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Published in: Health and Quality of Life Outcomes 1/2009

Open Access 01-12-2009 | Research

Validation of the Clinical COPD Questionnaire (CCQ) in primary care

Authors: Björn Ställberg, Mika Nokela, Per-Olof Ehrs, Paul Hjemdal, Eva Wikström Jonsson

Published in: Health and Quality of Life Outcomes | Issue 1/2009

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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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Literature
2.
go back to reference Assessing health status and quality-of-life instruments: attributes and review criteria Qual Life Res 2002, 11: 193–205. 10.1023/A:1015291021312 Assessing health status and quality-of-life instruments: attributes and review criteria Qual Life Res 2002, 11: 193–205. 10.1023/A:1015291021312
3.
go back to reference Mear I, Molen T, Moerk A-C, Lindemann M: Linguistic validation of the clinical COPD questionnaire (CCQ) for use in international studies. Eur Respir J 2005. Mear I, Molen T, Moerk A-C, Lindemann M: Linguistic validation of the clinical COPD questionnaire (CCQ) for use in international studies. Eur Respir J 2005.
4.
go back to reference Engstrom CP, Persson LO, Larsson S, Sullivan M: Reliability and validity of a Swedish version of the St George's Respiratory Questionnaire. Eur Respir J 1998, 11: 61–66. 10.1183/09031936.98.11010061CrossRef Engstrom CP, Persson LO, Larsson S, Sullivan M: Reliability and validity of a Swedish version of the St George's Respiratory Questionnaire. Eur Respir J 1998, 11: 61–66. 10.1183/09031936.98.11010061CrossRef
5.
go back to reference Molen T, Willemse BW, Schokker S, Ten Hacken NH, Postma DS, Juniper EF: Development, validity and responsiveness of the Clinical COPD Questionnaire. Health Qual Life Outcomes 2003, 1: 13. 10.1186/1477-7525-1-13CrossRef Molen T, Willemse BW, Schokker S, Ten Hacken NH, Postma DS, Juniper EF: Development, validity and responsiveness of the Clinical COPD Questionnaire. Health Qual Life Outcomes 2003, 1: 13. 10.1186/1477-7525-1-13CrossRef
6.
go back to reference Bolton CE, Ionescu AA, Edwards PH, Faulkner TA, Edwards SM, Shale DJ: Attaining a correct diagnosis of COPD in general practice. Respir Med 2005, 99: 493–500. 10.1016/j.rmed.2004.09.015CrossRef Bolton CE, Ionescu AA, Edwards PH, Faulkner TA, Edwards SM, Shale DJ: Attaining a correct diagnosis of COPD in general practice. Respir Med 2005, 99: 493–500. 10.1016/j.rmed.2004.09.015CrossRef
7.
go back to reference Kooi HH, Tuinenga MG, Schokker S, Molen T: How to measure Clinical Control in Patients with COPD. The Development of the Clinical COPD Questionnaire (CCQ). QoL Newsletter 2003, 31: 9–11. Kooi HH, Tuinenga MG, Schokker S, Molen T: How to measure Clinical Control in Patients with COPD. The Development of the Clinical COPD Questionnaire (CCQ). QoL Newsletter 2003, 31: 9–11.
8.
go back to reference Jones PW, Quirk FH, Baveystock CM, Littlejohns P: A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis 1992, 145: 1321–1327.CrossRef Jones PW, Quirk FH, Baveystock CM, Littlejohns P: A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis 1992, 145: 1321–1327.CrossRef
9.
go back to reference Jones PW, Quirk FH, Baveystock CM: The St George's Respiratory Questionnaire. Respir Med 1991,85(Suppl B):25–31. 10.1016/S0954-6111(06)80166-6CrossRef Jones PW, Quirk FH, Baveystock CM: The St George's Respiratory Questionnaire. Respir Med 1991,85(Suppl B):25–31. 10.1016/S0954-6111(06)80166-6CrossRef
10.
go back to reference Stewart A, Hays R, Ware J: The MOS short-form general health survey. Reliability and validity in a patient population. Med Care 1988, 26: 724–732. 10.1097/00005650-198807000-00007CrossRef Stewart A, Hays R, Ware J: The MOS short-form general health survey. Reliability and validity in a patient population. Med Care 1988, 26: 724–732. 10.1097/00005650-198807000-00007CrossRef
11.
go back to reference Bousquet J, Knani J, Dhivert H, Richard A, Chicoye A, Ware JE Jr, Michel FB: Quality of life in asthma. I. Internal consistency and validity of the SF-36 questionnaire. Am J Respir Crit Care Med 1994, 149: 371–375.CrossRef Bousquet J, Knani J, Dhivert H, Richard A, Chicoye A, Ware JE Jr, Michel FB: Quality of life in asthma. I. Internal consistency and validity of the SF-36 questionnaire. Am J Respir Crit Care Med 1994, 149: 371–375.CrossRef
12.
go back to reference Alonso J, Prieto L, Ferrer M, Vilagut G, Broquetas JM, Roca J, Batlle JS, Anto JM: Testing the measurement properties of the Spanish version of the SF-36 Health Survey among male patients with chronic obstructive pulmonary disease. Quality of Life in COPD Study Group. J Clin Epidemiol 1998, 51: 1087–1094. 10.1016/S0895-4356(98)00100-0CrossRef Alonso J, Prieto L, Ferrer M, Vilagut G, Broquetas JM, Roca J, Batlle JS, Anto JM: Testing the measurement properties of the Spanish version of the SF-36 Health Survey among male patients with chronic obstructive pulmonary disease. Quality of Life in COPD Study Group. J Clin Epidemiol 1998, 51: 1087–1094. 10.1016/S0895-4356(98)00100-0CrossRef
13.
go back to reference Mahler DA, Mackowiak JI: Evaluation of the short-form 36-item questionnaire to measure health-related quality of life in patients with COPD. Chest 1995, 107: 1585–1589. 10.1378/chest.107.6.1585CrossRef Mahler DA, Mackowiak JI: Evaluation of the short-form 36-item questionnaire to measure health-related quality of life in patients with COPD. Chest 1995, 107: 1585–1589. 10.1378/chest.107.6.1585CrossRef
14.
go back to reference Ware JE Jr, et al.: SF-36 Health Survey Manual and Interpretation Guide. 1995. Ware JE Jr, et al.: SF-36 Health Survey Manual and Interpretation Guide. 1995.
15.
go back to reference Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999, 15: 141–155. 10.2165/00019053-199915020-00003CrossRef Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999, 15: 141–155. 10.2165/00019053-199915020-00003CrossRef
16.
go back to reference Desikan R, Mason HL, Rupp MT, Skehan M: Health-related quality of life and healthcare resource utilization by COPD patients: a comparison of three instruments. Qual Life Res 2002, 11: 739–751. 10.1023/A:1020836719321CrossRef Desikan R, Mason HL, Rupp MT, Skehan M: Health-related quality of life and healthcare resource utilization by COPD patients: a comparison of three instruments. Qual Life Res 2002, 11: 739–751. 10.1023/A:1020836719321CrossRef
17.
go back to reference Domingo-Salvany A, Lamarca R, Ferrer M, Garcia-Aymerich J, Alonso J, Felez M, Khalaf A, Marrades RM, Monso E, Serra-Batlles J, Anto JM: Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002, 166: 680–685. 10.1164/rccm.2112043CrossRef Domingo-Salvany A, Lamarca R, Ferrer M, Garcia-Aymerich J, Alonso J, Felez M, Khalaf A, Marrades RM, Monso E, Serra-Batlles J, Anto JM: Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002, 166: 680–685. 10.1164/rccm.2112043CrossRef
18.
go back to reference Schunemann HJ, Griffith L, Jaeschke R, Goldstein R, Stubbing D, Guyatt GH: Evaluation of the minimal important difference for the feeling thermometer and the St. George's Respiratory Questionnaire in patients with chronic airflow obstruction. J Clin Epidemiol 2003, 56: 1170–1176. 10.1016/S0895-4356(03)00115-XCrossRef Schunemann HJ, Griffith L, Jaeschke R, Goldstein R, Stubbing D, Guyatt GH: Evaluation of the minimal important difference for the feeling thermometer and the St. George's Respiratory Questionnaire in patients with chronic airflow obstruction. J Clin Epidemiol 2003, 56: 1170–1176. 10.1016/S0895-4356(03)00115-XCrossRef
19.
go back to reference Kocks JW, Tuinenga MG, Uil SM, Berg JW, Stahl E, Molen T: Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire. Respir Res 2006, 7: 62. 10.1186/1465-9921-7-62CrossRef Kocks JW, Tuinenga MG, Uil SM, Berg JW, Stahl E, Molen T: Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire. Respir Res 2006, 7: 62. 10.1186/1465-9921-7-62CrossRef
20.
go back to reference Nunnally JC, Bernstein IH: Psychometric theory. 3rd edition. New York: McGraw-Hill; 1994. Nunnally JC, Bernstein IH: Psychometric theory. 3rd edition. New York: McGraw-Hill; 1994.
21.
go back to reference Schunemann HJ, Goldstein R, Mador MJ, McKim D, Stahl E, Puhan M, Griffith LE, Grant B, Austin P, Collins R, Guyatt GH: A randomised trial to evaluate the self-administered standardised chronic respiratory questionnaire. Eur Respir J 2005, 25: 31–40. 10.1183/09031936.04.00029704CrossRef Schunemann HJ, Goldstein R, Mador MJ, McKim D, Stahl E, Puhan M, Griffith LE, Grant B, Austin P, Collins R, Guyatt GH: A randomised trial to evaluate the self-administered standardised chronic respiratory questionnaire. Eur Respir J 2005, 25: 31–40. 10.1183/09031936.04.00029704CrossRef
22.
go back to reference Janse AJ, Gemke RJ, Uiterwaal CS, Tweel I, Kimpen JL, Sinnema G: Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004, 57: 653–661. 10.1016/j.jclinepi.2003.11.013CrossRef Janse AJ, Gemke RJ, Uiterwaal CS, Tweel I, Kimpen JL, Sinnema G: Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004, 57: 653–661. 10.1016/j.jclinepi.2003.11.013CrossRef
Metadata
Title
Validation of the Clinical COPD Questionnaire (CCQ) in primary care
Authors
Björn Ställberg
Mika Nokela
Per-Olof Ehrs
Paul Hjemdal
Eva Wikström Jonsson
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-7-26

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