Content comparison of health-related quality of life instruments for obstructive sleep apnea

Stucki, Armin; Cieza, Alarcos; Schuurmans, Macé M.; Ustun, Bedirhan; Stucki, Gerold; Gradinger, Felix; Partinen, Markku

doi:10.1016/j.sleep.2007.01.020

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Volume 9, Issue 2 , Pages 199-206, January 2008

Content comparison of health-related quality of life instruments for obstructive sleep apnea☆☆ ☆

Armin Stucki
- Department of Internal Medicine, University Hospital Bern, Bern, Switzerland
- Corresponding author. Tel.: +41 31 632 05 24; fax: +41 31 382 43 60.
Alarcos Cieza
- ICF Research Branch of the WHO Collaborating Center for the Family of International Classifications at the German Institute of Medical Documentation and Information (DIMDI), IMBK, Ludwig-Maximilian University, Munich, Germany
- Science Swiss Paraplegic Research, Nottwil, Switzerland
Macé M. Schuurmans
- Pulmonology and Centre of Sleep Disorders, University Hospital Bern, Switzerland
Bedirhan Ustun
- Classification, Assessment, Surveys and Terminology Team, World Health Organization, Geneva, Switzerland
Gerold Stucki
- ICF Research Branch of the WHO Collaborating Center for the Family of International Classifications at the German Institute of Medical Documentation and Information (DIMDI), IMBK, Ludwig-Maximilian University, Munich, Germany
- Department of Physical Medicine and Rehabilitation, Ludwig-Maximilian University, Munich, Germany
- Science Swiss Paraplegic Research, Nottwil, Switzerland
Felix Gradinger
- Science Swiss Paraplegic Research, Nottwil, Switzerland
Markku Partinen
- Skogby Sleep Clinic, Rinnekoti Research Centre, Espoo, Finland

Received 28 June 2006; received in revised form 28 November 2006; accepted 31 January 2007.

Abstract

Background and purpose

Due to the increasing importance of quality of life assessments in obstructive sleep apnea (OSA) patients and due to an increased use of the International Classification of Functioning, Disability and Health (ICF), for comparative purposes it is essential to understand the relationship between health-related quality of life (HRQOL) instruments and the ICF. The purpose of this study was to compare the content covered by OSA-specific instruments using the ICF.

Patients and methods

OSA-specific instruments were identified, including the Calgary Sleep Apnea Quality of Life Index, the Functional Outcomes of Sleep Questionnaire, the Obstructive Sleep Apnea Patient-Oriented Severity Index, and the Quebec Sleep Questionnaire, and linked to the ICF by six health professionals according to standardized guidelines. The degree of agreement between health professionals was calculated by means of the kappa statistic.

Results

A total of 308 concepts were identified and linked to 78 different ICF categories; 35 categories of the component body function, one category of the component body structure, 38 categories of the component activities and participation, and four categories of the component environmental factors. Only contents within the chapters mental functions, mobility and social life were addressed by all instruments. Forty-seven categories were covered by only one instrument.

Conclusion

The ICF proved highly useful for the comparison of HRQOL instruments. This analysis may help researchers and clinicians to choose the most appropriate HRQOL instrument for a specific purpose as well as help to compare study outcomes of studies using different instruments for HRQOL assessment.

Keywords: ICF, Sleep, Obstructive sleep apnea, Health status, Quality of life, Disorders of excessive somnolence