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. 1997 Oct;52(10):879–887. doi: 10.1136/thx.52.10.879

Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting

R Harper, J E Brazier, J C Waterhouse, S J Walters, N M Jones, P Howard
PMCID: PMC1758425  PMID: 9404375

Abstract

BACKGROUND: To assist clinicians and researchers in choosing outcome measures for patients with chronic obstructive pulmonary disease attending routine outpatient clinics, a comparative assessment was undertaken of four questionnaires designed to reflect the patients' perception of their physical and emotional health in terms of their feasibility, validity, reliability, and responsiveness to health change. METHODS: Two condition specific questionnaires, the St George's Respiratory Questionnaire (SGRQ) and Guyatt's Chronic Respiratory Questionnaire (CRQ), and two generic questionnaires, the Short Form-36 Health Survey (SF-36) and Euroqol (EQ), were compared for their discriminative and evaluative properties. Spirometric tests and a walking test were also performed. One hundred and fifty six adults who were clinically judged to have COPD and who attended an outpatient chest clinic were assessed at recruitment and six and 12 months later. Patients were also asked whether their health had changed since their last assessment. RESULTS: Completion rates and consistency between items for dimensions of the SGRQ were lower than for dimensions of the other questionnaires. The distributions of responses were skewed for certain dimensions in all questionnaires except the CRQ. Validity was supported for all instruments insofar as patients' scores were associated with differences in disease severity. The generic questionnaires better reflected other health problems. All instruments were reliable over time. The condition specific questionnaires were more responsive between baseline and first follow up visit but this difference did not persist. While certain dimensions of the SF-36 were responsive to patient perceived changes, this did not apply to the derived single index of the EQ. The rating scale of the EQ, however, provided a quick and easy indicator of change. CONCLUSIONS: Evidence from this study supports the CRQ and the SF-36 as comprehensive outcome measures for patients with longstanding COPD. 




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Selected References

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  1. Brazier J. E., Harper R., Jones N. M., O'Cathain A., Thomas K. J., Usherwood T., Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160–164. doi: 10.1136/bmj.305.6846.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cassileth B. R., Lusk E. J., Strouse T. B., Miller D. S., Brown L. L., Cross P. A., Tenaglia A. N. Psychosocial status in chronic illness. A comparative analysis of six diagnostic groups. N Engl J Med. 1984 Aug 23;311(8):506–511. doi: 10.1056/NEJM198408233110805. [DOI] [PubMed] [Google Scholar]
  3. Fitzpatrick R., Ziebland S., Jenkinson C., Mowat A., Mowat A. A comparison of the sensitivity to change of several health status instruments in rheumatoid arthritis. J Rheumatol. 1993 Mar;20(3):429–436. [PubMed] [Google Scholar]
  4. Fitzpatrick R., Ziebland S., Jenkinson C., Mowat A., Mowat A. Transition questions to assess outcomes in rheumatoid arthritis. Br J Rheumatol. 1993 Sep;32(9):807–811. doi: 10.1093/rheumatology/32.9.807. [DOI] [PubMed] [Google Scholar]
  5. Garratt A. M., Ruta D. A., Abdalla M. I., Russell I. T. SF 36 health survey questionnaire: II. Responsiveness to changes in health status in four common clinical conditions. Qual Health Care. 1994 Dec;3(4):186–192. doi: 10.1136/qshc.3.4.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Guyatt G. H., Berman L. B., Townsend M., Pugsley S. O., Chambers L. W. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987 Oct;42(10):773–778. doi: 10.1136/thx.42.10.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Guyatt G. H., Feeny D. H., Patrick D. L. Measuring health-related quality of life. Ann Intern Med. 1993 Apr 15;118(8):622–629. doi: 10.7326/0003-4819-118-8-199304150-00009. [DOI] [PubMed] [Google Scholar]
  8. Hayes V., Morris J., Wolfe C., Morgan M. The SF-36 health survey questionnaire: is it suitable for use with older adults? Age Ageing. 1995 Mar;24(2):120–125. doi: 10.1093/ageing/24.2.120. [DOI] [PubMed] [Google Scholar]
  9. Jones P. W. Quality of life measurement for patients with diseases of the airways. Thorax. 1991 Sep;46(9):676–682. doi: 10.1136/thx.46.9.676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jones P. W., Quirk F. H., Baveystock C. M., Littlejohns P. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis. 1992 Jun;145(6):1321–1327. doi: 10.1164/ajrccm/145.6.1321. [DOI] [PubMed] [Google Scholar]
  11. Stewart A. L., Greenfield S., Hays R. D., Wells K., Rogers W. H., Berry S. D., McGlynn E. A., Ware J. E., Jr Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):907–913. [PubMed] [Google Scholar]
  12. Ziebland S., Fitzpatrick R., Jenkinson C., Mowat A., Mowat A. Comparison of two approaches to measuring change in health status in rheumatoid arthritis: the Health Assessment Questionnaire (HAQ) and modified HAQ. Ann Rheum Dis. 1992 Nov;51(11):1202–1205. doi: 10.1136/ard.51.11.1202. [DOI] [PMC free article] [PubMed] [Google Scholar]

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