Health-Related Quality of Life in Patients With Ventricular Assist Device: Psychometric Evaluation of the German Version of the Quality of Life With a Ventricular Assist Device Questionnaire.

The study was cross-sectional, so it cannot show whether the questionnaire detects changes in quality of life over time. Patients who were too ill or too weak may not have taken part, and those in long-term care or rehabilitation centres were excluded, so the sample may have had better quality of life than more disabled patients. The sample had a high mean Kansas City Cardiomyopathy Questionnaire score (65.35), and the authors said this points to a restricted range of quality of life. The intended factor structure did not fit well, and the sample was too small for a 54-item higher-order model. The cognitive domain had low internal consistency (Cronbach alpha 0.58), partly because it contained only 3 items. The meaning/spiritual domain had no German comparator, so its convergent validity could not be tested. Self-report may be affected by recall bias and socially desirable answers. The questionnaire is lengthy, and the authors said item reduction and dimensional reassessment are needed.

Do not conclude that the German QoLVAD is a fully validated five-domain measure. The intended factor structure did not fit well, the cognitive domain had low internal consistency, and the authors said item deletion and dimensional reassessment are still needed.