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Validation of the clinical COPD Questionnaire (CCQ) in primary care.

Ställberg B, Nokela M, Ehrs PO, Hjemdal P, Jonsson EW - Health Qual Life Outcomes (2009)

Bottom Line: Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care.All analyses was performed on both groups.The concordance intra-class correlation between SGRQ and CCQ was 0.91 (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health and Caring Sciences, Section of Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden. b.stallberg@salem.mail.telia.com

ABSTRACT

Background: Patient centred outcomes, such as health status, are important in Chronic Obstructive Pulmonary Disease (COPD). Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care. The newly developed, short Clinical COPD Questionnaire, CCQ, was therefore validated against the St George's Respiratory Questionnaire (SGRQ).

Methods: 111 patients diagnosed by general practitioners as having COPD completed the questionnaires twice, 2-3 months apart, without systematic changes in treatment. Within this sample of patients with "clinical COPD" a subgroup of patients with spirometry verified COPD was identified. All analyses was performed on both groups.

Results: The mean FEV1 (% predicted) was 58.1% for all patients with clinical COPD and 52.4% in the group with verified COPD (n = 83). Overall correlations between SGRQ and CCQ were strong for all patients with clinical COPD (0.84) and the verified COPD subgroup (0.82). The concordance intra-class correlation between SGRQ and CCQ was 0.91 (p < 0.05). Correlations between CCQ and SGRQ were moderate to good, regardless of COPD severity.

Conclusion: The CCQ is a valid and reliable instrument for assessments of health status on the group level in patients treated for COPD in primary care but its reliability may not be sufficient for the monitoring of individual patients.

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Related in: MedlinePlus

Relationship between SGRQ scores and other estimations for COPD in the entire study sample (n = 111). The group with COPD verified by spirometry (filled triangles), GP diagnosis of COPD not verified by spirometry (empty triangles). a. Scatterplot of SGRQ scores against CCQ scores. Intercept for the regression lines: 0.35: slope 0.048: r2 0.70. b. Change in SGRQ score between visit one and two plotted against change in CCQ score. Intercept for the regression lines: -0.22: slope 0.045: r2 0.32. c. Change in SGRQ scores plotted against GPs estimation of change between visit one and two displays large disagreement between the change in health status as recorded by the patient's SGRQ and the caregiver's estimation of change. The lines represent the minimal important difference (± 4) for SGRQ.
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Figure 2: Relationship between SGRQ scores and other estimations for COPD in the entire study sample (n = 111). The group with COPD verified by spirometry (filled triangles), GP diagnosis of COPD not verified by spirometry (empty triangles). a. Scatterplot of SGRQ scores against CCQ scores. Intercept for the regression lines: 0.35: slope 0.048: r2 0.70. b. Change in SGRQ score between visit one and two plotted against change in CCQ score. Intercept for the regression lines: -0.22: slope 0.045: r2 0.32. c. Change in SGRQ scores plotted against GPs estimation of change between visit one and two displays large disagreement between the change in health status as recorded by the patient's SGRQ and the caregiver's estimation of change. The lines represent the minimal important difference (± 4) for SGRQ.

Mentions: Correlations between SGRQ and CCQ overall scores were strong for the entire population with clinical COPD (0.84; Fig. 2a) and the verified COPD subgroup (0.82, not shown). The Symptoms domains of SGRQ and CCQ correlated moderately (0.70 for clinical COPD). In our study, the internal consistency (Cronbach's alpha) was good, except in the Symptoms domains of both instruments. The Spearman correlation coefficients were good both in patients with FEV1 <50% and >50% of predicted (data not shown).


Validation of the clinical COPD Questionnaire (CCQ) in primary care.

Ställberg B, Nokela M, Ehrs PO, Hjemdal P, Jonsson EW - Health Qual Life Outcomes (2009)

Relationship between SGRQ scores and other estimations for COPD in the entire study sample (n = 111). The group with COPD verified by spirometry (filled triangles), GP diagnosis of COPD not verified by spirometry (empty triangles). a. Scatterplot of SGRQ scores against CCQ scores. Intercept for the regression lines: 0.35: slope 0.048: r2 0.70. b. Change in SGRQ score between visit one and two plotted against change in CCQ score. Intercept for the regression lines: -0.22: slope 0.045: r2 0.32. c. Change in SGRQ scores plotted against GPs estimation of change between visit one and two displays large disagreement between the change in health status as recorded by the patient's SGRQ and the caregiver's estimation of change. The lines represent the minimal important difference (± 4) for SGRQ.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2666647&req=5

Figure 2: Relationship between SGRQ scores and other estimations for COPD in the entire study sample (n = 111). The group with COPD verified by spirometry (filled triangles), GP diagnosis of COPD not verified by spirometry (empty triangles). a. Scatterplot of SGRQ scores against CCQ scores. Intercept for the regression lines: 0.35: slope 0.048: r2 0.70. b. Change in SGRQ score between visit one and two plotted against change in CCQ score. Intercept for the regression lines: -0.22: slope 0.045: r2 0.32. c. Change in SGRQ scores plotted against GPs estimation of change between visit one and two displays large disagreement between the change in health status as recorded by the patient's SGRQ and the caregiver's estimation of change. The lines represent the minimal important difference (± 4) for SGRQ.
Mentions: Correlations between SGRQ and CCQ overall scores were strong for the entire population with clinical COPD (0.84; Fig. 2a) and the verified COPD subgroup (0.82, not shown). The Symptoms domains of SGRQ and CCQ correlated moderately (0.70 for clinical COPD). In our study, the internal consistency (Cronbach's alpha) was good, except in the Symptoms domains of both instruments. The Spearman correlation coefficients were good both in patients with FEV1 <50% and >50% of predicted (data not shown).

Bottom Line: Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care.All analyses was performed on both groups.The concordance intra-class correlation between SGRQ and CCQ was 0.91 (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health and Caring Sciences, Section of Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden. b.stallberg@salem.mail.telia.com

ABSTRACT

Background: Patient centred outcomes, such as health status, are important in Chronic Obstructive Pulmonary Disease (COPD). Extensive questionnaires on health status have good measurement properties, but are not suitable for use in primary care. The newly developed, short Clinical COPD Questionnaire, CCQ, was therefore validated against the St George's Respiratory Questionnaire (SGRQ).

Methods: 111 patients diagnosed by general practitioners as having COPD completed the questionnaires twice, 2-3 months apart, without systematic changes in treatment. Within this sample of patients with "clinical COPD" a subgroup of patients with spirometry verified COPD was identified. All analyses was performed on both groups.

Results: The mean FEV1 (% predicted) was 58.1% for all patients with clinical COPD and 52.4% in the group with verified COPD (n = 83). Overall correlations between SGRQ and CCQ were strong for all patients with clinical COPD (0.84) and the verified COPD subgroup (0.82). The concordance intra-class correlation between SGRQ and CCQ was 0.91 (p < 0.05). Correlations between CCQ and SGRQ were moderate to good, regardless of COPD severity.

Conclusion: The CCQ is a valid and reliable instrument for assessments of health status on the group level in patients treated for COPD in primary care but its reliability may not be sufficient for the monitoring of individual patients.

Show MeSH
Related in: MedlinePlus