Qualit ity y of life

  • f life in

in m mult ltiple iple scle sclerosis: rosis: the disa disabi bilit lity a and d im impa pact ct profile profile ( (DIP). J J Neurol.

  • l. 1996 Ju

1996 Jun;243( ;243(6) 6):469–74. :469–74.

  • 7.
  • 7. Naess H

ss H, Be Beisk iske A AG, My , Myhr KM. . Qualit ity of

  • f life

life a amon

  • ng young pa

patients ts with is th ischaemic aemic stro roke c ke compared mpared with patients th patients with mul th multipl iple scle sclerosis.

  • rosis. Acta N

Neurol

  • l Sca

Scand.

  • d. 2008 Ma

2008 Mar;117( r;117(3) 3):181–5. :181–5.

  • 8. R
  • 8. Rudick

dick RA, , Mille Miller D, C r D, Clou

  • ugh JD,

JD, Gra Gragg LA LA, , Farm rmer R RG. . Qualit ity of life

  • f life in

in m mult ltiple iple scle sclerosis.

  • rosis. Comparison

ison wit with in infla flammatory ry bowe bowel dise l disease a and d rh rheumatoid id arthrit

  • ritis. A
  • s. Arch

ch Neurol.

  • l. 1992;49(

1992;49(12) 12):1237–42. :1237–42.

  • 9. Mot
  • 9. Motl RW, Gosn

, Gosney JL. Effe

  • JL. Effect

ct of e

  • f exercise

cise t training on

  • n qu

qualit ity of life in mu

  • f life in mult

ltiple iple sclerosis: sclerosis: a met meta-a

  • ana

nalysis.

  • lysis. Mu

Mult lt Scler. Scler. 2008;14( 2008;14(1) 1):129–35. :129–35.

  • 10. H
  • 10. Heesen C, Cohen JA

JA. . Doe Does t the pa patient know be

  • w best

st? Qualit ity y of life

  • f life a

asse ssessm ssment in in m mult ltiple iple scle sclerosis rosis tria

  • ials. Mu
  • ls. Mult

lt Scle Scler r J. 2014

  • J. 2014 F

Feb b 1;20( 1;20(2) 2):131–2. :131–2.

  • 11. W
  • 11. Ware

re Jr Jr JE, K JE, Kosin sinski M, M, Kelle ller r SD. A

  • SD. A 12-

12-Item Sh Short

  • rt-Form

rm H Health Su Surve rvey: : con construction

  • n of sca
  • f scales a

and d pre prelim imin inary t test sts s of

  • f

re relia liabilit ility a and d va validit

  • lidity. Me

. Med d Care re. . 1996;34( 1996;34(3) 3):220–33. :220–33.

  • 12. F
  • 12. Ford H

rd HL, , Ge Gerry rry E, Te E, Tennant A, W Whalle lley D, H D, Haig igh R, Joh Johnson son MH

  • MH. De

. Deve velopin loping a dise disease-spe specific ific qu qualit ity of life

  • f life m

measure for for pe people

  • ple wit

with m mult ltiple iple scle sclerosis.

  • rosis. Clin

in R

  • Rehabil. 2001
  • bil. 2001 Ju

Jun;15( ;15(3) 3):247–58. :247–58.

  • 13. H
  • 13. Hoba

bart rt J, La J, Lampin ping D, F D, Fitzpa patrick ick R, R Riazi i A, Th Thom

  • mpson

pson A. Th The Mu Mult ltiple iple Scle Sclerosis I rosis Impa pact ct Sca Scale ( (MSI SIS- S-29) 29): a : a n new w pa patient-ba base sed

  • u
  • utcom
  • me m
  • measure. Bra
  • Brain. 2001

2001 Ma May;124( ;124(Pt 5) 5):962–73. :962–73.