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Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Self-administration and interviewer-administration of the German Chronic Respiratory Questionnaire: instrument development and assessment of validity and reliability in two randomised studies

Authors: Milo A Puhan, Michaela Behnke, Martin Frey, Thomas Grueter, Otto Brandli, Alfred Lichtenschopf, Gordon H Guyatt, Holger J Schunemann

Published in: Health and Quality of Life Outcomes | Issue 1/2004

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Abstract

Background

Assessment of health-related quality of life (HRQL) is important in patients with chronic obstructive pulmonary disease (COPD). Despite the high prevalence of COPD in Germany, Switzerland and Austria there is no validated disease-specific instrument available. The objective of this study was to translate the Chronic Respiratory Questionnaire (CRQ), one of the most widely used respiratory HRQL questionnaires, into German, develop an interviewer- and self-administered version including both standardised and individualised dyspnoea questions, and validate these versions in two randomised studies.

Methods

We recruited three groups of patients with COPD in Switzerland, Germany and Austria. The 44 patients of the first group completed the CRQ during pilot testing to adapt the CRQ to German-speaking patients. We then recruited 80 patients participating in pulmonary rehabilitation programs to assess internal consistency reliability and cross-sectional validity of the CRQ. The third group consisted of 38 patients with stable COPD without an intervention to assess test-retest reliability. To compare the interviewer- and self-administered versions, we randomised patients in groups 2 and 3 to the interviewer- or self-administered CRQ. Patients completed both the standardised and individualised dyspnoea questions.

Results

For both administration formats and all domains, we found good internal consistency reliability (Crohnbach's alpha between 0.73 and 0.89). Cross-sectional validity tended to be better for the standardised compared to the individualised dyspnoea questions and cross-sectional validity was slightly better for the self-administered format. Test-retest reliability was good for both the interviewer-administered CRQ (intraclass correlation coefficients for different domains between 0.81 and 0.95) and the self-administered format (intraclass correlation coefficients between 0.78 and 0.86). Lower within-person variability was responsible for the higher test-retest reliability of the interviewer-administered format while between person variability was similar for both formats.

Conclusions

Investigators in German-speaking countries can choose between valid and reliable self-and interviewer-administered CRQ formats.
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Literature
1.
go back to reference Guyatt GH, Feeny DH, Patrick DL: Measuring health-related quality of life. Ann Intern Med 1993, 118: 622–629.PubMedCrossRef Guyatt GH, Feeny DH, Patrick DL: Measuring health-related quality of life. Ann Intern Med 1993, 118: 622–629.PubMedCrossRef
2.
go back to reference Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001, 163: 1256–1276.PubMedCrossRef Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001, 163: 1256–1276.PubMedCrossRef
3.
go back to reference Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, Anderson J, Maden C: Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003, 361: 449–456. 10.1016/S0140-6736(03)12459-2PubMedCrossRef Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, Anderson J, Maden C: Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003, 361: 449–456. 10.1016/S0140-6736(03)12459-2PubMedCrossRef
4.
go back to reference Behnke M, Taube C, Kirsten D, Lehnigk B, Jorres RA, Magnussen H: Home-based exercise is capable of preserving hospital-based improvements in severe chronic obstructive pulmonary disease. Respir Med 2000, 94: 1184–1191. 10.1053/rmed.2000.0949PubMedCrossRef Behnke M, Taube C, Kirsten D, Lehnigk B, Jorres RA, Magnussen H: Home-based exercise is capable of preserving hospital-based improvements in severe chronic obstructive pulmonary disease. Respir Med 2000, 94: 1184–1191. 10.1053/rmed.2000.0949PubMedCrossRef
5.
go back to reference Puhan MA, Koller M, Brandli O, Steurer J: [Pulmonary rehabilitation of COPD in Switzerland--an assessment of current status]. Schweiz Rundsch Med Prax 2003, 92: 111–116. Puhan MA, Koller M, Brandli O, Steurer J: [Pulmonary rehabilitation of COPD in Switzerland--an assessment of current status]. Schweiz Rundsch Med Prax 2003, 92: 111–116.
6.
go back to reference Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW: A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987, 42: 773–778.PubMedCentralPubMedCrossRef Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW: A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987, 42: 773–778.PubMedCentralPubMedCrossRef
7.
go back to reference Harper R, Brazier JE, Waterhouse JC, Walters SJ, Jones NM, Howard P: Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting. Thorax 1997, 52: 879–887.PubMedCentralPubMedCrossRef Harper R, Brazier JE, Waterhouse JC, Walters SJ, Jones NM, Howard P: Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting. Thorax 1997, 52: 879–887.PubMedCentralPubMedCrossRef
8.
go back to reference Wijkstra PJ, TenVergert EM, van Altena R, Otten V, Postma DS, Kraan J, Koeter GH: Reliability and validity of the chronic respiratory questionnaire (CRQ). Thorax 1994, 49: 465–467.PubMedCentralPubMedCrossRef Wijkstra PJ, TenVergert EM, van Altena R, Otten V, Postma DS, Kraan J, Koeter GH: Reliability and validity of the chronic respiratory questionnaire (CRQ). Thorax 1994, 49: 465–467.PubMedCentralPubMedCrossRef
9.
go back to reference Goldstein RS, Todd TR, Guyatt G, Keshavjee S, Dolmage TE, van Rooy S, Krip B, Maltais F, LeBlanc P, Pakhale S, Waddell TK: Influence of lung volume reduction surgery (LVRS) on health related quality of life in patients with chronic obstructive pulmonary disease. Thorax 2003, 58: 405–410. 10.1136/thorax.58.5.405PubMedCentralPubMedCrossRef Goldstein RS, Todd TR, Guyatt G, Keshavjee S, Dolmage TE, van Rooy S, Krip B, Maltais F, LeBlanc P, Pakhale S, Waddell TK: Influence of lung volume reduction surgery (LVRS) on health related quality of life in patients with chronic obstructive pulmonary disease. Thorax 2003, 58: 405–410. 10.1136/thorax.58.5.405PubMedCentralPubMedCrossRef
10.
go back to reference Tsukino M, Nishimura K, McKenna SP, Ikeda A, Hajiro T, Zhang M, Izumi T: Change in generic and disease-specific health-related quality of life during a one-year period in patients with newly detected chronic obstructive pulmonary disease. Respiration 2002, 69: 513–520. 10.1159/000066456PubMedCrossRef Tsukino M, Nishimura K, McKenna SP, Ikeda A, Hajiro T, Zhang M, Izumi T: Change in generic and disease-specific health-related quality of life during a one-year period in patients with newly detected chronic obstructive pulmonary disease. Respiration 2002, 69: 513–520. 10.1159/000066456PubMedCrossRef
11.
go back to reference Lacasse Y, Brosseau L, Milne S, Martin S, Wong E, Guyatt GH, Goldstein RS: Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2002, CD003793. Lacasse Y, Brosseau L, Milne S, Martin S, Wong E, Guyatt GH, Goldstein RS: Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2002, CD003793.
12.
go back to reference Redelmeier DA, Guyatt GH, Goldstein RS: Assessing the minimal important difference in symptoms: a comparison of two techniques. J Clin Epidemiol 1996, 49: 1215–1219. 10.1016/S0895-4356(96)00206-5PubMedCrossRef Redelmeier DA, Guyatt GH, Goldstein RS: Assessing the minimal important difference in symptoms: a comparison of two techniques. J Clin Epidemiol 1996, 49: 1215–1219. 10.1016/S0895-4356(96)00206-5PubMedCrossRef
13.
go back to reference Wyrwich KW, Tierney WM, Wolinsky FD: Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 1999, 52: 861–873. 10.1016/S0895-4356(99)00071-2PubMedCrossRef Wyrwich KW, Tierney WM, Wolinsky FD: Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 1999, 52: 861–873. 10.1016/S0895-4356(99)00071-2PubMedCrossRef
14.
go back to reference Jaeschke R, Singer J, Guyatt GH: Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989, 10: 407–415. 10.1016/0197-2456(89)90005-6PubMedCrossRef Jaeschke R, Singer J, Guyatt GH: Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989, 10: 407–415. 10.1016/0197-2456(89)90005-6PubMedCrossRef
15.
go back to reference Wyrwich KW, Fihn SD, Tierney WM, Kroenke K, Babu AN, Wolinsky FD: Clinically important changes in health-related quality of life for patients with chronic obstructive pulmonary disease: an expert consensus panel report. J Gen Intern Med 2003, 18: 196–202.PubMedCentralPubMedCrossRef Wyrwich KW, Fihn SD, Tierney WM, Kroenke K, Babu AN, Wolinsky FD: Clinically important changes in health-related quality of life for patients with chronic obstructive pulmonary disease: an expert consensus panel report. J Gen Intern Med 2003, 18: 196–202.PubMedCentralPubMedCrossRef
16.
17.
go back to reference Williams JE, Singh SJ, Sewell L, Guyatt GH, Morgan MD: Development of a self-reported Chronic Respiratory Questionnaire (CRQ-SR). Thorax 2001, 56: 954–959. 10.1136/thorax.56.12.954PubMedCentralPubMedCrossRef Williams JE, Singh SJ, Sewell L, Guyatt GH, Morgan MD: Development of a self-reported Chronic Respiratory Questionnaire (CRQ-SR). Thorax 2001, 56: 954–959. 10.1136/thorax.56.12.954PubMedCentralPubMedCrossRef
18.
go back to reference Schunemann Holger J., Griffith Lauren, Jaeschke Roman, Goldstein Roger, Stubbing David, Austin Peggy, Guyatt Gordon H.: A Comparison of the Original Chronic Respiratory Questionnaire With a Standardized Version. Chest 2003, 124: 1421–1429. 10.1378/chest.124.4.1421PubMedCrossRef Schunemann Holger J., Griffith Lauren, Jaeschke Roman, Goldstein Roger, Stubbing David, Austin Peggy, Guyatt Gordon H.: A Comparison of the Original Chronic Respiratory Questionnaire With a Standardized Version. Chest 2003, 124: 1421–1429. 10.1378/chest.124.4.1421PubMedCrossRef
19.
go back to reference M.A. Puhan, M. Behnke, M. Laschke, A. Lichtenschopf, O. Brandli, G.H. Guyatt, Schunemann HJ: Self-administration and standardisation of the chronic respiratory questionnaire: A randomised trial in three German-speaking countries. Respiratory Medicine 2004, in press. M.A. Puhan, M. Behnke, M. Laschke, A. Lichtenschopf, O. Brandli, G.H. Guyatt, Schunemann HJ: Self-administration and standardisation of the chronic respiratory questionnaire: A randomised trial in three German-speaking countries. Respiratory Medicine 2004, in press.
20.
go back to reference Bullinger M: Creating and Evaluation Cross-Cultural Instruments. Quality of Life and Pharmacoeconomics in Clinical Trials Second Edition (Edited by: SpilkerB). Philadelphia, Lippincott 1996, 69: 659–668. Bullinger M: Creating and Evaluation Cross-Cultural Instruments. Quality of Life and Pharmacoeconomics in Clinical Trials Second Edition (Edited by: SpilkerB). Philadelphia, Lippincott 1996, 69: 659–668.
21.
go back to reference Kirsten DK, Taube C, Lehnigk B, Jorres RA, Magnussen H: Exercise training improves recovery in patients with COPD after an acute exacerbation 1. Respir Med 1998, 92: 1191–1198.PubMedCrossRef Kirsten DK, Taube C, Lehnigk B, Jorres RA, Magnussen H: Exercise training improves recovery in patients with COPD after an acute exacerbation 1. Respir Med 1998, 92: 1191–1198.PubMedCrossRef
22.
go back to reference Bullinger M: German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment. Soc Sci Med 1995, 41: 1359–1366. 10.1016/0277-9536(95)00115-NPubMedCrossRef Bullinger M: German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment. Soc Sci Med 1995, 41: 1359–1366. 10.1016/0277-9536(95)00115-NPubMedCrossRef
23.
go back to reference Griffiths TL, Burr ML, Campbell IA, Lewis-Jenkins V, Mullins J, Shiels K, Turner-Lawlor PJ, Payne N, Newcombe RG, Ionescu AA, Thomas J, Tunbridge J, Lonescu AA: Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet 2000, 355: 362–368. 10.1016/S0140-6736(99)07042-7PubMedCrossRef Griffiths TL, Burr ML, Campbell IA, Lewis-Jenkins V, Mullins J, Shiels K, Turner-Lawlor PJ, Payne N, Newcombe RG, Ionescu AA, Thomas J, Tunbridge J, Lonescu AA: Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial. Lancet 2000, 355: 362–368. 10.1016/S0140-6736(99)07042-7PubMedCrossRef
24.
go back to reference Fries JF, Ramey DR: "Arthritis specific" global health analog scales assess "generic" health related quality-of-life in patients with rheumatoid arthritis. J Rheumatol 1997, 24: 1697–1702.PubMed Fries JF, Ramey DR: "Arthritis specific" global health analog scales assess "generic" health related quality-of-life in patients with rheumatoid arthritis. J Rheumatol 1997, 24: 1697–1702.PubMed
25.
go back to reference Mathias SD, Colwell HH, Miller DP, Moreland LW, Buatti M, Wanke L: Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000, 22: 128–139. 10.1016/S0149-2918(00)87984-9PubMedCrossRef Mathias SD, Colwell HH, Miller DP, Moreland LW, Buatti M, Wanke L: Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000, 22: 128–139. 10.1016/S0149-2918(00)87984-9PubMedCrossRef
26.
go back to reference Schunemann HJ, Griffith L, Stubbing D, Goldstein R, Guyatt GH: A clinical trial to evaluate the measurement properties of 2 direct preference instruments administered with and without hypothetical marker states. Med Decis Making 2003, 23: 140–149. 10.1177/0272989X03251243PubMedCrossRef Schunemann HJ, Griffith L, Stubbing D, Goldstein R, Guyatt GH: A clinical trial to evaluate the measurement properties of 2 direct preference instruments administered with and without hypothetical marker states. Med Decis Making 2003, 23: 140–149. 10.1177/0272989X03251243PubMedCrossRef
27.
go back to reference Streiner D, Norman G Oxford Medical Publications. Health measurement scales Second Edition Oxford, Oxford University Press 1998, 60–65. Streiner D, Norman G Oxford Medical Publications. Health measurement scales Second Edition Oxford, Oxford University Press 1998, 60–65.
Metadata
Title
Self-administration and interviewer-administration of the German Chronic Respiratory Questionnaire: instrument development and assessment of validity and reliability in two randomised studies
Authors
Milo A Puhan
Michaela Behnke
Martin Frey
Thomas Grueter
Otto Brandli
Alfred Lichtenschopf
Gordon H Guyatt
Holger J Schunemann
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-1

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