Identifying cut-off scores for interpretation of the Heart Failure Impact Questionnaire.
Tsui-Wen Hsu, Hui-Chin Chang, Chi-Hung Huang and 3 others
PMID 30338103WHAT IT FOUND
A proposed combined heart failure quality-of-life cut-off marked poor status when MLHFQ score was 45 or higher, or 24 or higher with SF-36 below 60.
Patients with three or more comorbidities or NYHA class IV were more likely to fall there.
Key findings
01A proposed poor quality-of-life definition used MLHFQ 45 or higher, or MLHFQ 24 or higher with SF-36 below 60.
02Using that combined definition, 47 patients were classified as having good quality of life and 178 as poor.
03Poor quality of life was linked to three or more comorbidities (odds ratio 4.86, 95% confidence interval 2.20 to 10.75) and NYHA class IV (odds ratio 3.79, 95% confidence interval 1.38 to 10.45).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample of 225 patients from one hospital in northern Taiwan, recruited during hospitalization, so it may not represent all heart failure patients. The design was cross-sectional, so it cannot show cause and effect or whether the cut-off predicts later outcomes. The new combined cut-off was proposed but not externally validated; the authors call for larger studies to validate it. The paper says the weighted index was checked with a receiver operating characteristic curve, but it does not report sensitivity or specificity values. Other possible influences on quality of life, such as exercise, body weight, daily activities, socioeconomic factors, family support, and 6-minute walk test, were not included.
Declared interests
No conflict of interest was declared by the authors. The paper does not state who funded the work.
The easy way to misread this
Do not conclude that using these cut-off scores improves heart failure care or predicts future decline. The poor quality-of-life definition used both MLHFQ and SF-36 scores, and the study did not report sensitivity or specificity values.