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Comparison of health-related quality of life measures for chronic renal failure: quality of well-being scale, short-form-6D, and the kidney disease quality of life instrument

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Abstract

Background

Studies have found that health-related quality of life (HRQOL) measurements with different conceptual bases yield widely varying results within the same study sample. Using data from a cohort of patients with chronic kidney failure, the purpose of this study was to compare the Quality of Well-Being Scale-Self-Administered (QWB-SA), the Short-Form-6D (SF-6D), and the Kidney Disease Component Summary (KDCS).

Methods

Baseline data from a multi-site prospective observational study of 322 veterans receiving hemodialysis were analyzed. Descriptive statistics were calculated. Confirmatory factor analysis was conducted to determine how closely the three HRQOL tools reflected the same underlying construct.

Results

Our confirmatory factor analysis offered strong evidence that the subscales of the QWB-SA, SF-6D, and 7-subscale KDCS measured more than one factor in this study sample. In the three-factor model, the SF-6D and 7-subscale KDCS correlated .911 (P < .05), indicating 83% of the variance in the 7-subscale KDCS was correlated with the SF-6D. However, a two-factor model, in which the highly correlated SF-6D and 7-subscale KDCS were combined, fit the data almost as well as the three-factor model.

Conclusion

The three HRQOL measures addressed different underlying HRQOL constructs in this sample. The QWB-SA was significantly different from the SF-6D and KDCS.

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Notes

  1. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.

Abbreviations

CFA:

Confirmatory factor analysis

CKD:

Chronic kidney disease

CRF:

Chronic renal failure

CFI:

Comparative fit index

EQ-5D:

EuroQol instrument

GFI:

Goodness-of-fit index

HRQOL:

Health-related quality of life

HUI:

Health utilities index

ICED:

Index of coexistent disease

IPI:

Index of physical impairment

KDCS:

Kidney disease component summary

KDQOL:

Kidney disease quality of life instrument

KDQOL-SF:

Kidney disease quality of life instrument-short form

NFI:

Normed fit index

NNFI:

Non-normed fit index

QALYs:

Quality-adjusted life years

QOL:

Quality of life

QWB:

Quality of well-being scale

QWB-SA:

Quality of well-being scale-self-administered

RMSEA:

Root-mean-square error of approximation

SF-6D:

Short-form-6D

SF-12:

Short-form-12

SF-36:

Short-form-36

SRMR:

Standardized root-mean-square residual

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Acknowledgments

This research was supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service—“Cost and Effectiveness of End-Stage Renal Disease Care” (D. Hynes, principal investigator) (ECI-20-016). Dr. Hynes is also supported by a 5-year Veterans Affairs Health Services Research and Development Service Research Career Scientist Award. Dr. Saban is supported by a 3-year Veterans Affairs Health Services Research and Development Service Postdoctoral Fellowship (TPN 42-001). We also kindly thank Madeline Thornton for her assistance in formatting the path diagrams. Lastly, we would like to express our gratitude to the anonymous manuscript reviewers whose thought-provoking feedback helped strengthen this paper.

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Authors and Affiliations

  1. Center for Management of Chronic Complex Care, Edward Hines Jr. VA Hospital, P.O. Box 5000 (151H), Hines, IL, 60141, USA

    Karen L. Saban, Kevin T. Stroupe, Margaret M. Browning & Denise M. Hynes

  2. Loyola University Chicago Niehoff School of Nursing, Chicago, IL, USA

    Karen L. Saban & Denise M. Hynes

  3. Veterans Affairs Information Resource Center, Hines, IL, USA

    Kevin T. Stroupe, Margaret M. Browning & Denise M. Hynes

  4. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Kevin T. Stroupe

  5. Department of Psychology, Loyola University Chicago, Chicago, IL, USA

    Fred B. Bryant

  6. Veterans Affairs Cooperative Studies Program Coordinating Center, Hines, IL, USA

    Domenic J. Reda

  7. Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA

    Denise M. Hynes

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  1. Karen L. Saban
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Correspondence to Karen L. Saban.

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Appendix Comparison of HRQOL results from selected studies
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Saban, K.L., Stroupe, K.T., Bryant, F.B. et al. Comparison of health-related quality of life measures for chronic renal failure: quality of well-being scale, short-form-6D, and the kidney disease quality of life instrument. Qual Life Res 17, 1103–1115 (2008). https://doi.org/10.1007/s11136-008-9387-5

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