The MacNew is a self-administered heart disease-specific health-related quality of life [HRQL] instrument. The MacNew is a modification of the original interviewer-administered Quality of Life after Myocardial Infarction [QLMI] instrument originally developed on a series of moderately anxious and depressed patients who had recovered from an acute myocardial infarction.
The MacNew is designed to evaluate the impact of treatment, including cardiac rehabilitation, and has been shown to be valid, reliable and responsive, is simple to administer and well-accepted by patients, and normative data are available for patients with myocardial infarction, angina pectoris, and heart failure. The MacNew heart disease questionnaire addresses three major HRQL domains, the Emotional, Physical, and Social domains which can be combined to fgive a Global HRQL score. There are substantial correlations between the MacNew and other HRQL measures and moderate to strong concordance with predictions about how the instrument should behave as a valid and reliable measure of HRQL. Correlations between the MacNew and other measures provide moderate to strong evidence of its ability to discriminate between patients following myocardial infarction according to their HRQL and in measuring changes in HRQL over time.
The MacNew has been validated in Chinese, Dutch, English, Farsi, German, Portuguese and Spanish patients with myocardial infarction and in Chinese, English, Dutch, German and Turkish in patients with angina and Dutch and Portuguese in patients with acute coronary syndrome. It also has been validated in Chinese, Dutch, English and German in patients with heart failure. and in German in patients with a pacemaker. Although the MacNew has been favorably reviewed against a selection of other heart disease-specific HRQL instruments there are plans to confirm its psychometric properties in a large international cohort of patients with heart disease.
Predictors of health-related quality of life have been identified, and poor health-related quality of life on the MacNew is an independent predictor of later mortality and morbidity. With rehabilitation, the time course of recovery of health-related quality of life, using the MacNew, is more rapid than that of exercise tolerance. There is a valid and responsive measure of health-related quality of life for spouses of survivors of an acute myocardial infarction.
In addition to English, the MacNew is available in the following languages.