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Patient-reported outcome (PRO) questionnaires considered in this paper contain multiple subscales, although not all subscales are equally relevant for administration in all target patient populations. A group of measurement experts, developers, license holders, and other scientific-, regulatory-, payer-, and patient-focused stakeholders participated in a panel to discuss the benefits and challenges of a modular approach, defined here as administering a subset of subscales out of a multi-scaled PRO measure. This paper supports the position that it is acceptable, and sometimes preferable, to take a modular approach when administering PRO questionnaires, provided that certain conditions have been met and a rigorous selection process performed. Based on the experiences and perspectives of all stakeholders, using a modular approach can reduce patient burden and increase the relevancy of the items administered, and thereby improve measurement precision and eliminate wasted data without sacrificing the scientific validity and utility of the instrument. The panelists agreed that implementing a modular approach is not expected to have a meaningful impact on item responses, subscale scores, variability, reliability, validity, and effect size estimates; however, collecting additional evidence for the impact of context may be desirable. It is also important to recognize that adequate rationale and evidence (e.g., of fit-for-purpose status and relevance to patients) and a robust consensus process that includes patient perspectives are required to inform selection of subscales, as in any other measurement circumstance, is expected. We believe that the considerations discussed within (content validity, administration context, and psychometric factors) are relevant across multiple therapeutic areas. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a health-related quality of life (HRQoL) questionnaire for patients with current or previous coronavirus disease (COVID-19) in an international setting. Methods: This multicenter international methodology study followed standardized guidelines for a four-phase questionnaire development. Here, we report on the pretesting and validation of our international questionnaire. Adults with current or previous COVID-19, in institutions or at home were eligible. In the pretesting, 54 participants completed the questionnaire followed by interviews to identify administration problems and evaluate content validity. Thereafter, 371 participants completed the revised questionnaire and a debriefing form to allow preliminary psychometric analysis. Validity and reliability were assessed (correlation-based methods, Cronbach's α, and intra-class correlation coefficient). Results: Eleven countries within and outside Europe enrolled patients. From the pretesting, 71 of the 80 original items fulfilled the criteria for item-retention. Most participants (80%) completed the revised 71-item questionnaire within 15 min, on paper (n = 175) or digitally (n = 196). The final questionnaire included 61 items that fulfilled criteria for item retention or were important to subgroups. Item-scale correlations were > 0.7 for all but nine items. Internal consistency (range 0.68–0.92) and test–retest results (all but one scale > 0.7) were acceptable. The instrument consists of 15 multi-item scales and six single items. Conclusion: The Oslo COVID-19 QLQ-W61© is an international, stand-alone, multidimensional HRQoL questionnaire that can assess the symptoms, functioning, and overall quality of life in COVID-19 patients. It is available for use in research and clinical practice. Further psychometric validation in larger patient samples will be performed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess psychometric properties of the Japanese version of the EQ-5D-Y (3 levels) with a focus on feasibility, reliability, and construct validity.Methods: Respondents were recruited from the general populations of three cities in Japan. First, children and adolescents responded to the EQ-5D-Y and PedsQL by self-report. Parents were also asked to evaluate the health states of their children/adolescents using proxy versions of these questionnaires. Next, the EQ-5D-Y was mailed to their residence approximately 2 weeks later, and both children/adolescents and their parents responded to the questionnaire. Reliability was confirmed by self-report test-retest methods and a comparison of self-report responses with proxy responses. Spearman's correlation coefficients were calculated between responses to the EQ-5D-Y and both responses to and scores of the PedsQL in order to assess construct validity.Results: A total of 654 children/adolescents from aged 8 to 15 (median age: 11) responded to the questionnaires at both the first- and second-stage surveys. Test-retest agreement was sufficiently high and was influenced by age. Proxy test-retest results revealed that parents' responses were more reliable compared to the self-report results. Some correlations (|r| > 0.3) between items of the EQ-5D-Y and PedsQL were found. Meanwhile, no correlations were found between proxy responses to the EQ-5D-Y and self-report responses to the PedsQL.Conclusions: The EQ-5D-Y demonstrates reliability and validity among children/adolescents and their parents in Japan. Construct validity of the EQ-5D-Y by self-report was confirmed through comparisons with the PedsQL. Proxy responses to the EQ-5D-Y were more reliable compared to the self-report results, but construct validity was not confirmed in the proxy version. [ABSTRACT FROM AUTHOR]

Purpose: The Child Health Utility 9D (CHU9D), a new generic preference-based health-related quality of life (HRQoL) instrument, was developed specifically for the application in cost-effectiveness analyses of treatments and interventions for children and adolescents. The main objective of this study was to examine the psychometric property of the Chinese version of CHU9D (CHU9D-CHN) in a large school-based sample in China.Methods: Data were collected using a multi-stage sampling method from third-to-ninth-grade students in Shaanxi Province, China. Participants self-completed a hard-copy questionnaire including the CHU9D-CHN instrument, the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), information on socio-demographic characteristics and self-reported health status. The psychometric properties of the CHU9D-CHN, including the internal consistency, 2-week test-retest reliability, convergent and known-groups validity were studied.Results: A total of 1912 students participated in the survey. The CHU9D-CHN internal consistency and test-retest reliability were good to excellent with a Cronbach's alpha of 0.77 and an intra-class correlation coefficient of 0.65, respectively. The CHU9D utility scores moderately correlated with the PedsQL total scores (r = .57, P < .001), demonstrating good convergent validity. Difference of the CHU9D utility scores among the different participants with levels of self-reported general health, health services utilisation and left-behind status demonstrated good construct validity.Conclusion: The findings demonstrated adequate psychometric performance for the CHU9D-CHN. The CHU9D-CHN was a satisfactory, reliable and valid instrument to measure and value HRQoL for children and adolescents in China. [ABSTRACT FROM AUTHOR]

Purpose: Sleep problems are common in adolescents and have a negative impact on daytime functioning. However, there is a lack of well-validated adolescent sleep questionnaires. The Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance and Sleep-Related Impairment item banks are well-validated instruments developed for and tested in adults. The aim of this study was to evaluate their structural validity in adolescents.Methods: Test and retest data were collected for the Dutch-Flemish V1.0 PROMIS Sleep Disturbance (27) and Sleep-Related Impairment (16 items) item banks from 1046 adolescents (11-19 years). Cross-validation methods, Confirmatory (CFA), and Exploratory Factor Analyses (EFA) were used. Fit indices and factor loadings were used to improve the models. The final models were assessed for model fit using retest data.Results: The one-factor Sleep Disturbance (CFI = 0.795, TLI = 0.778, RMSEA = 0.117) and Sleep-Related Impairment (CFI = 0.897, TLI = 0.882, RMSEA = 0.156) models could not be replicated in adolescents. Cross-validation resulted in a final Sleep Disturbance model of 23 and a Sleep-Related Impairment model of 11 items. Retest data CFA showed adequate fit for the Sleep-Related Impairment-11 (CFI = 0.981, TLI = 0.976, RMSEA = 0.116). The Sleep Disturbance-23 model fit indices stayed below the recommended values (CFI = 0.895, TLI = 0.885, RMSEA = 0.105).Conclusions: While the PROMIS Sleep Disturbance-23 for adolescents and PROMIS Sleep-Related Impairment-11 for adolescents provide a framework to assess adolescent sleep, additional research is needed to replicate these findings in a larger and more diverse sample. [ABSTRACT FROM AUTHOR]

Background: Data from subjective patient-reported outcome measures (PROMs) are now being used in the health sector to make or support decisions about individuals, groups and populations. Contemporary validity theorists define validity not as a statistical property of the test but as the extent to which empirical evidence supports the interpretation of test scores for an intended use. However, validity testing theory and methodology are rarely evident in the PROM validation literature. Application of this theory and methodology would provide structure for comprehensive validation planning to support improved PROM development and sound arguments for the validity of PROM score interpretation and use in each new context.Objective: This paper proposes the application of contemporary validity theory and methodology to PROM validity testing.Illustrative Example: The validity testing principles will be applied to a hypothetical case study with a focus on the interpretation and use of scores from a translated PROM that measures health literacy (the Health Literacy Questionnaire or HLQ).Discussion: Although robust psychometric properties of a PROM are a pre-condition to its use, a PROM's validity lies in the sound argument that a network of empirical evidence supports the intended interpretation and use of PROM scores for decision making in a particular context. The health sector is yet to apply contemporary theory and methodology to PROM development and validation. The theoretical and methodological processes in this paper are offered as an advancement of the theory and practice of PROM validity testing in the health sector. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective is to provide evidence of convergent and discriminant validity for the pediatric and parent-proxy versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Anger, Peer Relations, Mobility, Pain Interference, and Fatigue item banks, the Neurology Quality of Life measurement system (Neuro-QOL) Cognition-General Concerns and Stigma item banks, and the Traumatic Brain Injury Quality of Life (TBI-QOL) Executive Function and Headache item banks in a pediatric traumatic brain injury (TBI) sample.Methods: Participants were 134 parent-child (ages 8-18 years) days. Children all sustained TBI and the dyads completed outcome ratings 6 months after injury at one of six medical centers across the United States. Ratings included PROMIS, Neuro-QOL, and TBI-QOL item banks, as well as the Pediatric Quality of Life inventory (PedsQL), the Health Behavior Inventory (HBI), and the Strengths and Difficulties Questionnaire (SDQ) as legacy criterion measures against which these item banks were validated.Results: The PROMIS, Neuro-QOL, and TBI-QOL item banks demonstrated good convergent validity, as evidenced by moderate to strong correlations with comparable scales on the legacy measures. PROMIS, Neuro-QOL, and TBI-QOL item banks showed weaker correlations with ratings of unrelated constructs on legacy measures, providing evidence of discriminant validity.Conclusion: Our results indicate that the constructs measured by the PROMIS, Neuro-QOL, and TBI-QOL item banks are valid in our pediatric TBI sample and that it is appropriate to use these standardized scores for our primary study analyses. [ABSTRACT FROM AUTHOR]

Purpose: Recently, we developed a computer-adaptive test (CAT) for assessing health-related quality of life (HRQoL) in children and adolescents: the Kids-CAT. It measures five generic HRQoL dimensions. The aims of this article were (1) to present the study design and (2) to investigate its psychometric properties in a clinical setting.Methods: The Kids-CAT study is a longitudinal prospective study with eight measurements over one year at two University Medical Centers in Germany. For validating the Kids-CAT, 270 consecutive 7- to 17-year-old patients with asthma (n = 52), diabetes (n = 182) or juvenile arthritis (n = 36) answered well-established HRQoL instruments (Pediatric Quality of Life Inventory™ (PedsQL), KIDSCREEN-27) and scales measuring related constructs (e.g., social support, self-efficacy). Measurement precision, test-retest reliability, convergent and discriminant validity were investigated.Results: The mean standard error of measurement ranged between .38 and .49 for the five dimensions, which equals a reliability between .86 and .76, respectively. The Kids-CAT measured most reliably in the lower HRQoL range. Convergent validity was supported by moderate to high correlations of the Kids-CAT dimensions with corresponding PedsQL dimensions ranging between .52 and .72. A lower correlation was found between the social dimensions of both instruments. Discriminant validity was confirmed by lower correlations with non-corresponding subscales of the PedsQL.Conclusions: The Kids-CAT measures pediatric HRQoL reliably, particularly in lower areas of HRQoL. Its test-retest reliability should be re-investigated in future studies. The validity of the instrument was demonstrated. Overall, results suggest that the Kids-CAT is a promising candidate for detecting psychosocial needs in chronically ill children. [ABSTRACT FROM AUTHOR]

Purpose: The determinants of the health-related quality of life of women with polycystic ovary syndrome are not fully understood. The aim of this study was to develop a comprehensive instrument to assess the health-related quality of life of Iranian women with PCOS and to assess its psychometric properties.Methods: We used a mixed-method, sequential, exploratory design including both qualitative [in-depth interview to define the components of health-related quality of life questionnaire (PCOSQ)] and quantitative approaches (to assess the psychometric properties of PCOSQ).Results: A preliminary questionnaire was developed including 147 items which emerged from the qualitative phase of the study. Considering the optimum cutoff points for content validity ratio (CVR), content validity index (CVI), and impact score, items of the preliminary questionnaire were reduced from 147 to 88 items. Finally, by excluding highly correlated items using the exploratory factor analysis, a 50-item questionnaire was obtained. The Kaiser criteria (eigenvalues >1) and Scree plot tests demonstrated that six factors were optimum with an estimated 47.3 % of variance. Assessment of the psychometric properties of the questionnaire demonstrated a mean CVI = 0.92, CVR = 0.91, Cronbach's alpha for whole questionnaire = 0.88 (0.61-0.88 for subscales), Spearman's correlation coefficients of test-retest = 0.75, and the intra-class correlation coefficient for the PCOS questionnaire subscales ranging from 0.57 to 0.88. Eventually the final questionnaire included 50 items in six domains, 'psychosocial and emotional,' 'fertility,' 'sexual function,' 'obesity and menstrual disorders,' 'hirsutism,' and 'coping' and rated on a 5-point Likert scale.Conclusion: The PCOSQ-50 is a valid and reliable instrument for the assessment of quality of life of women with PCOS, capable of assessing some obscure aspects overlooked by previous HRQL questionnaires. [ABSTRACT FROM AUTHOR]

Purpose: The Alcohol Quality of Life Scale (AQoLS) is a new patient-reported outcome 34-item questionnaire measuring health-related quality of life (HRQOL), specific to patients with an alcohol use disorder, developed from the patients' perspective. This is the first report establishing evidence in support of measurement reliability and validity of the AQoLS.Methods: A total of 285 randomly selected patients receiving interventions for alcohol use disorder in addiction specialised care settings in France were included in the study (response rate 80.1 %). Exploratory factor analysis was conducted to evaluate the hypothesised-during-development-stage dimensional structure of the AQoLS. Internal consistency of the total score and the dimensions subscores were assessed through Cronbach's alpha coefficients. Construct validity was tested through correlations with the Short-Form 36 Health Survey (SF-36) and EuroQol 5 dimensions (EQ-5D).Results: Exploratory analysis indicated seven observed dimensions which differed slightly from the 7 dimensions defined a priori in the framework hypothesised during the scale development: activities, relationships, living conditions, negative emotions, self-esteem, control and sleep. A major common factor allows the summing of the 34 items to obtain a total score. All the 34 items were acceptable. Cronbach's alpha for the AQoLS total score was 0.96 and ranged from 0.8 to 0.9 for the dimensions subscores. Negative correlations between AQoLS and all dimensions of the SF-36, but general health and positive correlations between AQoLS and all items of the EQ-5D were shown. As expected, the correlations were mostly moderate in magnitude, low with scores referring to physical areas and the highest with the SF-36 MSC.Conclusion: This study provides evidence of the measure's psychometric properties in terms of construct validity and internal consistency. The "control" and "self-esteem" dimensions are of particular interest as these concepts are not captured in existing HRQOL. Further longitudinal validation of the scale is necessary to assess sensitivity to change. [ABSTRACT FROM AUTHOR]

Objective: Given the absence of well-validated measures to measure personal recovery in the Chinese communities, this study translated the 24-item Recovery Assessment Scale (RAS-24) into Chinese, investigated its psychometric properties, and confirmed its five-factor structure, as proposed by Corrigan et al. (Schizophr Bull 30(4):1035-1041, 2004), among a sample of people in recovery of mental illness in Hong Kong.Methods: A sample of 596 people in recovery was recruited for scale validation. The RAS-24 was translated into traditional Chinese, and its factor structure was tested by confirmatory factor analysis. Cronbach's alpha coefficients were used to assess the internal consistency of the Chinese version of the RAS-24 (RAS-C). Concurrent and construct validity were examined by investigating the correlation of the RAS-C with Recovery Markers Questionnaire (RMQ), Test's Life Satisfaction Scale, Self-Stigma Scale, and Behavior and Symptom Identification Scale.Results: The RAS-C full scale and subscales yielded good internal consistency (Cronbach's α = .73-.93). The finding supported the five-factor solution proposed by Corrigan et al. (2004), χ2(242) = 783.81, p < .001, CFI = .91, RMSEA = .06, SRMR = .05. The RAS-C has established concurrent validity with RMQ and demonstrated construct validity with life satisfaction, self-stigma, as well as symptoms and functional difficulties.Conclusion: The Chinese version of the RAS-24 was found to have promising psychometric properties in assessing the subjective perception of recovery among Hong Kong Chinese. The validation of RAS-C among Chinese enables its usage to gauge personal recovery outcomes among Chinese in recovery. In addition, the validated measure can contribute to the comparison of recovery across English-speaking and Chinese-speaking samples. [ABSTRACT FROM AUTHOR]

Purpose: The content validity of patient-reported outcomes (PROs) commonly used to measure postoperative recovery is unknown. The objective of this study was to develop a conceptual framework for recovery after abdominal surgery and to analyze the content of PRO instruments against this conceptual framework.Methods: Qualitative methods were used to develop a conceptual framework for recovery. Patients undergoing abdominal surgery and healthcare professionals were interviewed. Recovery-related concepts were identified using a thematic analysis, and concepts were then linked to the International Classification of Functioning, Disability and Health (ICF). The contents of eight PRO instruments that have been used to measure recovery were then examined using this conceptual framework.Results: A total of 17 patients and 15 healthcare professionals were interviewed. A total of 22 important recovery-related concepts were identified and linked to the ICF. The four most important concepts were "Energy level," "Sensation of pain," "General physical endurance," and "Carrying out daily routine." The number of important recovery-related concepts covered by each instrument ranged from 1 to 22 (mean 7.3 concepts). The SF36 (n = 22), European Organization for the Treatment and Research of Cancer Quality-of-Life Questionnaire-C30 (n = 20), and the Gastrointestinal Quality-of-Life Index (n = 19) covered the greatest number of important recovery concepts. No instrument covered all of the important concepts.Conclusions: The comparison of the contents of PRO instruments commonly used to measure postoperative recovery after abdominal surgery demonstrated major gaps in the representation of concepts that are important to patients and healthcare professionals. [ABSTRACT FROM AUTHOR]

Purpose: To translate, cross-culturally adapt and test the measurement properties of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) short and long versions in Brazilian-Portuguese.Methods: The ÖMPSQ versions were translated, cross-culturally adapted and pretested in 30 patients with acute and subacute non-specific low back pain. Internal consistency, reproducibility (reliability and agreement), construct validity, and ceiling and floor effects were tested in 100 patients. Construct validity was assessed using the Roland-Morris Disability Questionnaire (RMDQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Numerical Rating Scale.Results: Internal consistency was adequate (ÖMPSQ: Cronbach's alpha = 0.83; ÖMPSQ-short: Cronbach's alpha = 0.72). Reliability was substantial (ÖMPSQ: ICC2,1 0.76; ÖMPSQ-short: 0.78). Standard error of measurement was very good for the ÖMPSQ (5 %) and good for the ÖMPSQ-short (6.7 %); limits of agreement were 13.07 for the ÖMPSQ and 1.37 for the ÖMPSQ-short; and the minimum detectable change was 25.12 for the ÖMPSQ and 15.51 for the ÖMPSQ-short. The ÖMPSQ total score showed a good correlation with the RMDQ (r = 0.73) and the TSK (r = 0.64) and a moderate correlation with pain intensity (current pain: r = 0.36; last 2 weeks: r = 0.37; last episode: r = 0.46). Moreover, ÖMPSQ-short showed a good correlation with RMDQ (r = 0.69) and a moderate correlation with TSK (r = 0.57) and pain (current pain: r = 0.34; last 2 weeks: r = 0.36; last episode: r = 0.54). No ceiling or floor effects were detected in both versions.Conclusion: The Brazilian-Portuguese ÖMPSQ and ÖMPSQ-short showed acceptable measurement properties and provide evidence that the Brazilian-Portuguese versions of ÖMPSQ and ÖMPSQ-short are similar to the original versions. [ABSTRACT FROM AUTHOR]

Purpose: The Carer Experience Scale (CES) is an index measure of the caring experience, focusing on six domains: activities outside caring, support from family and friends, assistance from the government and other organizations, fulfilment from caring, control over caring and getting on with the care recipient. This is an initial study of the construct validity of the CES focusing on validity in a heterogeneous group of carers in the UK. Methods: The CES was included in a cross-sectional quality of life survey conducted in a UK city in 2010. The survey included a number of questions about the characteristics of the carer, care recipient, caring situation and motivation for caring. Hypotheses regarding the anticipated associations between these contextual variables and the caring experience were developed and statistically tested. Results: Seven hundred and thirty carers fully completed the CES questionnaire. Associations between variables hypothesised to relate to the caring experience (such as recipient health and intensity of caring) and the CES were largely as expected, providing evidence that the CES captures the caring experience in a valid way. Most hypothesised associations were statistically significant in both carers of older and younger adults. Conclusions: This study provides early encouraging evidence for the construct validity of the CES instrument. Further investigation is required to examine the validity of the CES in specific clinical subgroups and to examine the responsiveness of the CES in detecting changes in the carer's outcomes over time. [ABSTRACT FROM AUTHOR]

Purpose: To assess the construct validity of the CHU9D in an adolescent general population sample. The CHU9D is a new generic preference-based measure of health-related quality of life developed specifically for application in the economic evaluation of health care treatments and interventions for young people. Methods: A web-based survey was developed including the CHU9D and HUI2 instruments and administered to a community-based sample of consenting adolescents ( n = 710) aged 11-17 years. The practicality, face and construct validity of the CHU9D was examined. The relationship between the CHU9D and HUI2 instruments was assessed by a comparison of responses to similar dimensions and the utility scores derived from the two instruments. Results: The CHU9D demonstrated high completion rates. CHU9D was able to discriminate between respondents according to their self-reported general health (Kruskal-Wallis P value <0.001). The mean CHU9D adolescent population utilities were similar to those generated from the HUI2 [Mean (SD) CHU9D utility 0.844 (0.102) and HUI2 utility 0.872 (0.138)], and the intra-class correlation coefficient indicated good levels of agreement overall (ICC = 0.742). Conclusion: The findings from this study provide support for the practicality, face and construct validity of the CHU9D for application with adolescents aged 11-17 years. [ABSTRACT FROM AUTHOR]

To examine the structure of the sense of coherence (SOC) scale in a general population. This study analysed the responses of 6,217 subjects aged 30 years and over who participated in the Finnish Health 2000 survey (response rate 77.4%). Participants completed an abbreviated 12-item version of the SOC scale. Two alternative structures were tested using confirmatory factor analysis: a one-factor model, with all scale items loaded onto a single latent factor representing the SOC construct, versus a second-order factor model, with scale items loaded onto their corresponding latent factors representing the three SOC components (comprehensibility, manageability and meaningfulness), which are, in turn, dependent on one single higher-order SOC construct. The one-factor model was fitted to the data after allowing the errors of comprehensibility item 5 and manageability item 6 to correlate, as was done in previous studies among Finnish adults. The comparative fit index (CFI), Tucker–Lewis index (TLI) and root mean square error of approximation (RMSEA) for the one-factor model were, respectively, 0.97–0.98, 0.96–0.97 and 0.05–0.09 across both sexes and three age groups. The second-order factor model had correlations between latent factors higher than 1, even after alternative model modifications, casting doubts on this more complex structure. These data suggest that the components of comprehensibility, manageability and meaningfulness should be merged when measuring SOC with the 12-item SOC scale in the Finnish general population. [ABSTRACT FROM AUTHOR]

The Low Vision Quality of Life (LVQOL) questionnaire and the Vision-related Quality of Life Core Measure (VCM1) are two of the many vision-related quality of life (QOL) questionnaires that have been developed in recent years. Although psychometric properties of the LVQOL and VCM1 compare well with other vision-related QOL questionnaires, construct and longitudinal validity have not been assessed (adequately). The purpose of this study was to examine the cross-sectional and longitudinal construct validity of these questionnaires by testing specific pre-specified hypotheses about the relations of these questionnaires with other measures. The percentage of hypotheses regarding the cross-sectional construct validity that were refuted for the LVQOL was 22% for the basic aspects of vision subscale, 50% for the mobility subscale, 39% for the adjustment subscale and 17% for the reading and fine work subscale. For the VCM1 this percentage was 57%. For the longitudinal construct validity the percentage of hypotheses that were refuted ranged from 33 to 75% for the LVQOL subscales and was 50% for the VCM1. In conclusion, cross-sectional construct validity was satisfactory for the LVQOL subscales, but seemed poor for the VCM1. In addition, the longitudinal validity of these scales was poor to moderate. [ABSTRACT FROM AUTHOR]