A Measure of Quality of Life for Clinical Trials in Chronic Lung Disease

Department of Medicine, McMaster University, Hamilton, Ontario.
Thorax (Impact Factor: 8.29). 11/1987; 42(10):773-8. DOI: 10.1136/thx.42.10.773
Source: PubMed


Since the relationships between pulmonary function, exercise capacity, and functional state or quality of life are generally weak, a self report questionnaire has been developed to determine the effect of treatment on quality of life in clinical trials. One hundred patients with chronic airflow limitation were asked how their quality of life was affected by their illness, and how important their symptoms and limitations were. The most frequent and important items were used to construct a questionnaire evaluating four dimensions: dyspnoea, fatigue, emotional function, and the patient's feeling of control over the disease (mastery). Reproducibility, tested by repeated administration to patients in a stable condition, was excellent: the coefficient of variation was less than 12% for all four dimensions. Responsiveness (sensitivity to change) was tested by administering the questionnaire to 13 patients before and after optimisation of their drug treatment and to another 28 before and after participation in a respiratory rehabilitation programme. In both cases large, statistically significant improvements in all four dimensions were noted. Changes in questionnaire score were correlated with changes in spirometric values, exercise capacity, and patients' and physicians' global ratings. Thus it has been shown that the questionnaire is precise, valid, and responsive. It can therefore serve as a useful disease specific measure of quality of life for clinical trials.

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    • "The original CRQ includes 20 items across four domains: dyspnea, fatigue, emotional functioning and mastery of breathlessness (Guyatt et al, 1987). Tsai et al. (2008) developed a standardized eight-item short-form CRQ (SF-CRQ) where they maintained the four domains (with two items per domain). "
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    ABSTRACT: Background: The Chronic Respiratory Questionnaire short form (SF-CRQ) is frequently used in patients with obstructive pulmonary disease and it has demonstrated excellent psychometric properties. The CRQ (both in its original or short form) has not been previously used in the assessment of lung cancer patients’ HRQL. Therefore this study, being part of a larger therapeutic trial, aims to evaluate the psychometric properties of the SF-CRQ in patients diagnosed with thoracic malignancies. Methods: Forty-six patients were assessed at two time points (with a four-week interval) using the SF-CRQ, the modified Borg Scale, five numerical rating scales related to perceived severity of breathlessness, and the Hospital Anxiety & Depression Scale. Internal consistency reliability was investigated by Cronbach’s α reliability coefficient, test-retest reliability by Spearman-Brown reliability coefficient (p) and convergent validity by Pearson’s correlation coefficient between the SF-CRQ, and the conceptual similar scales mentioned above and content validity was also explored. A principal component factor analysis was performed.Results: The internal consistency was high, indicated by an α=0.88 (baseline) and 0.91 (after one month). The SF-CRQ had good stability with test-retest reliability ranging from r=0.64 to r=0.78, p<0.001. Factor analysis suggests a single construct in this population showing that the items of the SF-CRQ scale are strongly correlated and represent the conceptual meaning of the underlying construct, which is the quality of life of lung cancer patients as related to breathlessness. Conclusion: The data analyses supported the convergent, content, and construct validity of the SF-CRQ indicating this is a valid and reliable instrument for the assessment of quality of life related to breathlessness in lung cancer patients. This study is the first study that provides initial data of the psychometric properties of the SF-CRQ in lung cancer patients, and further validation with larger sample sizes and across different settings and dyspnea severity is needed. Keywords: breathlessness, quality of life, lung cancer patients, Chronic Respiratory Questionnaire
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    • "Alternatively, a multidimensional scale, which correlates better with quality of life, can be used (Bausewein, Farquhar, Booth, Gysels, & Higginson, 2007). Consequently, multidimensional clinical instruments were developed in order to provide a more comprehensive assessment of the severity of dyspnea, combined with the Chronic Respiratory Disease Questionnaire (CRQ) incorporates five physical activities that are specific for individual patients (Guyatt et al., 1987). These instruments have been shown to be valid, reliable, and responsive (Reda, Kotz, Kocks, Wesseling, & van Schayck, 2010). "

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    • "The BODE index (bodymass index, airflow obstruction, dyspnea, and exercise capacity index) [27] was assessed as a prognosis factor for COPD patients. The disease-specific health-related quality of life (QOL) was measured using the Japanese version of the Chronic Respiratory Disease Questionnaire (CRQ) [28]. "
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    ABSTRACT: We evaluated the effects of low-intensity and home-based pulmonary rehabilitation (PR) on physical activity (PA) and the feedback provided by a pedometer in stable elderly patients with chronic obstructive pulmonary disease (COPD). We assessed PA using a newly developed triaxial accelerometer (A-MES™, Kumamoto, Japan), which measures the time spent walking, standing, sitting and lying down. Twenty-seven elderly patients with COPD (age 74 ± 8 yrs; %FEV1 56.6 ± 18.7%) participated. They were randomly selected to undergo PR (pulmonary rehabilitation only) or PR + P (PR plus the feedback from using a pedometer). Their PA and pulmonary function, exercise capacity (6-min walking distance; 6MWD), quadriceps femoris muscle force (QF) were evaluated before the PR began (baseline) and at 1 year later. We compared the patients' changes in PA and other factors between the baseline values and those obtained 1 year later and analyzed the relationships between the changes in PA and other factors in the both groups. The increase in the time spent walking in the PR + P group (51.3 ± 63.7 min/day) was significantly greater than that of PR group (12.3 ± 25.5 min/day) after the PR. The improvement rate of daily walking time after PR was significantly correlated with that of the 6MWD and QF in all subjects. These data suggest that low-intensity and home-based PR with the feedback from using pedometer was effective in improving PA, and the improvements of physiological factors were correlated with increased walking time in stable elderly patients with COPD. Copyright © 2015 Elsevier Ltd. All rights reserved.
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