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Kansas City Cardiomyopathy Questionnaire - Short version (KCCQ-12) Flow

Kansas City Cardiomyopathy Questionnaire - Short Version flow

Introduction

The Kansas City Cardiomyopathy Questionnaire (KCCQ), a commonly used instrument for measuring health status in patients with heart faliure. It has excellent psychometric properties and the first version was 23-items long [1]. To support its use in clincial care, creating a shorter and simplear meassure was needed [2]. Therfore, the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12) created [3].

The Kansas City Cardiomyopathy Questionnaire - Short Version flow contains the Kansas City Cardiomyopathy Questionnaire - Short version (KCCQ-12) questionnaire and associated calculation. After form submission, the Kansas City Cardiomyopathy Questionnaire - Short Version calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the Kansas City Cardiomyopathy Questionnaire - Short Version calculation.

Kansas City Cardiomyopathy Questionnaire - Short version (KCCQ-12) questionnaire

Scoring the KCCQ-12

Four domain scores and one summary score are generated from the KCCQ-12:

  • Physical Limitation Score (KCCQ12-PL)
  • Symptom Frequency Score (KCCQ12-SF)
  • Quality of Life Score (KCCQ12-QL)
  • Social Limitation Score (KCCQ12-SL)
  • Summary Score (KCCQ12)

General information:
Scores are scaled 0-100, where 0 denotes the lowest reportable health status and 100 the highest.

The domain scores

Physical Limitation Score (KCCQ12-PL)

The Physical Limitation score corresponds to Questions 1a, 1b and 1c. Responses are coded as follows:

  1. Extremely limited
  2. Quite a bit limited
  3. Moderately limited
  4. Slightly limited
  5. Not at all limited
  6. Limited for other reasons or did not do the activity

A response of 6 is treated as a missing value for the purposes of scoring. If responses to two or more questions are missing, no score is computed. Otherwise, the score is then calculated by taking the average of the non-missing responses and rescaling to 0-100, as follows:

KCCQ12-PL = 100*[(average of Questions 1a, 1b and 1c) – 1]/4

Symptom Frequency Score (KCCQ12-SF)

The Symptom Frequency score corresponds to Questions 2, 3, 4 and 5. Responses are coded as follows:

Question 2 Response

  1. Every morning
  2. 3 or more times per week but not every day
  3. 1-2 times per week
  4. Less than once a week
  5. Never over the past 2 weeks

Questions 3 and 4 Response

  1. All of the time
  2. Several times per day
  3. At least once a day
  4. 3 or more times per week but not every day
  5. 1-2 times per week
  6. Less than once a week
  7. Never over the past 2 weeks

Question 5 Response

  1. Every night
  2. 3 or more times per week but not every day
  3. 1-2 times per week
  4. Less than once a week
  5. Never over the past 2 weeks

If responses to three or more questions are missing, no score is computed. Otherwise, the score is then calculated by first rescaling each non-missing response to 0-100, then taking the average of the rescaled non-missing responses, as follows:

  • Q2 rescaled = 100 × (Q2 response – 1) ÷ 4
  • Q3 rescaled = 100 × (Q3 response – 1) ÷ 6
  • Q4 rescaled = 100 × (Q4 response – 1) ÷ 6
  • Q5 rescaled = 100 × (Q5 response – 1) ÷ 4

KCCQ12-SF = average of rescaled responses

Quality of Life Score (KCCQ12-QL)

The Quality of Life score corresponds to Questions 6 and 7. Responses are coded as follows:

Question 6 Response

  1. It has extremely limited my enjoyment of life
  2. It has limited my enjoyment of life quite a bit3
  3. has moderately limited my enjoyment of life
  4. It has slightly limited my enjoyment of life
  5. It has not limited my enjoyment of life at all

Question 7 Response

  1. Not at all satisfied
  2. Mostly dissatisfied
  3. Somewhat satisfied
  4. Mostly satisfied
  5. Completely satisfied

If responses to both questions are missing, no score is computed. Otherwise, the score is calculated by taking the average of the non-missing responses and rescaling to 0-100, as follows:

KCCQ12-QL = 100*[(average of Questions 6 and 7) – 1]/4

Social Limitation Score (KCCQ12-SL)

The Social Limitation score corresponds to Questions 8a, 8b and 8c. Responses are coded as follows:

  1. Severely limited
  2. Limited quite a bit
  3. Moderately limited
  4. Slightly limited
  5. Did not limit at all
  6. Does not apply or did not do for other reasons

A response of 6 is treated as a missing value for the purposes of scoring. If responses to two or more questions are missing, no score is computed. Otherwise, the score is then calculated by taking the averageof the non-missing responses and rescaling to 0-100, as follows:

KCCQ12-SL = 100*[(average of Questions 8a, 8b and 8c) – 1]/4

Summary score (KCCQ12)

The Summary score represents an integration of the patient’s physical limitation, symptom frequency, quality of life and social limitation. If all four domain scores are missing, no summary score is computed. Otherwise, the score is calculated as the average of the non-missing domain scores:

KCCQ12 = average of KCCQ12-PL, KCCQ12-SF, KCCQ12-QL and KCCQ12-SL

References

[1] Green CP, Porter CB, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol. 2000 Apr;35(5):1245-55. doi: 10.1016/s0735-1097(00)00531-3. PMID: 10758967.
[2] Rumsfeld JS. Health status and clinical practice: when will they meet? Circulation. 2002 Jul 2;106(1):5-7. doi: 10.1161/01.cir.0000020805.31531.48. PMID: 12093759.
[3] Spertus JA, Jones PG. Development and Validation of a Short Version of the Kansas City Cardiomyopathy Questionnaire. Circ Cardiovasc Qual Outcomes. 2015 Sep;8(5):469-76. doi: 10.1161/CIRCOUTCOMES.115.001958. PMID: 26307129; PMCID: PMC4885562.

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