Viegas Pedro, Roseta Leonor, Jácome Cristina, Paixão Cátia, Castro Luísa, Ribeiro Carla
Pulmonology Department, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, Portugal.
CINTESIS@RISE, MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal.
ERJ Open Res. 2025 Sep 15;11(5). doi: 10.1183/23120541.01405-2024. eCollection 2025 Sep.
The S-Noninvasive Ventilation (S-NIV) questionnaire is a simple tool that allows monitoring of symptoms and side-effects in individuals using home mechanical ventilation (HMV). Its longitudinal use in monitorisation is complicated by the current absence of a minimal clinically important difference (MCID), which could facilitate the application of a more tailored follow-up and therapy optimisation. We aimed to establish the MCID for the S-NIV in people with COPD under HMV.
We conducted an observational study with adult individuals with COPD treated with HMV, followed in an HMV outpatient clinic. The S-NIV, the Severe Respiratory Insufficiency (SRI) questionnaire and the St George's Respiratory Questionnaire (SGRQ) were applied at baseline and after a 6-month period. Demographic and clinical data were collected from hospital records. The MCID was computed using both distribution- and anchor-based methods. The pooled MCID was computed using the weighted mean (two-thirds anchor- and one-third distribution-based methods).
A total of 99 participants (71% male) were included, with a mean±sd age of 72±9 years and a median (interquartile range (IQR)) forced expiratory volume in 1 s of 37 (29-49)% predicted. Median time under HMV was 40 (IQR 24-84) months. The SRI (r=0.311, p=0.002) and the SGRQ (r= -0.334, p=0.001) questionnaires were correlated with S-NIV, and therefore were used as anchors. Our pooled analysis resulted in a MCID of 0.8 points.
A MCID of 0.8 points in the S-NIV questionnaire is proposed in stable individuals with COPD using HMV, supporting the identification of clinically significant changes and management improvement.
S-无创通气（S-NIV）问卷是一种简单的工具，可用于监测使用家庭机械通气（HMV）的个体的症状和副作用。目前缺乏最小临床重要差异（MCID），这使得其在监测中的长期应用变得复杂，而MCID有助于进行更具针对性的随访和优化治疗。我们旨在确定HMV下慢性阻塞性肺疾病（COPD）患者S-NIV的MCID。
我们对在HMV门诊接受治疗的成年COPD患者进行了一项观察性研究。在基线时和6个月后应用S-NIV、严重呼吸功能不全（SRI）问卷和圣乔治呼吸问卷（SGRQ）。从医院记录中收集人口统计学和临床数据。使用基于分布和锚定的方法计算MCID。合并的MCID使用加权平均值（三分之二基于锚定和三分之一基于分布的方法）计算。
共纳入99名参与者（71%为男性），平均年龄±标准差为72±9岁，1秒用力呼气量预测值的中位数（四分位间距（IQR））为37（29-49）%。HMV下的中位时间为40（IQR 24-84）个月。SRI问卷（r=0.311，p=0.002）和SGRQ问卷（r=-0.334，p=0.001）与S-NIV相关，因此用作锚定指标。我们的汇总分析得出MCID为0.8分。
对于使用HMV的稳定COPD个体，建议S-NIV问卷的MCID为0.8分，这有助于识别具有临床意义的变化并改善管理。
