A New Measure to Assess Asthma's Impact on Quality of Life from the Patient's Perspective (original) (raw)
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The Journal of allergy and clinical immunology, 2018
The Asthma Impact on Quality of Life Scale (A-IQOLS) assesses patient-perceived negative effect of asthma on quality of life (QoL). Its standard error of measurement is known, it has strong construct, convergent, and divergent validity, and provides information that is unique among asthma outcome measures. To characterize A-IQOLS' psychometric properties and suitability for use in demographically and clinically diverse adult asthma populations. Data from participants in five independent asthma studies, whose samples ranging from patients with well-controlled moderate asthma to patients with severe, poorly controlled asthma were pooled to determine the psychometric performance of A-IQOLS scores, overall and in multiple demographic, disease status, and study subgroups. Pooled sample (n = 597) age averaged 45 years; 66% were female, 65% were White, 22% African American, 11% Hispanic, and 11% had ≤ high school education. The rated importance of its underlying life dimensions and the...
Development of a measure of asthma-specific quality of life among adults
Quality of Life Research, 2014
PURPOSE: A key goal in asthma treatment is improvement in quality of life (QoL), but existing measures often confound QoL with symptoms and functional impairment. The current study addresses these limitations and the need for valid patient-reported outcome measures by using state-of-the-art methods to develop an item bank assessing QoL in adults with asthma. This article describes the process for developing an initial item pool for field testing. METHODS: Five focus group interviews were conducted with a total of 50 asthmatic adults. We used "pile sorting/binning" and "winnowing" methods to identify key QoL dimensions and develop a pool of items based on statements made in the focus group interviews. We then conducted a literature review and consulted with an expert panel to ensure that no key concepts were omitted. Finally, we conducted individual cognitive interviews to ensure that items were well understood and inform final item refinement. RESULTS: Six hundred and sixty-one QoL statements were identified from focus group interview transcripts and subsequently used to generate a pool of 112 items in 16 different content areas. CONCLUSIONS: Items covering a broad range of content were developed that can serve as a valid gauge of individuals' perceptions of the effects of asthma and its treatment on their lives. These items do not directly measure symptoms or functional impairment, yet they include a broader range of content than most existent measures of asthma-specific QoL.
Validation of the asthma impact survey, a brief asthma-specific quality of life tool
Quality of Life Research, 2007
Background: The Asthma Impact Survey (AIS-6) is a new six question asthma outcome tool for which information on validity has not been published. Objective: To provide validation for the AIS-6 as a brief asthma-specific quality of life tool. Methods: Surveys were sent to a random sample of members of a large managed care organization who were at least 35 years of age and in the two-year period preceding the survey had either (1) at least one documented asthma-related medical encounter, or (2) at least a 6 months supply of asthma medication dispensed. In addition to the AIS-6, the survey included a validated quality of life tool [the mini-Asthma Quality of Life Questionnaire (AQLQ)]; a validated asthma control questionnaire [the Asthma Therapy Assessment Questionnaire TM (ATAQ)]; a validated symptom severity scale (AOMS); and information regarding demographics, co-morbidities, asthma severity, and asthma management. The results of the AIS-6 were compared to the results of the other tools by means of correlation and factor analysis. Independent predictors of AIS-6 and AQLQ scores were determined by multiple stepwise linear regression analyses. Results: AIS-6 scores were significantly related to female sex, educational level, income, smoking, body mass index (BMI), COPD, steroid use, and hospitalization history in bivariate analyses. The AIS-6 score significantly correlated (r = ) 0.84, p < 0.0001) with the AQLQ total score and loaded on the three factors (activity, symptoms, and concern/ bother) reflected by the survey information and on which the AQLQ also loaded. Significant but somewhat smaller correlations were found between the AIS-6 and the ATAQ (r = 0.70, p < 0.0001) and the AOMS (r = 0.55, p < 0.0001). Independent predictors were the same for the AIS-6 and AQLQ and included oral steroid use, COPD history, BMI, female sex, educational level, and hospitalization in the past year. Conclusion: These data support the validity of the short six-question AIS-6 as an asthmaspecific quality of life tool.
Asthma outcomes: Quality of life
Journal of Allergy and Clinical Immunology, 2012
Background: ''Asthma-related quality of life'' (QOL) refers to the perceived impact that asthma has on the patient's QOL. Objective: National Institutes of Health institutes and other federal agencies convened an expert group to recommend standardized measures of the impact of asthma on QOL for use in future asthma clinical research. Methods: We reviewed published documentation regarding the development and psychometric evaluation; clinical research use since 2000; and extent to which the content of each existing QOL instrument provides a unique, reliable, and valid assessment of the intended construct. We classified instruments as core (required in future studies), supplemental (used according to the study's aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an National Institutes of Health-organized workshop convened in March 2010 and finalized in September 2011. Results: Eleven instruments for adults and 6 for children were identified for review. None qualified as core instruments because they predominantly measured indicators of asthma control (symptoms and/or functional status); failed to provide a distinct, reliable score measuring all key dimensions of the intended construct; and/or lacked adequate psychometric data. Conclusions: In the absence of existing instruments that meet the stated criteria, currently available instruments are classified as either supplemental or emerging. Research is strongly recommended to develop and evaluate instruments that provide a distinct, reliable measure of the patient's perception of the impact of asthma on all of the key dimensions of QOL, an important outcome that is not captured in other outcome measures.
Measuring asthma-specific quality of life: structured review
Allergy, 2011
Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.
Asthma and Health-Related Quality of Life
Allergology International, 2005
The health-related quality of life (HRQoL) is assessed using instruments that have been validated scientifically. From the viewpoint of assessment, they are different from other clinical indices because the subjects themselves evaluate their own HRQoL (the patients in many clinical settings). As an index for evaluating health care services or outcomes, the HRQoL is as important as life expectancy. These instruments can be classified into generic and disease-specific instruments. There are numerous disease-specific instruments that can be used for patients with asthma, such as Juniper et al .'s Asthma Quality of Life Questionnaire (AQLQ), the Living with Asthma Questionnaire (LWAQ), the St. George's Respiratory Questionnaire (SGRQ) , and Marks et al .'s Asthma Quality of Life Questionnaire (AQLQ). The characteristics of each instrument should be considered in the selection of specific HRQoL questionnaires for clinical research. Generally, the HRQoL is more disturbed in patients with severe asthma, and has been considered to be an important end-point in randomized controlled trials that involve asthma patients. We expect that further studies will also be performed in Japan
Does health-related quality of life in asthma patients correlate with the clinical indices?
South African Family Practice, 2014
Background: Assessment of health-related quality of life (HRQOL) has been shown to be more relevant to patients who have chronic diseases such as asthma, as achieving the best possible quality of life is the paramount objective in the management of such patients. This study assessed the quality of life of asthma patients and correlated it with the various clinical indices of asthma, such as age, sex, the duration of the asthma, medication used and its severity. Design: The study was a cross-sectional, analytical, case-control design, involving three approaches, i.e. quality of life, clinical assessment and lung function assessment. The patients who participated in this study completed the Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ). Statistical analysis was performed using Epi Info ™ version 6.04.
An 18-item standardized Asthma Quality of Life Questionnaire-AQLQ(S)
Quality of Life Research, 2008
The purpose of the present study was to examine the validity and reliability of the Asthma Quality of Life Questionnaire-AQLQ(S) in a sample of 160 Greek patients with asthma. Following evidence for sample-specific validity, the AQLQ(S) model was examined through exploratory and confirmatory factor analysis. An 18-item AQLQ(S) with the four factors of symptoms, activity limitations, sleep, and exposure in environmental stimuli fits the data (v 2 /df ratio = 2.26, NNFI = 0.92, CFI = 0.94, SRMR = 0.05). The 18-item AQLQ(S) showed a high internal consistency (Cronbach' a coefficient ranged from 0.83 to 0.96) and high 9-week test-retest reliability (overall r = 0.88, ICC = 0.94). Responsiveness was confirmed throughout 2X2 ANOVA and 2X2 MANOVA, with respect to the total score (F = 42.30, P \ 0.05), and the four AQLQ(S) factors (Wilks' k = 0.68, F = 17.59, P \ 0.05). The cross-sectional correlations between the 18-item AQLQ(S) and the: (1) FEV1% predicted and (2) Borg scale were low and moderately high, respectively. In conclusion, the 18-item AQLQ(S) derived from exploratory and confirmatory factor analysis appeared to have sufficient construct validity, cross-sectional validity, responsiveness, satisfactory test-retest reliability and internal consistency evidence for the Greek sample of adults with asthma.