Andrea Zanini1, Marina Aiello2, Daniela Adamo3, Silvia Casale3, Francesca Cherubino3, Sabrina Della Patrona3, Eleonora Raimondi3, Elisabetta Zampogna3, Alfredo Chetta2, Antonio Spanevello4. 1. Division of Pneumology, Istituto di Ricovero e Cura a Carattere Scientifico Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, Tradate Department of Clinical and Experimental Medicine, University of Insubria, Varese andrea.zanini@fsm.it. 2. Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy. 3. Division of Pneumology, Istituto di Ricovero e Cura a Carattere Scientifico Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, Tradate. 4. Division of Pneumology, Istituto di Ricovero e Cura a Carattere Scientifico Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, Tradate Department of Clinical and Experimental Medicine, University of Insubria, Varese.
Abstract
BACKGROUND: The effect of pulmonary rehabilitation (PR) on the EuroQol Group's 5-dimension questionnaire (EQ-5D) in COPD has been poorly investigated. In addition, conflicting results were reported about the visual analog scale component of EQ-5D (EQ-VAS). The purpose of this study was to evaluate the responsiveness of EQ-VAS to PR and its relationship with clinical and functional parameters in subjects with COPD, as well as to define the minimal clinically important difference (MCID) estimate for the EQ-VAS after PR. METHODS: A total of 468 in-patients with stable moderate-to-severe COPD, allocated to a 3-wk PR program, were retrospectively evaluated. EQ-VAS was assessed before and after PR, and its relationship with baseline pulmonary function, changes in 6-min walk test, and baseline, and transitional dyspnea index (BDI/TDI) after PR were evaluated. Using an anchor-based approach and receiver operating characteristic curves, the EQ-VAS change cutoff that identified subjects achieving the known MCID for TDI after PR was identified. RESULTS: Four hundred and thirty-nine subjects (94%, mean FEV1 55.3% predicted) completed pre- and post-PR EQ-VAS scores. After PR, EQ-VAS increased from 58 ± 17 to 72 ± 15 (ΔEQ-VAS 14 ± 12, P < .001). ΔEQ-VAS was negatively related to baseline FEV1 (r = -0.32, P < .001) and positively to TDI (r = 0.50, P < .001) and 6-min walk distance (r = 0.46, P < .001) changes. Receiver operating characteristic curves identified an EQ-VAS change cutoff of 8 as the best discriminating value to identify the MCID for TDI (0.78 sensitivity and 0.81 specificity; area under curve: 0.845, P < .001). CONCLUSIONS: Our study shows that, in in-patients with stable moderate-to-severe COPD, EQ-VAS is a valid and reliable tool to assess the responsiveness to PR, with an estimated MCID of 8 points. The EQ-VAS can be a practical alternative to more time-consuming measures of health-related quality of life.
BACKGROUND: The effect of pulmonary rehabilitation (PR) on the EuroQol Group's 5-dimension questionnaire (EQ-5D) in COPD has been poorly investigated. In addition, conflicting results were reported about the visual analog scale component of EQ-5D (EQ-VAS). The purpose of this study was to evaluate the responsiveness of EQ-VAS to PR and its relationship with clinical and functional parameters in subjects with COPD, as well as to define the minimal clinically important difference (MCID) estimate for the EQ-VAS after PR. METHODS: A total of 468 in-patients with stable moderate-to-severe COPD, allocated to a 3-wk PR program, were retrospectively evaluated. EQ-VAS was assessed before and after PR, and its relationship with baseline pulmonary function, changes in 6-min walk test, and baseline, and transitional dyspnea index (BDI/TDI) after PR were evaluated. Using an anchor-based approach and receiver operating characteristic curves, the EQ-VAS change cutoff that identified subjects achieving the known MCID for TDI after PR was identified. RESULTS: Four hundred and thirty-nine subjects (94%, mean FEV1 55.3% predicted) completed pre- and post-PREQ-VAS scores. After PR, EQ-VAS increased from 58 ± 17 to 72 ± 15 (ΔEQ-VAS 14 ± 12, P < .001). ΔEQ-VAS was negatively related to baseline FEV1 (r = -0.32, P < .001) and positively to TDI (r = 0.50, P < .001) and 6-min walk distance (r = 0.46, P < .001) changes. Receiver operating characteristic curves identified an EQ-VAS change cutoff of 8 as the best discriminating value to identify the MCID for TDI (0.78 sensitivity and 0.81 specificity; area under curve: 0.845, P < .001). CONCLUSIONS: Our study shows that, in in-patients with stable moderate-to-severe COPD, EQ-VAS is a valid and reliable tool to assess the responsiveness to PR, with an estimated MCID of 8 points. The EQ-VAS can be a practical alternative to more time-consuming measures of health-related quality of life.
Authors: Alison E Turnbull; Hongkai Ji; Victor D Dinglas; Albert W Wu; Pedro A Mendez-Tellez; Cheryl Dennison Himmelfarb; Carl B Shanholtz; Megan M Hosey; Ramona O Hopkins; Dale M Needham Journal: Chest Date: 2021-08-19 Impact factor: 9.410
Authors: Breda Cushen; Aisling Madden; Deirdre Long; Yvonne Whelan; Michael Emmet O'Brien; Deirdre Carroll; Des O'Flynn; Michelle Forde; Virginia Pye; Loretto Grogan; Margaret Casey; Karolina Farrell; Richard W Costello; Clare Lewis Journal: Ir J Med Sci Date: 2021-05-06 Impact factor: 2.089
Authors: Sophia Humphries; John Wallert; Katarina Mars; Claes Held; Robin Hofmann; Erik M G Olsson Journal: Eur Heart J Acute Cardiovasc Care Date: 2022-06-22
Authors: Margarethe E Wacker; Rudolf A Jörres; Annika Karch; Sarah Wilke; Joachim Heinrich; Stefan Karrasch; Armin Koch; Holger Schulz; Henrik Watz; Reiner Leidl; Claus Vogelmeier; Rolf Holle Journal: BMC Pulm Med Date: 2016-05-10 Impact factor: 3.317
Authors: Claire M Nolan; Louise Longworth; Joanne Lord; Jane L Canavan; Sarah E Jones; Samantha S C Kon; William D-C Man Journal: Thorax Date: 2016-03-30 Impact factor: 9.139