Background
In response to recommendations from the 2010 NIH Asthma Outcomes Workshop, we developed a system for measuring the negative impact of asthma on Quality of Life (QoL), referred to as the RAND Negative Impact of Asthma on Quality of Life (RAND-IAQL) item bank. The bank contains 65 items that focus on the patient’s perception of the impact or bother of asthma on his or her life.
Objective
Evidence for the validity of two short-forms, The RAND-IAQL-4 and 12, from the bank is presented.
Methods
Using a sample of 2032 adults with asthma, we validated our short-forms against the Marks Asthma Quality of Life Questionnaire (M-AQLQ); The Asthma Control Test; and generic measures of QoL developed by PROMIS®. Discriminant validity was examined by comparing scores of respondents who differed according to multiple health indicators.
Results
Our sample ranged in age from 18–99 (mean of 43), 14% of whom were Hispanic, 11% Asian, 19% African American and 56% non-Hispanic White. Men had significantly worse impact of asthma on QoL than women. Impact of asthma on QoL was greatest in African Americans and Hispanics compared to non-Hispanic Whites. Our measures correlated highly with Marks AQLQ and more strongly with the PROMIS® global physical than mental scale. They differentiated between adults with asthma according to their perceived severity, level of control, presence or absence of exacerbations and physical comorbidity.
Conclusion
The RAND-IAQL item bank, measuring the impact of asthma on QoL, will complement other patient-reported outcomes such as measures of asthma symptoms, functioning and control.