UCSD 呼吸困难问卷在特发性肺纤维化中具有纵向构建效度。
The UCSD shortness of breath questionnaire has longitudinal construct validity in idiopathic pulmonary fibrosis.
机构信息
Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
出版信息
Respir Med. 2012 Oct;106(10):1447-55. doi: 10.1016/j.rmed.2012.06.018. Epub 2012 Jul 15.
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease that often causes disabling dyspnea. In IPF and other lung diseases, patient-reported outcomes (PROs)-questionnaires designed to gather information from the patient's perspective-can determine whether therapies affect dyspnea or other outcomes meaningful to patients. Before a PRO can be used confidently as an outcome measure in a longitudinal trial, studies must demonstrate the PRO's ability to capture change over time in the target population. Our goal in this study was to examine whether the UCSD Shortness of Breath Questionnaire does so in patients with IPF.
METHODS
We used data from the Sildenafil Trial of Exercise Performance in Idiopathic Pulmonary Fibrosis (STEP-IPF) to perform analyses that examined associations between UCSD scores and five external measures (anchors) at baseline and over time. Anchors included the Activity domain from St. George's Respiratory Questionnaire (SGRQ-A), the Physical Functioning domain from the SF-36 (SF36-PF), forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide (DLCO), and distance walked during a timed walk test (6MWD). Linear regression models were used to examine relationships between UCSD scores and anchors over time.
RESULTS
At baseline, UCSD scores were weakly correlated with percent predicted FVC (-0.21, p = 0.005) and percent predicted DLCO (-0.20, p = 0.008), moderately correlated with 6MWD (-0.39, p < 0.0001) and strongly correlated with SGRQ-A (0.79, p < 0.0001) and SF36-PF (-0.72, p < 0.0001). Change over time in UCSD scores was associated with change in FVC (estimate = 2.54, standard error [SE] = 1.23, p = 0.04), SGRQ-A (estimate = 7.94, SE = 1.11, p < 0.0001), SF36-PF (estimate = 6.00, SE = 1.13, p < 0.0001), and 6MWD (estimate = 4.23, SE = 1.18, p = 0.0004) but not DLCO (estimate = 0.33, SE = 1.33, p = 0.80).
CONCLUSIONS
These results support the validity of the UCSD to assess change in dyspnea over time in patients with IPF.
背景
特发性肺纤维化（IPF）是一种进行性间质性肺疾病，常导致致残性呼吸困难。在 IPF 和其他肺部疾病中，从患者角度收集信息的患者报告结局（PRO）-问卷可以确定治疗是否影响呼吸困难或其他对患者有意义的结局。在 PRO 能够作为纵向试验中的结局测量被自信地使用之前，研究必须证明 PRO 能够在目标人群中随时间捕获变化。我们在这项研究中的目标是检验 UCSD 呼吸困难问卷是否适用于 IPF 患者。
方法
我们使用特发性肺纤维化运动性能中使用西地那非的试验（STEP-IPF）的数据进行分析，该分析考察了 UCSD 评分与基线和随时间变化的五个外部测量指标（锚定物）之间的关联。锚定物包括圣乔治呼吸问卷（SGRQ-A）的活动域、SF-36（SF36-PF）的身体功能域、用力肺活量（FVC）、一氧化碳弥散量（DLCO）和定时步行测试（6MWD）中的步行距离。线性回归模型用于研究 UCSD 评分与随时间变化的锚定物之间的关系。
结果
在基线时，UCSD 评分与预计 FVC 的百分比呈弱相关（-0.21，p=0.005），与预计 DLCO 的百分比呈中度相关（-0.20，p=0.008），与 6MWD 呈中度相关（-0.39，p<0.0001），与 SGRQ-A（0.79，p<0.0001）和 SF36-PF（-0.72，p<0.0001）呈强相关。UCSD 评分随时间的变化与 FVC 的变化相关（估计值=2.54，标准误差[SE]=1.23，p=0.04）、SGRQ-A（估计值=7.94，SE=1.11，p<0.0001）、SF36-PF（估计值=6.00，SE=1.13，p<0.0001）和 6MWD（估计值=4.23，SE=1.18，p=0.0004），但与 DLCO 无关（估计值=0.33，SE=1.33，p=0.80）。
结论
这些结果支持 UCSD 用于评估 IPF 患者随时间变化的呼吸困难的有效性。
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