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Mapping the Minnesota Living with Heart Failure Questionnaire (MLHFQ) onto the Assessment of Quality of Life 8D (AQoL-8D) utility scores

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The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is a widely used condition-specific measure of quality of life (QoL) in patients with heart failure. To use information from the MLHFQ in an economic evaluation, the MLHFQ must be mapped onto a preference-based measure of QoL. This study aims to develop a mapping algorithm between the MLHFQ and the Assessment of Quality of Life (AQoL) 8D utility instrument in patients with dilated cardiomyopathy (DCM).


MLHFQ and AQoL-8D data were collected on 61 Australian adults with idiopathic DCM or other non-hypertrophic cardiomyopathies. Three statistical methods were used as follows: ordinary least squares (OLS) regression, the robust MM estimator, and the generalised linear models (GLM). Each included a range of explanatory variables. Model performance was assessed using key goodness-of-fit measures, the mean absolute error (MAE), and the root-mean-square error (RMSE).


The MLHFQ summary score and AQoL-8D utility scores were strongly correlated (r =  − 0.83, p < 0.0001) and the two subscales of the MLHFQ were correlated with the eight dimensions of the AQoL-8D. Utility scores were predicted with acceptable precision based on responses to the MLHFQ physical, emotional, social, and other subscales. OLS and GLM performed similarly with MAE and RMSE ranging 0.086–0.106 and 0.114–0.130, respectively.


The mapping algorithm developed in this study allows the derivation of AQoL-8D utilities from MLHFQ scores for use in cost-effectiveness analyses and most importantly, enables the economic evaluation of alternative heart failure therapy options when only the MLHFQ has been collected.

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Fig. 1
Fig. 2

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.



Dilated cardiomyopathy


Quality of life


Quality adjusted life year


Minnesota Living with Heart Failure Questionnaire


Assessment of Quality of Life 8 Dimension


Implantable cardioverter defibrillator


Ordinary least squares


Generalised linear models


Mean absolute error


Root-mean-square error


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The study was funded by the members of the Melbourne Genomics Health Alliance and the State Government of Victoria (Department of Health and Human Services).

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Authors and Affiliations



MC led on the analysis of the data with support from IG. JR is the clinical lead for the project. MM led design of the patient surveys used and supervised data entry and cleaning. JR, DH, MM contributed to the design of the study. All authors have contributed to the manuscript and have read and approved the final version.

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Correspondence to Ilias Goranitis.

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The authors declare that they have no conflict of interest.

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The study received Human Research Ethics Committee approval (HREC/ 13/MH/326) and complied with the Declaration of Helsinki. Written, informed consent to participate in the study was obtained from all participants.

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Catchpool, M., Ramchand, J., Hare, D.L. et al. Mapping the Minnesota Living with Heart Failure Questionnaire (MLHFQ) onto the Assessment of Quality of Life 8D (AQoL-8D) utility scores. Qual Life Res 29, 2815–2822 (2020).

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