The Wellcome Trust-Wolfson Northern Ireland Clinical Research Facility, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Eur Respir J. 2021 Nov 11;58(5). doi: 10.1183/13993003.00025-2021. Print 2021 Nov.
Understanding the psychometric properties of health-related quality of life (HRQoL) questionnaires can help inform selection in clinical trials. Our objective was to assess the psychometric properties of HRQoL questionnaires in bronchiectasis using a systematic review and meta-analysis of the literature.
A literature search was conducted. HRQoL questionnaires were assessed for psychometric properties (reliability, validity, minimal clinically important difference (MCID) and floor/ceiling effects). Meta-analyses assessed the associations of HRQoL with clinical measures and responsiveness of HRQoL in clinical trials.
166 studies and 12 HRQoL questionnaires were included. The Bronchiectasis Health Questionnaire (BHQ), Leicester Cough Questionnaire (LCQ), Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) had good internal consistency in all domains reported (Cronbach's α≥0.7) across all studies, and the Quality of Life-Bronchiectasis (QOL-B), St George's Respiratory Questionnaire (SGRQ), Chronic Respiratory Disease Questionnaire (CRDQ) and Seattle Obstructive Lung Disease Questionnaire (SOLQ) had good internal consistency in all domains in the majority of (but not all) studies. BHQ, SGRQ, LCQ and CAT had good test-retest reliability in all domains reported (intraclass correlation coefficient ≥0.7) across all studies, and QOL-B, CRDQ and SOLQ had good test-retest reliability in all domains in the majority of (but not all) studies. HRQoL questionnaires were able to discriminate between demographics, important markers of clinical status, disease severity, exacerbations and bacteriology. For HRQoL responsiveness, there was a difference between the treatment and placebo effect.
SGRQ was the most widely used HRQoL questionnaire in bronchiectasis studies and it had good psychometric properties; however, good psychometric data are emerging on the bronchiectasis-specific HRQoL questionnaires QOL-B and BHQ. Future studies should focus on the medium- to long-term test-retest reliability, responsiveness and MCID in these HRQoL questionnaires which show potential in bronchiectasis.
了解健康相关生活质量（HRQoL）问卷的心理测量特性可以帮助在临床试验中进行选择。我们的目的是通过对文献的系统回顾和荟萃分析来评估支气管扩张症中 HRQoL 问卷的心理测量特性。
进行了文献检索。对 HRQoL 问卷的心理测量特性（信度、效度、最小临床重要差异（MCID）和地板/天花板效应）进行了评估。荟萃分析评估了 HRQoL 与临床指标的相关性以及临床试验中 HRQoL 的反应性。
纳入了 166 项研究和 12 种 HRQoL 问卷。在所有研究中，支气管扩张症健康问卷（BHQ）、莱斯特咳嗽问卷（LCQ）、慢性阻塞性肺疾病评估测试（CAT）和医疗结局研究 36 项短式健康调查（SF-36）在所有报告的领域都具有良好的内部一致性（Cronbach's α≥0.7），而质量生活-支气管扩张症（QOL-B）、圣乔治呼吸问卷（SGRQ）、慢性呼吸道疾病问卷（CRDQ）和西雅图阻塞性肺病问卷（SOLQ）在大多数（但不是全部）研究中在所有领域都具有良好的内部一致性。在所有研究中，BHQ、SGRQ、LCQ 和 CAT 在所有报告的领域都具有良好的重测信度（组内相关系数≥0.7），而 QOL-B、CRDQ 和 SOLQ 在大多数（但不是全部）研究中在所有领域都具有良好的重测信度。HRQoL 问卷能够区分人口统计学、重要的临床状态标志物、疾病严重程度、恶化和细菌学。对于 HRQoL 反应性，治疗和安慰剂效应之间存在差异。
SGRQ 是支气管扩张症研究中使用最广泛的 HRQoL 问卷，具有良好的心理测量特性；然而，支气管扩张症特异性 HRQoL 问卷 QOL-B 和 BHQ 的良好心理测量数据正在出现。未来的研究应侧重于这些 HRQoL 问卷的中长期重测信度、反应性和 MCID，这些问卷在支气管扩张症中具有潜力。
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