Measurement of quality of recovery using the QoR-40: a quantitative systematic review

Benjamin Gornall, Paul S Myles, Cathie Smith, Justin Burke, Kate Leslie, M J Pereira, James E Bost, Kirsten B Kluivers, Ulrica Nilsson, Yuu Tanaka, Andrew Benjamin Forbes

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167 Citations (Scopus)


Several rating scales have been developed to measure quality of recovery after surgery and anaesthesia, but the most extensively used is the QoR-40, a 40-item questionnaire that provides a global score and subscores across five dimensions: patient support, comfort, emotions, physical independence, and pain. It has been evaluated in a variety of settings, but its overall psychometric properties (validity, reliability, ease of use, and interpretation) and clinical utility are uncertain.MethodsWe undertook a quantitative systematic review of studies evaluating psychometric properties of the QoR-40. Data were combined in meta-analyses using random effects models. This resulted in a total sample of 3459 patients from 17 studies originating in nine countries.ResultsWe confirmed content, construct, and convergent [pooled r=0.58, 95 confidence interval (CI): 0.51-0.65] validity. Reliability was confirmed by excellent intraclass correlation (pooled a=0.91, 95 CI: 0.88-0.93), test-retest reliability (pooled r=0.90, 95 CI: 0.86-0.92), and inter-rater reliability (intraclass correlation=0.86). The clinical utility of the QoR-40 instrument was supported by high patient recruitment into evaluation studies (97 ), and an excellent completion and return rate (97 ). The mean time to complete the QoR-40 was 5.1 (95 CI: 4.4-5.7) min.ConclusionsThe QoR-40 is a widely used and extensively validated measure of quality of recovery. The QoR-40 is a suitable measure of postoperative quality of recovery in a range of clinical and research situations. ? The Author [2013]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.
Original languageEnglish
Pages (from-to)161 - 169
Number of pages9
JournalBritish Journal of Anaesthesia
Issue number2
Publication statusPublished - 2013

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