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Ware JE, Gandek B, Allison J. The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions. Int J Stat Med Res. 2016;5(1):17-40doi: 10.6000/1929-6029.2016.05.01.3.
Ware, J. E., Gandek, B., & Allison, J. (2016). The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions. International journal of statistics in medical research, 5(1), 17-40. https://doi.org/10.6000/1929-6029.2016.05.01.3
Ware, John E, et al. "The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions." International journal of statistics in medical research vol. 5,1 (2016): 17-40. doi: https://doi.org/10.6000/1929-6029.2016.05.01.3
Ware JE, Gandek B, Allison J. The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions. Int J Stat Med Res. 2016;5(1):17-40. doi: 10.6000/1929-6029.2016.05.01.3. PMID: 27087882; PMCID: PMC4831653.
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Int J Stat Med Res. 2016;5(1):17-40. doi: 10.6000/1929-6029.2016.05.01.3.

The Validity of Disease-specific Quality of Life Attributions Among Adults with Multiple Chronic Conditions.

International journal of statistics in medical research

John E Ware, Barbara Gandek, Jeroan Allison

Affiliations

  1. University of Massachusetts Medical School, Worcester, MA; John Ware Research Group, Watertown, MA.
  2. University of Massachusetts Medical School, Worcester, MA.

PMID: 27087882 PMCID: PMC4831653 DOI: 10.6000/1929-6029.2016.05.01.3

Abstract

BACKGROUND: A crucial assumption underlying all disease-specific quality of life (QOL) measures, that patients can validly differentiate a specific disease

METHODS: Adults age 18 and older (N=4,480) sampled from eight pre-identified condition groups (asthma, COPD, angina/MI with angina, congestive heart failure, diabetes, chronic kidney disease, osteoarthritis, rheumatoid arthritis) completed an Internet survey. Comorbid conditions were determined using a 35-condition checklist. Product-moment correlations were analyzed separately by pre-identified condition group using the multitrait-multimethod of construct validation, where traits were defined by 9-26 conditions and each condition was measured by two methods: disease severity rating and Disease-specific Quality of Life Impact Scale (QDIS) global rating. A third method (symptom or clinical marker) was available for the eight pre-identified conditions.

RESULTS: In support of convergent validity, 22 of 24 convergent correlations were substantial (r=0.38-0.84, median=0.53). In support of discriminant validity, 833 of 924 tests (90.2%) yielded significantly higher convergent than discriminant correlations across the eight pre-identified conditions. Exceptions to this pattern of results were most often observed for comorbid conditions within the same clinical area.

CONCLUSIONS: Collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions. Noteworthy exceptions should be considered when interpreting some specific QOL impact attributions and warrant further study. Pursuit of a summary disease-specific QOL impact score standardized across MCC is recommended.

Keywords: Disease-specific measures; Health-related quality of life; Multiple chronic conditions; Multitrait-multimethod analysis; Patient-reported outcomes; Validity

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