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 instrument has high internal consistency and good convergent validity. It has been shown to be responsive to changes on individual level if the art of the symptoms are not too minor, but is not as suitable for comparison between populations.[73] "
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    ABSTRACT: Patient-reported outcomes (PROs), such as symptoms and perceived health status, are essential in chronic obstructive pulmonary disease (COPD) for determining disease severity, impact on daily life, effect of treatment and recovery from exacerbations. This field has evolved rapidly and there are a plethora of instruments assessing different PROs. Here, we aim to provide an understanding of the concept of PROs in COPD. The PROs reflect important aspects of COPD which have a direct impact on daily life. Common symptoms such as dyspnea, cough, phlegm, anxiety, fatigue, and pain and as well as physical function and the risk for and occurrence of acute exacerbations should be assessed both in the clinic and in research. Besides impact on daily life, some of the PROs are related to disease progress and mortality. Construction of composite variables including different disease specific and generic PROs provide a general estimation of health status.
    Full-text · Article · Jan 2016 · Expert Review of Respiratory Medicine
    • "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
    No preview · Article · Sep 2015 · Journal of Thoracic Oncology
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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). "

    Full-text · Dataset · Feb 2015
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