van der Molen T, Postma D S, Schreurs A J, Bosveld H E, Sears M R, Meyboom de Jong B
Department of General Practice, University of Groningen, The Netherlands.
Qual Life Res. 1997 May;6(4):353-61. doi: 10.1023/a:1018483310277.
The objective of this study was to compare the two most frequently used asthma-specific quality of life (QOL) questionnaires and two generic QOL questionnaries with clinical data in order to establish their ability to discriminate in asthma severity, also referred to as cross-sectional construct validity. We conducted a multicentre, randomized, placebo-controlled study investigating the long-term effects of the long-acting beta 2-agonist formoterol in asthma patients using inhaled corticosteroids and short-acting beta 2-agonists. Before randomization, the peak expiratory flow (PEF) and use of beta 2-agonists for relief of symptoms were recorded twice daily for 1 month. At the end of the run-in period, the forced expiratory volume in 1 s (FEV1), airway hyper-responsiveness (PC20 methacholine) and QOL were measured, using two asthma-specific questionnaires, the Asthma Quality of Life Questionnaire (AQLQ) and the Living with Asthma Quality of Life Questionnaire (LWAQ), as well as two generic questionnaires, the Short Form 36 (SF-36) and the Psychological General Well Being (PGWB) index. The quality of life of the patients (n = 110) was only mildly impaired. The mean symptom score was 3.6 on a scale of 0-21 and the mean FEV1 was 65% of that predicted. The correlations between the QOL parameters and objective measures of asthma severity, such as the FEV1, PEF and PC20, were low (0.01-0.37). The correlations between the QOL parameters and subjective measures of asthma severity, such as symptom scores (range 0.26-0.65) and beta 2-agonist use for the relief of symptoms (0.09-0.39), were higher. The correlations of the activity and symptoms domains of the AQLQ with diary-obtained symptom scores were r = 0.50 (p < 0.0001) and r = 0.65 (p < 0.0001), respectively. The correlation between the physical construct of the LWAQ and symptom scores was r = 0.42 (p < 0.001) and that between the physical sumscore of the SF-36 and symptom scores was r = 0.50 (p < 0.001). The correlation between the PGWB and symptom scores was r = 0.41 (p < 0.001). The relation between the FEV1, PEF and PC20 and QOL was very low. The QOL measurements related well to the symptom scores. The AQLQ had a better cross-sectional construct validity than the LWAQ. The cross-sectional construct validity of the SF-36 was surprisingly high for this group of patients and the SF-36 performed better than the PGWB and LWAQ.
本研究的目的是比较两种最常用的哮喘特异性生活质量（QOL）问卷和两种通用QOL问卷与临床数据，以确定它们区分哮喘严重程度的能力，也称为横断面结构效度。我们进行了一项多中心、随机、安慰剂对照研究，调查长效β2受体激动剂福莫特罗对使用吸入性糖皮质激素和短效β2受体激动剂的哮喘患者的长期影响。在随机分组前，每日两次记录呼气峰值流速（PEF）和使用β2受体激动剂缓解症状的情况，持续1个月。在导入期结束时，使用两种哮喘特异性问卷，即哮喘生活质量问卷（AQLQ）和哮喘患者生活质量问卷（LWAQ），以及两种通用问卷，即简明健康状况调查量表（SF-36）和心理总体幸福感（PGWB）指数，测量1秒用力呼气容积（FEV1）、气道高反应性（PC20乙酰甲胆碱）和生活质量。患者（n = 110）的生活质量仅受到轻度损害。症状平均评分为3.6（0 - 21分制），FEV1平均为预测值的65%。生活质量参数与哮喘严重程度的客观指标（如FEV1、PEF和PC20）之间的相关性较低（0.01 - 0.37）。生活质量参数与哮喘严重程度的主观指标（如症状评分（范围0.26 - 0.65）和使用β2受体激动剂缓解症状情况（0.09 - 0.39））之间的相关性较高。AQLQ的活动和症状领域与日记记录的症状评分之间的相关性分别为r = 0.50（p < 0.0001）和r = 0.65（p < 0.0001）。LWAQ的身体结构与症状评分之间的相关性为r = 0.42（p < 0.001），SF-36的身体总分与症状评分之间的相关性为r = 0.50（p < 0.001）。PGWB与症状评分之间的相关性为r = 0.41（p < 0.001）。FEV1、PEF和PC20与生活质量之间的关系非常低。生活质量测量与症状评分密切相关。AQLQ的横断面结构效度优于LWAQ。对于该组患者，SF-36的横断面结构效度出奇地高，且SF-36的表现优于PGWB和LWAQ。
