Williams J E, Singh S J, Sewell L, Guyatt G H, Morgan M D
Department of Respiratory Medicine, University Hospitals of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK.
Thorax. 2001 Dec;56(12):954-9. doi: 10.1136/thorax.56.12.954.
The Chronic Respiratory Questionnaire (CRQ) is an established measure of health status for chronic obstructive pulmonary disease (COPD). It has been found to be reproducible and sensitive to change, but as an interviewer led questionnaire is very time consuming to administer. A study was undertaken to develop a self-reported version of the CRQ (CRQ-SR) and to compare the results of this questionnaire with the conventional interviewer led CRQ (CRQ-IL).
Fifty two patients with moderate to severe COPD participated in the study. Subjects completed the CRQ-SR 1 week after completing the CRQ-IL, and a further CRQ-SR was administered 1 week later. For patients in group A (n=27) the dyspnoea provoking activities that they had previously selected were transcribed onto the second CRQ-SR, while patients in group B (n=25) were not informed of their previous dyspnoea provoking activities when they completed the second CRQ-SR. To assess the short term reproducibility and reliability of the CRQ-SR it was then administered twice at an interval of 7-10 days to a further group of 21 patients. The CRQ-IL was not administered. Longer term reproducibility was examined in 39 stable patients who completed the CRQ-SR at initial assessment and then again 7 weeks later.
Mean scores per dimension, mean differences, and limits of agreement are given for each dimension in the comparison of the two questionnaires. There were no statistically significant differences between the CRQ-IL and CRQ-SR in the mastery and fatigue dimensions (p>0.05). A statistically significant difference between the two scores was found in the dyspnoea dimension (p=0.006) and the emotional function dimension (p=0.04), but these differences were well within the minimum clinically important threshold. No statistically significant difference in the mean dyspnoea score was seen between groups A and B. The CRQ-SR was found to be reproducible both in the short term and after the longer period of 7 weeks, with no statistically or clinically significant differences in any dimension. Test-retest reliability was found to be high in each dimension, both in the short and longer term.
The CRQ-SR is a reproducible, reliable, and stable measure of health status. It compares well with the CRQ-IL but cannot be used interchangeably. The main advantage of the CRQ-SR over the CRQ-IL is that is quick to administer, reducing assessment time and hence cost.
慢性呼吸问卷(CRQ)是一种用于评估慢性阻塞性肺疾病(COPD)健康状况的既定方法。已发现它具有可重复性且对变化敏感,但作为一种由访谈者主导的问卷,实施起来非常耗时。因此开展了一项研究以开发CRQ的自我报告版本(CRQ-SR),并将该问卷的结果与传统的访谈者主导的CRQ(CRQ-IL)进行比较。
52例中重度COPD患者参与了该研究。受试者在完成CRQ-IL 1周后完成CRQ-SR,1周后再次进行CRQ-SR测试。对于A组(n = 27)的患者,将他们之前选择的诱发呼吸困难的活动记录在第二份CRQ-SR上,而B组(n = 25)的患者在完成第二份CRQ-SR时未被告知他们之前诱发呼吸困难的活动。为了评估CRQ-SR的短期可重复性和可靠性,随后在另一组21例患者中每隔7 - 10天进行两次CRQ-SR测试。未实施CRQ-IL。在39例稳定患者中检查了长期可重复性,这些患者在初始评估时完成CRQ-SR,7周后再次完成。
在两份问卷的比较中,给出了每个维度的平均得分、平均差异和一致性界限。在掌握度和疲劳维度上,CRQ-IL和CRQ-SR之间无统计学显著差异(p>0.05)。在呼吸困难维度(p = 0.006)和情绪功能维度(p = 0.04)上发现两组得分存在统计学显著差异,但这些差异完全在最小临床重要阈值范围内。A组和B组之间的平均呼吸困难得分无统计学显著差异。发现CRQ-SR在短期和7周的较长时间内均具有可重复性,在任何维度上均无统计学或临床显著差异。重测信度在短期和长期的每个维度上均较高。
CRQ-SR是一种可重复、可靠且稳定的健康状况评估方法。它与CRQ-IL比较良好,但不能互换使用。CRQ-SR相对于CRQ-IL的主要优点是实施快速,减少了评估时间,从而降低了成本。