Disease-specific Health Status Questionnaire Research Articles

Which scoring system is better in association with exercise capacity and health status in noncystic fibrosis bronchiectasis patients?

Background/aim Two different scoring systems were developed to determine the severity of bronchiectasis: FACED scoring and the bronchiectasis severity index (BSI). In this study, we aim to compare these 2 scoring systems according to the 6-min walking distance test and a disease-specific health status questionnaire in patients with noncystic fibrosis bronchiectasis (NCFB). Materials and methods Smoking history, emergency and hospital admissions, and body mass index were obtained from NCFB patients admitted to our hospitals’ pulmonary rehabilitation unit between 2013 and 2018. Detailed pulmonary function tests were performed for all participants. Dyspnea perceptions were determined according to the mMRC dyspnea scale. The 6-min walking test was used to determine exercise capacity. The Saint George respiratory questionnaire (SGRQ) was applied to determine health status. Both FACED and BSI scores were calculated for all participants. Results There were a total of 183 participants, 153 of whom were men. A significant and strong correlation was found between FACED and BSI scores. As the severity of bronchiectasis increased, walking distance was significantly decreased and health status was significantly worse in both FACED and BSI scoring. A statistically significant but weak negative correlation was found between FACED score and walking distance. There was a significant negative correlation between BSI and walking distance, a stronger negative correlation than with FACED. Similarly, there was a significant negative correlation between health status and both FACED and BSI, but this correlation was stronger in the BSI score. Conclusion Although both FACED and BSI scores were negatively correlated with walking distance and health status in patients with NCFB, BSI was more strongly associated.

The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference

BackgroundThe EQ-5D, a generic health status questionnaire that is widely used in health economic evaluation, was recently expanded to the EQ-5D-5L to address criticisms of unresponsiveness and ceiling effect.AimsTo describe...

Impact of symptoms of anxiety and depression on COPD Assessment Test scores

Anxiety and depression are common comorbidities in patients with chronic obstructive pulmonary disease (COPD) and affect patients’ health status [1, 2]. Health status in COPD patients is frequently assessed by the St George’s Respiratory Questionnaire (SGRQ), which is a validated disease-specific questionnaire widely used in clinical trials [3], but complex and time-consuming to complete and score. Consequently, the COPD Assessment Test (CAT) has been developed [4]. This is a disease-specific health status questionnaire containing eight items with good sensitivity, reliability and responsiveness [4]. CAT scores are strongly positively correlated with SGRQ scores in patients with COPD [4]. Therefore, it is reasonable to hypothesise that those COPD patients with symptoms of anxiety and/or depression will report higher CAT scores (equalling worse health status) compared to those without symptoms. The latest version of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) document [5] recommends the CAT as a tool to assess the impact of COPD on the individual patient beyond airflow limitation. Although it was known that clinically relevant symptoms of anxiety and depression are more common in patients in GOLD stage IV compared to patients in GOLD stages I and II [1], the frequency distribution of patients with symptoms of anxiety and depression across the updated GOLD classification remains unknown. Recently, Sillen et al. [6] reported a prevalence of symptoms of anxiety and depression of 38% and 32%, respectively, in COPD patients with GOLD group D. We aimed to assess …

Correlations between disease-specific and generic health status questionnaires in patients with advanced COPD: a one-year observational study

BackgroundLongitudinal studies analyzing the correlations between disease-specific and generic health status questionnaires at different time points in patients with advanced COPD are lacking. The aim of this study was to determine whether and to what extent a disease-specific health status questionnaire (Saint George’s Respiratory Questionnaire, SGRQ) correlates with generic health status questionnaires (EuroQol-5-Dimensions, EQ-5D; Assessment of Quality of Life instrument, AQoL; Medical Outcomes Study 36-Item Short-Form Health Survey, SF-36) at four different time points in patients with advanced COPD; and to determine the correlation between the changes in these questionnaires during one-year follow-up.MethodsDemographic and clinical characteristics were assessed in 105 outpatients with advanced COPD at baseline. Disease-specific health status (SGRQ) and generic health status (EQ-5D, AQoL, SF-36) were assessed at baseline, four, eight, and 12 months. Correlations were determined between SGRQ and EQ-5D, AQoL, and SF-36 scores and changes in these scores. Agreement in direction of change was assessed.ResultsEighty-four patients (80%) completed one-year follow-up and were included for analysis. SGRQ total score and EQ-5D index score, AQoL total score and SF-36 Physical Component Summary measure (SF-36 PCS) score were moderately to strongly correlated. The correlation of the changes between the SGRQ total score and EQ-5D index score, AQoL total score, SF-36 PCS, and SF-36 Mental Component Summary measure (SF-36 MCS) score were weak or absent. The direction of changes in SGRQ total scores agreed slightly with the direction of changes in EQ-5D index score, AQoL total score, and SF-36 PCS score.ConclusionsAt four, eight and 12 months after baseline, SGRQ total scores and EQ-5D index scores, AQoL total scores and SF-36 PCS scores were moderately to strongly correlated, while SGRQ total scores were weakly correlated with SF-36 MCS scores. The correlations between changes over time were weak or even absent. Disease-specific health status questionnaires and generic health status questionnaires should be used together to gain complete insight in health status and changes in health status over time in patients with advanced COPD.

Analysis of longitudinal changes in dyspnea of patients with chronic obstructive pulmonary disease: an observational study.

BackgroundGuidelines recommend that symptoms as well as lung function should be monitored for the management of patients with chronic obstructive pulmonary disease (COPD). However, limited data are available regarding the longitudinal change in dyspnea, and it remains unknown which of relevant measurements might be used for following dyspnea.MethodsWe previously consecutively recruited 137 male outpatients with moderate to very severe COPD, and followed them every 6 months for 5 years. We then reviewed and reanalyzed the data focusing on the relationships between the change in dyspnea and the changes in other clinical measurements of lung function, exercise tolerance tests and psychological status. Dyspnea with activities of daily living was assessed with the Oxygen Cost Diagram (OCD) and modified Medical Research Council dyspnea scale (mMRC), and two dimensions of disease-specific health status questionnaires of the Chronic Respiratory Disease Questionnaire (CRQ) and the St. George’s Respiratory Questionnaire (SGRQ) were also used. Dyspnea at the end of exercise tolerance tests was measured using the Borg scale.ResultsThe mMRC, CRQ dyspnea and SGRQ activity significantly worsened over time (p < 0.001), but the OCD did not (p = 0.097). Multiple regression analyses revealed that the changes in the OCD, mMRC, CRQ dyspnea and SGRQ activity were significantly correlated to changes in forced expiratory volume in one second (FEV1) (correlation of determination (r2) = 0.05-0.19), diffusing capacity for carbon monoxide (r2 = 0.04-0.08) and psychological status evaluated by Hospital Anxiety and Depression Scale (r2 = 0.14-0.17), although these correlations were weak. Peak Borg score decreased rather significantly, but was unrelated to changes in clinical measurements.ConclusionDyspnea worsened over time in patients with COPD. However, as different dyspnea measurements showed different evaluative characteristics, it is important to follow dyspnea using appropriate measurements. Progressive dyspnea was related not only to progressive airflow limitation, but also to various factors such as worsening of diffusing capacity or psychological status. Changes in peak dyspnea at the end of exercise may evaluate different aspects from other dyspnea measurements.

Feasibility and linguistic validity of the Swedish version of the PDQ-39

The Parkinson’s Disease Questionnaire – 39 is the most widely used disease-specific health status questionnaire for Parkinson’s disease. Evaluations of various language versions have focused on psychometric properties, whereas documented evaluations regarding linguistic validity, respondent burden and questionnaire content are largely lacking. Work with the Swedish Parkinson’s Disease Questionnaire – 39 has taken these aspects into account, which has resulted in a linguistically revised version which is currently being evaluated. Initial observations indicate that the revision rectified linguistic but not nonlinguistic problems, and that its feasibility in terms of respondent burden in more advanced disease can be challenged. There are also indications for the need for content improvements. These experiences are discussed along with their implications.

The impact of endometriosis upon quality of life: a qualitative analysis

Objective: to explore and describe the impact of endometriosis upon quality of life. Setting: Nuffield Department of Obstetrics and Gynaecology, University of Oxford. Design: qualitative study.Sample: twenty-four women with a laparoscopic diagnosis of endometriosis. Methods: face to face, individual, in-depth interviews.Results: analysis of the data revealed 15 descriptive categories. Pain, physical functioning, role performance, social functioning, emotional well-being, relationship with the medical profession, treatment, sexual intercourse, energy and vitality, employment and infertility were found to be a particular concern for women with endometriosis. Physical appearance, lack of control and powerlessness, feelings of social isolation and concerns that their daughters might develop endometriosis were new areas found to be negatively affected by the condition.Conclusions: the impact of endometriosis-associated symptoms upon quality of life is multidimensional and more complex than just negatively affecting psychosocial parameters. Conducting in-depth interviews to explore the subjective experiences of patients with endometriosis enabled the diverse areas of quality of life to be identified. Adopting a qualitative methodology is essential for item generation on disease specific health status questionnaires.

Evidence-based endoscopic sinus surgery.

Evidence-based medicine principles applied to otolaryngology and endoscopic sinus surgery provide the surgeon, patient, and third-party payer with all of the necessary requirements to evaluate the effectiveness of the surgery. Above all, they ensure long-term improvement in quality of life and patients' satisfaction. A specific study on the outcomes of endoscopic sinus surgery is presented. A longitudinal observational study of 51 patients undergoing endoscopic sinus surgery for recurrent acute rhinosinusitis, chronic rhinosinusitis, and nasal polyposis was done in two hospitals. Patients were evaluated preoperatively and 3 months postoperatively with a disease-specific health status questionnaire (Quebec French-Rhinosinusitis Outcome Measure) and a general health status questionnaire (the Medical Outcome Study 36-Item Short-Form Health Survey). The results show statistically significant improvement in quality of life after endoscopic sinus surgery in both the disease-specific and the disease-generic health status questionnaires. The broader subject of objective and subjective outcomes assessment, along with evidence-based evaluation, is discussed.

Validation of the Airways Questionnaire 20 - AQ20 in patients with chronic obstructive pulmonary disease (COPD) in Brazil

INTRODUCTION: A great emphasis has been placed on health-related quality of life of COPD patients and specific questionnaires have been developed in order to measure it. OBJECTIVE: This study describes the language and cultural adaptation of a new (and short) disease-specific health status questionnaire developed for chronic obstructive pulmonary diseases: the Airways Questionnaire 20 (AQ20). METHODS: In order to validate this questionnaire in Brazil, it was initially translated into Portuguese. The cultural adaptation was taken into consideration and then a back translation to English was undertaken, in order to obtain a final Portuguese version. Correlations were made with FEV1, SpO2, BMI and another disease-specific health status questionnaire, the Saint George Respiratory Questionnaire (SGRQ), previously validated in Brazil. The interclass correlation ratio was done to test the reproducibility of AQ20. RESULTS: The interclass correlation ratio for the total score was a = 0.90 (intra-observer variability) and a = 0.93 (inter-observer variability) (p < 0.05 for both). The correlation with total SGRQ score was 0.76, with p < 0.001. The average time to answer the AQ20 was 4 min and 6 s. CONCLUSION: The Brazilian Portuguese version of AQ20 is reproducible, of fast application and with good a correlation with SGRQ total score, which makes it a valid questionnaire to measure health status in obstructive patients in Brazil.

Assessing individual quality of life in amyotrophic lateral sclerosis.

Quality of life (QoL) assessment in amyotrophic lateral sclerosis (ALS) has typically involved the use of general or disease-specific health status questionnaires. This study assessed the feasibility of using a patient-centered approach to QoL measurement in ALS. (1) To assess the internal consistency reliability and validity of the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) as a measure of QoL in ALS. (2) To provide a brief description of QoL in ALS, and to examine the relationships between QoL, illness severity and psychological distress in this group. Twenty-six patients with ALS were recruited through the Irish Register for ALS/motor neurone disease (MND). Illness severity was assessed with the ALS Functional Rating Scale (ALSFRS). Levels of psychological distress were measured with the Hospital Anxiety and Depression Scale (HADS). Individual QoL was assessed with SEIQoL. Patients were at various stages of ALS. Mean levels of anxiety and depression were in the normal range. Twenty-one patients completed SEIQoL; five patients completed a shorter version, SEIQoL-Direct Weighting (SEIQoL-DW). Internal consistency reliability and validity results for SEIQoL were high. SEIQoL is generally acceptable for use in ALS in terms of its practical feasibility, and has high internal validity and consistency reliability in this patient group. However, patients severely disabled by ALS may not be able to complete SEIQoL; further research is required to confirm the use of SEIQoL-DW as an alternative measure of individual QoL in ALS.

HEALTH STATUS QUESTIONNAIRES

Because they accurately and efficiently tap into important aspects of rheumatic disease status and outcome, health status questionnaires have found increasing use in the clinic, controlled clinical trials, and observational studies. This article reviews utility assessment methodologies as well as generic and disease-specific health status questionnaires relevant to rheumatology.