Arietta Spinou1, Konstantinos C Fragkos2, Kai K Lee3, Caroline Elston3, Richard J Siegert4, Michael R Loebinger5, Robert Wilson5, Rachel Garrod6, Surinder S Birring1. 1. Division of Asthma, Allergy and Lung Biology, King's College London, Respiratory Medicine, London, UK. 2. Division of Medicine, University College London (UCL), London, UK. 3. Adult Cystic Fibrosis Unit, King's College Hospital, London, UK. 4. Auckland University of Technology (AUT), School of Public Health and Psychosocial Studies and School of Rehabilitation and Occupation Studies, Auckland, New Zealand. 5. Host Defence Unit, Royal Brompton Hospital, London, UK. 6. Denmark Hill Campus, King's College London, Therapies, London, UK.
Abstract
BACKGROUND: A range of questionnaires have been used to assess health-related quality of life (HRQOL) in bronchiectasis. A systematic review was conducted to evaluate their psychometric properties and assess associations between HRQOL and clinical measures. METHODS: Five electronic databases were searched. Studies eligible for inclusion were those that investigated the validity of HRQOL questionnaires and/or their association with other outcomes in adults with bronchiectasis. Patients with cystic fibrosis were excluded. The identified questionnaires were assessed for convergent, discriminant and cross-cultural translation validity; missing data, floor and ceiling effects, internal consistency, responsiveness and test-retest reliability. A meta-analysis was conducted to estimate the strength of associations between HRQOL and clinical measures. RESULTS: From 1918 studies identified, 43 studies were included in the systematic review, of which 38 were suitable for the meta-analysis. Nine HRQOL questionnaires were identified, with the most widely used being: St George's Respiratory Questionnaire, Leicester Cough Questionnaire, Quality of Life-Bronchiectasis and Short Form-36. HRQOL questionnaires had moderate to good internal consistency and good test-retest reliability. Only 8 of 18 studies that used translated HRQOL questionnaires reported or referred to the validity of the translated questionnaire. There was a stronger correlation (mean r (95% CI)) between HRQOL and subjective outcome measures, such as dyspnoea (0.55 (0.41 to 0.68)) and fatigue (0.42 (0.23 to 0.58)) compared with objective measures; exercise capacity (-0.41 (-0.54 to -0.24)), FEV1% predicted (-0.31 (-0.40 to -0.23)) and extent of bronchiectasis on CT scan (0.35 (0.03 to 0.61)); all p<0.001. CONCLUSIONS: This review supports most HRQOL questionnaires used in bronchiectasis have good psychometric properties. There was a weak to moderate association between HRQOL and objective outcome measures. This suggests that HRQOL questionnaires assess a unique aspect of health not captured by objective measures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: A range of questionnaires have been used to assess health-related quality of life (HRQOL) in bronchiectasis. A systematic review was conducted to evaluate their psychometric properties and assess associations between HRQOL and clinical measures. METHODS: Five electronic databases were searched. Studies eligible for inclusion were those that investigated the validity of HRQOL questionnaires and/or their association with other outcomes in adults with bronchiectasis. Patients with cystic fibrosis were excluded. The identified questionnaires were assessed for convergent, discriminant and cross-cultural translation validity; missing data, floor and ceiling effects, internal consistency, responsiveness and test-retest reliability. A meta-analysis was conducted to estimate the strength of associations between HRQOL and clinical measures. RESULTS: From 1918 studies identified, 43 studies were included in the systematic review, of which 38 were suitable for the meta-analysis. Nine HRQOL questionnaires were identified, with the most widely used being: St George's Respiratory Questionnaire, Leicester Cough Questionnaire, Quality of Life-Bronchiectasis and Short Form-36. HRQOL questionnaires had moderate to good internal consistency and good test-retest reliability. Only 8 of 18 studies that used translated HRQOL questionnaires reported or referred to the validity of the translated questionnaire. There was a stronger correlation (mean r (95% CI)) between HRQOL and subjective outcome measures, such as dyspnoea (0.55 (0.41 to 0.68)) and fatigue (0.42 (0.23 to 0.58)) compared with objective measures; exercise capacity (-0.41 (-0.54 to -0.24)), FEV1% predicted (-0.31 (-0.40 to -0.23)) and extent of bronchiectasis on CT scan (0.35 (0.03 to 0.61)); all p<0.001. CONCLUSIONS: This review supports most HRQOL questionnaires used in bronchiectasis have good psychometric properties. There was a weak to moderate association between HRQOL and objective outcome measures. This suggests that HRQOL questionnaires assess a unique aspect of health not captured by objective measures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Arietta Spinou; Kai K Lee; Aish Sinha; Caroline Elston; Michael R Loebinger; Robert Wilson; Kian Fan Chung; Nadia Yousaf; Ian D Pavord; Sergio Matos; Rachel Garrod; Surinder S Birring Journal: Lung Date: 2017-07-13 Impact factor: 2.584
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Authors: Judy Martina Bradley; Rohan Anand; Brenda O'Neill; Kathryn Ferguson; Mike Clarke; Mary Carroll; James Chalmers; Anthony De Soyza; Jamie Duckers; Adam T Hill; Michael R Loebinger; Fiona Copeland; Evie Gardner; Christina Campbell; Ashley Agus; Alistair McGuire; Roisin Boyle; Fionnuala McKinney; Naomi Dickson; Danny F McAuley; Stuart Elborn Journal: Trials Date: 2019-12-19 Impact factor: 2.279
Authors: Rebecca H McLeese; Arietta Spinou; Zina Alfahl; Michail Tsagris; J Stuart Elborn; James D Chalmers; Anthony De Soyza; Michael R Loebinger; Surinder S Birring; Konstantinos C Fragkos; Robert Wilson; Katherine O'Neill; Judy M Bradley Journal: Eur Respir J Date: 2021-11-11 Impact factor: 16.671