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The Transthyretin Amyloidosis \u2013 Quality of Life (ATTR-QOL) Questionnaire is a disease-specific patient-reported outcome (PRO) measure of the symptoms and impacts of ATTR amyloidosis. The objective of this study was to evaluate the structural validity, reliability, and construct validity of the ATTR-QOL Impact scales.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methodology<\/jats:title>\n            <jats:p>This was a non-interventional, online survey study of adults with self-reported diagnosis of symptomatic ATTR amyloidosis. The survey included the ATTR-QOL and additional criterion measures. A scoring algorithm was proposed and tested. Factor structure, differential item functioning, and psychometric properties were explored.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The analytic sample included 233 patients. Satisfactory fit was found for a 4-factor model of disease impacts (including Daily Activities, Physical Functioning, Social\/Role Functioning, and Emotional Wellbeing) and a scoring algorithm was developed. Twelve impact items were dropped from the ATTR-QOLv2 as a result of factor and differential item functioning analyses. Each scale showed evidence of satisfactory internal consistency reliability (Cronbach\u2019s \u03b1 range\u2009=\u20090.85\u20130.97) and test-retest reliability at 1 week (intraclass coefficient range\u2009=\u20090.84\u20130.97). Convergent validity was supported by correlations\u2009\u2265\u20090.30 between ATTR-QOL Impact scale scores and other PRO measures of related constructs. The ATTR-QOL Impact scales showed greater impact among patients with worse symptom severity, cardiac functioning, or unemployment due to ATTR amyloidosis (all p &lt; 0.05), supporting known-groups validity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The ATTR-QOL is a reliable and valid measure of impacts meaningful to patients with ATTR amyloidosis. This study resulted in updates to the ATTR-QOL for item reduction and the development of a scoring algorithm. Ongoing studies are collecting data to evaluate the symptom scales of the ATTR-QOL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s41687-025-00880-7","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T12:58:15Z","timestamp":1745931495000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reliability and validity of the Transthyretin Amyloidosis \u2013 Quality of Life (ATTR-QOL) Questionnaire impact scales"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9118-0673","authenticated-orcid":false,"given":"Andrew","family":"Lovley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2106-3652","authenticated-orcid":false,"given":"Kristen","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9772-5822","authenticated-orcid":false,"given":"Kaitlin","family":"LaGasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3506-0359","authenticated-orcid":false,"given":"Isabelle","family":"Lousada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-1046","authenticated-orcid":false,"given":"Kristen L.","family":"McCausland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2450-7693","authenticated-orcid":false,"given":"Michelle K.","family":"Carty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0201-4030","authenticated-orcid":false,"given":"Sabrina","family":"Rebello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-8224","authenticated-orcid":false,"given":"Jakob B.","family":"Bjorner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"issue":"3","key":"880_CR1","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1097\/CND.0000000000000270","volume":"21","author":"C Schwartzlow","year":"2020","unstructured":"Schwartzlow C, Kazamel M (2020) Hereditary transthyretin amyloidosis: clinical presentation and management updates. 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