A Systematic Review and Quality Assessment of Cardiovascular Disease–Specific Health-Related Quality-of-Life Instruments: Part II Psychometric Properties

OBJECTIVES: Health-related quality-of-life instruments for cardiovascular diseases (CVDs) have been commonly used to measure important patient-reported outcomes in clinical trials and practices. This study aimed to systematically identify and evaluate the psychometric properties of CVD-specific health-related quality-of-life instruments. METHODS: We searched cumulative index to nursing and allied health literature, Embase, and PubMed from inception to January 20, 2022. Studies that reported psychometric properties of CVD-specific instruments were included. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods for evaluating measurement properties and quality of evidence. Seven psychometric properties, including structural validity, internal consistency, test-retest reliability, convergent validity, divergent validity, discriminative validity, and responsiveness, were evaluated. RESULTS: We identified 142 studies reporting psychometric properties of 40 instruments. Five (12.5%) instruments demonstrated measurement properties with sufficient or inconsistent ratings; 16 (40.0%) instruments did not report any responsiveness evidence. Of the 40 instruments, 15 (37.5%) instruments were rated sufficient with high quality of evidence on internal consistency; 4 (10.0%) on structural validity, convergent validity and divergent validity; and 3 (7.5%) on discriminative validity. CONCLUSIONS: When measuring patient-reported outcomes in clinical trials or routine practice, it is important to choose instruments with established psychometric properties.