The Present and Future
JACC State-of-the-Art Review
Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art Review

https://doi.org/10.1016/j.jacc.2020.09.542Get rights and content
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Highlights

  • The KCCQ measures symptoms, physical and social limitations, and quality of life in patients with heart failure.

  • In clinical trials, mean differences in KCCQ scores are more difficult to interpret than the proportion of patients experiencing clinically important changes.

  • Broader understanding of the meaning of KCCQ scores might encourage greater use of the tool to support patient-centered care.

  • Research is needed on how best to integrate the KCCQ into practice and assess its impact on patient care.

Abstract

To improve the patient-centeredness of care, patient-reported outcomes have been increasingly used to quantify patients’ symptoms, function, and quality of life. In heart failure, the Kansas City Cardiomyopathy Questionnaire (KCCQ) has been qualified by the U.S. Food and Drug Administration as a Clinical Outcome Assessment and recommended as a performance measure for quantifying the quality of care. By systematically asking the same questions reproducibly over time, the KCCQ can validly and sensitively capture the impact of heart failure on patients’ lives and is strongly associated with clinical events over time. This review describes how to interpret the KCCQ, how it should be analyzed in clinical trials to maximize the interpretability of results, and how it can be used in clinical practice and population health. By providing a deeper understanding of the KCCQ, it is hoped that its use can further improve the patient-centeredness of heart failure care.

Key Words

clinical care
clinical trials
KCCQ
quality of life

Abbreviations and Acronyms

CI
confidence interval
FDA
U.S. Food and Drug Administration
HFpEF
heart failure with preserved ejection fraction
HFrEF
heart failure with reduced ejection fraction
KCCQ
Kansas City Cardiomyopathy Questionnaire
MCID
minimal clinically important difference
METs
metabolic equivalents
NNT
number-needed-to-treat
NYHA
New York Heart Association

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Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.