Abstract
Assessment of health-related quality of life (HRQL) is particularly important in patients with progressive and incurable diseases such as idiopathic pulmonary fibrosis (IPF). The St George’s Respiratory Questionnaire (SGRQ) has frequently been used to measure HRQL in patients with IPF, but it was developed for patients with obstructive lung diseases. The aim of this review was to examine published data on the psychometric performance of the SGRQ in patients with IPF. A comprehensive search was conducted to identify studies reporting data on the internal consistency, construct validity, test-retest reliability, and interpretability of the SGRQ in patients with IPF, published up to August 2013. In total, data from 30 papers were reviewed. Internal consistency was moderate for the SGRQ symptoms score and excellent for the SGRQ activity, impact and total scores. Validity of the SGRQ symptoms, activity, impact and total scores was supported by moderate to strong correlations with other patient-reported outcome measures and with a measure of exercise capacity. Most correlations were moderately strong between SGRQ activity or total scores and forced or static vital capacity, the most commonly used marker of IPF severity. There was evidence that changes in SGRQ domain and total scores could detect within-subject improvement in health status, and differentiate groups of patients whose health status had improved, declined or remained unchanged. Although the SGRQ was not developed specifically for use with patients with IPF, on balance, its psychometric properties are adequate and suggest that it may be a useful measure of HRQL in this patient population. However, several questions remain unaddressed, and further research is needed to confirm the SGRQ’s utility in IPF.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0124-1) contains supplementary material, which is available to authorized users.
Highlights
Idiopathic pulmonary fibrosis (IPF) is a specific form of fibrosing interstitial pneumonia characterized by progressive worsening of dyspnea and lung function [1]
We focused on the St George’s Respiratory Questionnaire (SGRQ)
Following a PubMed search, articles were excluded if they were not published between 1 January 1991 and 31 August 2013, were not published in English, did not report data on the psychometric properties of the SGRQ in patients with IPF or duplicated clinical trial data reported in another article (Figure 1)
Summary
Idiopathic pulmonary fibrosis (IPF) is a specific form of fibrosing interstitial pneumonia characterized by progressive worsening of dyspnea and lung function [1]. As IPF is a progressive disease with no cure, HRQL and other patient-centered outcomes are important endpoints to evaluate in research and clinical practice [6]. No disease-specific measure of HRQL has been established as suitable for longitudinal research in patients with IPF, several HRQL instruments (and others, including symptom and generic quality of life questionnaires) have been used [7,8]. Which patient-centered instrument(s) (including HRQL questionnaires) to use in a particular study depends on a number of factors, including the design of the study, the intervention being assessed, the hypotheses being tested, and the characteristics of the comparator group (general population, patients with IPF of different severity, patients with another disease, etc.). Whether a generic HRQL instrument might perform as well or better than a disease-specific HRQL instrument is uncertain
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