The dynamics in health-related quality of life of patients with stable coronary artery disease were revealed: a network analysis

T.H. Oreel, D. Borsboom, S. Epskamp, I.D. Hartog, J.E. Netjes, P.T. Nieuwkerk, J.P.S. Henriques, M. Scherer-Rath, H.W.M. van Laarhoven, M.A.G. Sprangers

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)


Objective: Health-related quality of life (HRQoL) is a dynamic construct. Experience sampling methods (ESM) are becoming increasingly popular to capture within-person fluctuations in HRQoL. An emerging approach to analyze such momentary data is network analysis. Our aim was to explore the use of network analysis for investigating the dynamics within individual's HRQoL. 

Study Design and Setting: We analyzed ESM data of 30 patients with stable coronary artery disease (CAD). Patients completed eight HRQoL items representing four scales (i.e., positive mood, negative mood, CAD symptoms, and physical state) at nine times a day for seven consecutive days. Network analysis was used to analyze the data at group level to estimate the average HRQoL dynamics and at patient level to estimate HRQoL dynamics of individual patients. 

Results: Group-level analysis showed that, on average, feeling “tired” and feeling “anxious” are the most central items in patients' HRQoL. Patient-level analysis revealed differences in patients’ network structures, indicating within-person differences in HRQoL dynamics. 

Conclusion: This study is one of the first to apply network analysis to momentary HRQoL data. To the extent that network models are meaningful representations of HRQoL dynamics, they may help deepening our insight into experienced HRQoL and provide targets for personalized treatment.

Original languageEnglish
Pages (from-to)116-123
Number of pages8
JournalJournal of Clinical Epidemiology
Early online date5 Dec 2018
Publication statusPublished - 1 Mar 2019


  • Experience sampling
  • Health-related quality of life
  • Network analysis
  • Personalized treatment
  • Psychometrics
  • Stable coronary artery disease

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