Development of a Novel Adult Congenital Heart Disease-Specific Patient-Reported Outcome Metric

J Am Heart Assoc. 2020 Jun 2;9(11):e015730. doi: 10.1161/JAHA.119.015730. Epub 2020 May 16.

Abstract

Background Patient-reported outcome metrics (PROs) quantify important outcomes in clinical trials and can be sensitive measures of patient experience in clinical practice. Currently, there is no validated disease-specific PRO for adults with congenital heart disease (ACHD). Methods and Results We conducted a preliminary psychometric validation of a novel ACHD PRO. ACHD patients were recruited prospectively from 2 institutions and completed a series of questionnaires, a physician health assessment, and a 6-minute walk test. Participants returned to complete the same questionnaires and assessment 3 months±2 weeks later. We tested the internal consistency and test-retest reliability by comparing responses among clinically stable patients at the 2 study visits. We assessed convergent and divergent validity by comparison of ACHD PRO responses to existing validated questionnaires. We assessed responsiveness by comparison with patient-reported clinical change. One hundred three patients completed 1 study visit and 81 completed both. The ACHD PRO demonstrated good internal consistency in each of its 5 domains (Cronbach's α: 0.87; 0.74; 0.74; 0.90; and 0.89, respectively) and in the overall summary score (0.92). Test-retest reliability was good with an intraclass correlation ≥0.73 for all domains and 0.78 for the Summary Score. The ACHD PRO accurately assessed domain concepts based on comparison with validated standards. Preliminary estimates of responsiveness suggest sensitivity to clinical status. Conclusions These studies provide initial support for the validity and reliability of the ACHD PRO. Further studies are needed to assess its sensitivity to changes in clinical status.

Keywords: adult congenital heart disease; patient‐reported health status; patient‐reported outcome metric; quality of life.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • District of Columbia
  • Female
  • Health Status Indicators*
  • Heart Defects, Congenital / diagnosis*
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / psychology
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Predictive Value of Tests
  • Prospective Studies
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Symptom Assessment
  • Texas
  • Walk Test
  • Young Adult