School of Nursing, Midwifery and Social Work, University of Manchester , Manchester , UK ; University Hospital of South Manchester Foundation Trust , Manchester , UK.
Aintree University Hospital NHS Foundation Trust , Liverpool , UK.
BMJ Open Respir Res. 2014 May 13;1(1):e000024. doi: 10.1136/bmjresp-2014-000024. eCollection 2014.
The A Tool to Assess Quality of Life in Idiopathic Pulmonary Fibrosis (ATAQ-IPF) was developed in the USA to assess health-related quality of life in patients with IPF. It is likely that some of the original ATAQ-IPF items perform differently when applied in different countries. This paper reports results of a study conducted to identify the need to refine the content of the ATAQ-IPF to minimise cross-country bias between the USA and the UK.
The ATAQ-IPF and other study measures were completed by patients attending specialist IPF clinics in the USA and UK. Rasch analysis was used to determine which items performed differently across countries (USA vs UK) and refine the original ATAQ-IPF to an instrument without cross-country bias (ATAQ-IPF-cA). Preliminary validation of the modified instrument was examined by assessing correlations between ATAQ-IPF-cA scores and scores from dyspnoea-specific patient-reported outcome (PRO) measures.
139 patients with IPF (USA=74; UK=65) participated in the study. A total of 41 items and 4 domains were removed from the original, 86-item instrument to yield the 43 items and 10 domains of the ATAQ-IPF-cA. Each domain had good fit to the Rasch model, internal consistency was comparable to the corresponding domains for the original ATAQ-IPF, and validity was supported by significant correlations between its scores and scores from dyspnoea-specific PROs.
The reliability and validity of the substantially shortened ATAQ-IPF-cA are acceptable and comparable to the original instrument. We recommend use of the ATAQ-IPF-cA in IPF studies in which participants are enrolled from the USA and UK.
评估特发性肺纤维化患者健康相关生活质量的 A 工具（ATAQ-IPF）是在美国开发的。当应用于不同国家时，原始 ATAQ-IPF 中的某些项目可能表现不同。本研究旨在确定是否需要细化 ATAQ-IPF 的内容，以最大限度地减少美国和英国之间的跨国偏见。
在美国和英国的特发性肺纤维化专家诊所就诊的患者完成了 ATAQ-IPF 和其他研究措施。使用 Rasch 分析来确定哪些项目在国家之间（美国与英国）表现不同，并对原始 ATAQ-IPF 进行细化，使其成为一种没有跨国偏见的工具（ATAQ-IPF-cA）。通过评估 ATAQ-IPF-cA 评分与呼吸困难特定患者报告结果（PRO）测量评分之间的相关性，初步验证了修改后的仪器。
共有 139 名特发性肺纤维化患者（美国 74 名，英国 65 名）参加了研究。从原始的 86 项仪器中总共删除了 41 项和 4 个领域，得出了 43 项和 10 个领域的 ATAQ-IPF-cA。每个领域都与 Rasch 模型拟合良好，内部一致性与原始 ATAQ-IPF 的相应领域相当，并且其评分与呼吸困难特定 PRO 之间的显著相关性支持了有效性。
显著缩短的 ATAQ-IPF-cA 的可靠性和有效性是可以接受的，与原始仪器相当。我们建议在招募来自美国和英国的参与者的特发性肺纤维化研究中使用 ATAQ-IPF-cA。
