Jeffrey J Swigris1, Hye-Seung Lee2, Marsha Cohen3, Yoshikazu Inoue4, Joel Moss5, Lianne G Singer6, Lisa R Young7, Francis X McCormack8. 1. Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO. Electronic address: swigrisj@njc.org. 2. Pediatrics Epidemiology Center, University of South Florida College of Medicine, Tampa, FL. 3. Women's Health Research Institute, Women's College Hospital, Toronto, ON, Canada. 4. National Hospital Organization Kinki-Chou Chest Medical Center, Osaka, Japan. 5. National Institutes of Health, Bethesda, MD. 6. Lung Transplantation Program, University of Toronto, Nashville, TN. 7. Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN. 8. Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, OH.
Abstract
BACKGROUND: Lymphangioleiomyomatosis (LAM) is an uncommon, progressive, cystic lung disease that causes shortness of breath, hypoxemia, and impaired health-related quality of life (HRQL). Whether St. George's Respiratory Questionnaire (SGRQ), a respiratory-specific HRQL instrument, captures longitudinal changes in HRQL in patients with LAM is unknown. METHODS: Using data from the Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus trial, we performed analyses to examine associations between SGRQ scores and values for four external measures (anchors). Anchors included (1) FEV₁, (2) diffusing capacity of the lung for carbon monoxide, (3) distance walked during the 6-min walk test, and (4) serum vascular endothelial growth factor-D. RESULTS: SGRQ scores correlated with the majority of anchor values at baseline, 6 months, and 12 months. Results from longitudinal analyses demonstrated that SGRQ change scores tracked changes over time in values for each of the four anchors. At 12 months, subjects with the greatest improvement from baseline in FEV₁ experienced the greatest improvement in SGRQ scores (Symptoms domain, -13.4 ± 14.6 points; Activity domain, -6.46 ± 8.20 points; Impacts domain, -6.25 ± 12.8 points; SGRQ total, -7.53 ± 10.0 points). Plots of cumulative distribution functions further supported the longitudinal validity of the SGRQ in LAM. CONCLUSIONS: In LAM, SGRQ scores are associated with variables used to assess LAM severity. The SGRQ is sensitive to change in LAM severity, particularly when change is defined by FEV₁, perhaps the most clinically relevant and prognostically important variable in LAM. The constellation of results here supports the validity of the SGRQ as capable of assessing longitudinal change in HRQL in LAM.
BACKGROUND:Lymphangioleiomyomatosis (LAM) is an uncommon, progressive, cystic lung disease that causes shortness of breath, hypoxemia, and impaired health-related quality of life (HRQL). Whether St. George's Respiratory Questionnaire (SGRQ), a respiratory-specific HRQL instrument, captures longitudinal changes in HRQL in patients with LAM is unknown. METHODS: Using data from the Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus trial, we performed analyses to examine associations between SGRQ scores and values for four external measures (anchors). Anchors included (1) FEV₁, (2) diffusing capacity of the lung for carbon monoxide, (3) distance walked during the 6-min walk test, and (4) serum vascular endothelial growth factor-D. RESULTS: SGRQ scores correlated with the majority of anchor values at baseline, 6 months, and 12 months. Results from longitudinal analyses demonstrated that SGRQ change scores tracked changes over time in values for each of the four anchors. At 12 months, subjects with the greatest improvement from baseline in FEV₁ experienced the greatest improvement in SGRQ scores (Symptoms domain, -13.4 ± 14.6 points; Activity domain, -6.46 ± 8.20 points; Impacts domain, -6.25 ± 12.8 points; SGRQ total, -7.53 ± 10.0 points). Plots of cumulative distribution functions further supported the longitudinal validity of the SGRQ in LAM. CONCLUSIONS: In LAM, SGRQ scores are associated with variables used to assess LAM severity. The SGRQ is sensitive to change in LAM severity, particularly when change is defined by FEV₁, perhaps the most clinically relevant and prognostically important variable in LAM. The constellation of results here supports the validity of the SGRQ as capable of assessing longitudinal change in HRQL in LAM.
Authors: Francis X McCormack; Yoshikazu Inoue; Joel Moss; Lianne G Singer; Charlie Strange; Koh Nakata; Alan F Barker; Jeffrey T Chapman; Mark L Brantly; James M Stocks; Kevin K Brown; Joseph P Lynch; Hilary J Goldberg; Lisa R Young; Brent W Kinder; Gregory P Downey; Eugene J Sullivan; Thomas V Colby; Roy T McKay; Marsha M Cohen; Leslie Korbee; Angelo M Taveira-DaSilva; Hye-Seung Lee; Jeffrey P Krischer; Bruce C Trapnell Journal: N Engl J Med Date: 2011-03-16 Impact factor: 91.245
Authors: Souheil El-Chemaly; Angelo Taveira-Dasilva; Hilary J Goldberg; Elizabeth Peters; Mary Haughey; Don Bienfang; Amanda M Jones; Patricia Julien-Williams; Ye Cui; Julian A Villalba; Shefali Bagwe; Rie Maurer; Ivan O Rosas; Joel Moss; Elizabeth P Henske Journal: Chest Date: 2017-02-10 Impact factor: 9.410
Authors: Lisa Young; Hye-Seung Lee; Yoshikazu Inoue; Joel Moss; Lianne G Singer; Charlie Strange; Koh Nakata; Alan F Barker; Jeffrey T Chapman; Mark L Brantly; James M Stocks; Kevin K Brown; Joseph P Lynch; Hilary J Goldberg; Gregory P Downey; Jeffrey J Swigris; Angelo M Taveira-DaSilva; Jeffrey P Krischer; Bruce C Trapnell; Francis X McCormack Journal: Lancet Respir Med Date: 2013-08 Impact factor: 30.700
Authors: Tarik D Walker; Jennifer Desserich; Karen Albright; Frederick S Wamboldt; Amanda Belkin; Kaitlin Fier; Jeffrey J Swigris Journal: Health Qual Life Outcomes Date: 2015-07-30 Impact factor: 3.186