British Journal of Anaesthesia, Vol 84, Issue 1 11-15, Copyright © 2000 by Oxford University Press
PS Myles, B Weitkamp, K Jones, J Melick and S Hensen
Quality of recovery after anaesthesia is an important measure of the early
postoperative health status of patients. We attempted to develop a valid,
reliable and responsive measure of quality of recovery after anaesthesia
and surgery. We studied 160 patients and asked them to rate postoperative
recovery using three methods: a 100-mm visual analogue scale (VAS), a
nine-item questionnaire and a 50-item questionnaire; the questionnaires
were repeated later on the same day. From these results, we developed a
40-item questionnaire as a measure of quality of recovery (QoR-40; maximum
score 200). We found good convergent validity between QoR-40 and VAS (r =
0.68, P < 0.001). Construct validity was supported by a negative
correlation with duration of hospital stay (rho = -0.24, P < 0.001) and
a lower mean QoR-40 score in women (162 (SD 26)) compared with men (173
(17)) (P = 0.002). There was also good test- retest reliability
(intra-class ri = 0.92, P < 0.001), internal consistency (Cronbach's
alpha = 0.93, P < 0.001) and split-half coefficient (alpha = 0.83, P
< 0.001). The standardized response mean, a measure of responsiveness,
was 0.65. The QoR-40 was completed in less than 6.3 (4.9) min. We believe
that the QoR-40 is a good objective measure of quality of recovery after
anaesthesia and surgery. It would be a useful end-point in perioperative
clinical studies.
ARTICLES
Validity and reliability of a postoperative quality of recovery score: the QoR-40
Department of Anaesthesia and Pain Management, Alfred Hospital, Prahran, Victoria, Australia.
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