Puhan Milo A, Behnke Michaela, Laschke Marco, Lichtenschopf Alfred, Brändli Otto, Guyatt Gordon H, Schünemann Holger J
Horten Centre, University of Zurich, Postfach Nord, CH-8091 Zurich, Switzerland.
Respir Med. 2004 Apr;98(4):342-50. doi: 10.1016/j.rmed.2003.10.013.
The chronic respiratory questionnaire (CRQ) has demonstrated excellent measurement properties in patients with chronic obstructive pulmonary disease (COPD), but in its original form it is limited by the requirement for interviewer-administration and the individualised dyspnoea questions. The objective of this randomised trial was to examine the evaluative properties of the interviewer and self-administered German CRQ as well as of a standardised CRQ dyspnoea domain. In a multinational trial we randomly allocated 71 patients with COPD to complete the interviewer administered CRQ (CRQ-IA) or the self-administered CRQ (CRQ-SA) and other validation measures at the beginning and end of a respiratory rehabilitation program. We assessed and compared responsiveness and longitudinal validity of the CRQ. The change scores of all CRQ domains were above the minimal clinically important difference of 0.5. Responsiveness of the fatigue domain was higher for the CRQ-SA compared to CRQ-IA (P = 0.02), but there was no difference in responsiveness on the other domains. Compared to the standardised dyspnoea domain the individualised dyspnoea questions tended to show greater responsiveness for both the CRQ-IA (P = 0.07) and CRQ-SA (P = 0.10). We found better longitudinal validity for the CRQ-SA represented by larger correlations between CRQ change scores and those of other validation instruments. Taken these results into consideration, researchers in COPD, in particular those in German-language countries can utilise any one of four CRQ formats that have proved both valid and responsive.
慢性呼吸问卷（CRQ）在慢性阻塞性肺疾病（COPD）患者中已显示出出色的测量特性，但在其原始形式中，它受到访谈者实施要求和个体化呼吸困难问题的限制。这项随机试验的目的是检验访谈者实施和自我实施的德语CRQ以及标准化CRQ呼吸困难领域的评估特性。在一项多国试验中，我们随机分配71例COPD患者在呼吸康复计划开始和结束时完成访谈者实施的CRQ（CRQ-IA）或自我实施的CRQ（CRQ-SA）以及其他验证措施。我们评估并比较了CRQ的反应性和纵向有效性。所有CRQ领域的变化分数均高于最小临床重要差异0.5。与CRQ-IA相比，CRQ-SA的疲劳领域反应性更高（P = 0.02），但其他领域的反应性没有差异。与标准化呼吸困难领域相比，个体化呼吸困难问题对于CRQ-IA（P = 0.07）和CRQ-SA（P = 0.10）都倾向于表现出更大的反应性。我们发现CRQ-SA具有更好的纵向有效性，表现为CRQ变化分数与其他验证工具的变化分数之间的相关性更大。考虑到这些结果，COPD研究人员，特别是德语国家的研究人员可以使用已证明有效且有反应性的四种CRQ格式中的任何一种。
