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The MacNew heart disease health-related quality of life questionnaire: Updated reference data for users

Stefan Höfer, Karam Turk-Adawi, Neil Oldridge


Background: The key to interpreting patient-reported health-related quality of life [HRQL] scores for use in person-centered healthcare approaches in clinical practice is having normative reference data to place the scores in the context of a meaningful reference group. The purpose of this analysis is to update and extend existing norms for the MacNew HRQL questionnaire.

Methods: Patients with angina, myocardial infarction, or heart failure enrolled in the HeartQoL Project provided MacNew HRQL Global scale and Physical, Emotional and Social subscale data from which norms have been generated.

Results: Patients (n=6,130; angina, 32.4%; myocardial infarction, 37.5% and heart failure, 30.1%) living in 22 different countries provided MacNew HRQL scores. Mean MacNew Global HRQL in the total group was 5.04 (±1.1); Global scale and Physical, Emotional, and Social subscale scores were higher in patients with MI than in patients with either angina or heart failure (p<0.001) and higher in patients with angina than in patients with heart failure (p<0.001). Mean Physical subscale scores were lower than either Emotional or Social subscale scores. Mean MacNew Global scale and subscale scores were higher in males and older patients than females and younger patients. The minimal important difference of 0.5 points on the 7-point MacNew was consistent with a 0.5 standard deviation around the mean MacNew scores in each diagnosis.

Conclusion: Norms for the MacNew questionnaire have been updated permitting meaningful interpretation of HRQL for an individual patient or for groups of patients with angina, myocardial infarction or heart failure.


Quality of Life; reference values; cardiovascular disease; heart failure; angina pectoris; myocardial infarction

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