Self-administration and standardisation of the chronic respiratory questionnaire: a randomised trial in three German-speaking countries

Abstract

The chronic respiratory questionnaire (CRQ) has demonstrated excellent measurement properties in patients with chronic obstructive pulmonary disease (COPD), but in its original form it is limited by the requirement for interviewer-administration and the individualised dyspnoea questions. The objective of this randomised trial was to examine the evaluative properties of the interviewer and self-administered German CRQ as well as of a standardised CRQ dyspnoea domain. In a multinational trial we randomly allocated 71 patients with COPD to complete the interviewer administered CRQ (CRQ-IA) or the self-administered CRQ (CRQ-SA) and other validation measures at the beginning and end of a respiratory rehabilitation program. We assessed and compared responsiveness and longitudinal validity of the CRQ. The change scores of all CRQ domains were above the minimal clinically important difference of 0.5. Responsiveness of the fatigue domain was higher for the CRQ-SA compared to CRQ-IA (P = 0.02), but there was no difference in responsiveness on the other domains. Compared to the standardised dyspnoea domain the individualised dyspnoea questions tended to show greater responsiveness for both the CRQ-IA (P = 0.07) and CRQ-SA (P = 0.10). We found better longitudinal validity for the CRQ-SA represented by larger correlations between CRQ change scores and those of other validation instruments. Taken these results into consideration, researchers in COPD, in particular those in German-language countries can utilise any one of four CRQ formats that have proved both valid and responsive.

Versão em português do Chronic Respiratory Questionnaire: estudo da validade e reprodutibilidade

“…sample (Table 1) presented relatively preserved exercise capacity in relation to that of patients participating in previous studies. (11,13,14) When comparing the scores of each CRQ domain obtained for the Brazilian patients with those obtained for patients from other countries in which the CRQ was validated, (13,14) we observed that the scores found for the fatigue, emotional function and mastery domains in the present study (4.5 ± 1.2; 4.8 ± 1.0; and 5.1 ± 1.3, respectively) were similar to those found for the Spanish-language version (4.47 ± 1.20; 4.80 ± 1.26; and 5.0 ± 1.5, respectively) and those found for the German-language version, with the exception of the mastery domain (4.2 ± 1.2, 4.4 ± 1.0 and 4.4 ± 1.2, respectively). However, for the dyspnea domain, the score obtained for the Brazilian population was considerably higher (4.6 ± 1.3) than that obtained for the Spanish population (3.15 ± 1.00) and for the Germanspeaking population (3.17 ± 0.66), indicating a better quality of life for this domain.…”

“…The CRQ has been translated and validated for use in the Netherlands, (12) in Spain (13) and in three German-speaking countries (Switzerland, Germany and Austria). (14) It has proven to be useful in a variety of interventions in COPD, including pharmacological interventions (15) and rehabilitation. (14,16) In addition, among the instruments that specifically assess the quality of life of patients with COPD, the CRQ has proven to be superior to the SGRQ because it is more responsive to interventions, such as pulmonary rehabilitation programs.…”

“…(14) It has proven to be useful in a variety of interventions in COPD, including pharmacological interventions (15) and rehabilitation. (14,16) In addition, among the instruments that specifically assess the quality of life of patients with COPD, the CRQ has proven to be superior to the SGRQ because it is more responsive to interventions, such as pulmonary rehabilitation programs. (17,18) Although the CRQ is widely used to assess the quality of life of patients with COPD, (19) no Portuguese-language version of this questionnaire has been validated for use in Brazil.…”

COPD patients' ability to follow exercise influences short-term outcomes of rehabilitation

“…As measures of the effects of respiratory rehabilitation, the selfadministered standardised German Chronic Respiratory Disease Questionnaire (CRQ) [15,16] and 6-min walking distance, as well as the short-time maximum exercise capacity (steep ramp test) and maximum exercise capacity (incremental exercise test), were used. The measurement of these outcomes has been described in detail previously [13].…”

COPD-Disability-Index (CDI) – ein neues Verfahren zur Erfassung der COPD-bedingten Beeinträchtigung

“…Die Daten− banken der American Thoracic Society (www.atsqol.org) oder die ¹Patient−Reported Outcome and Quality of Life Instruments" (www.proqolid.org) listen 8 englischsprachige Verfahren zur Er− fassung der krankheitsspezifischen Lebensqualität bei COPD−Pa− tienten auf. Allerdings dominieren ± auch im deutschsprachigen Raum ± vor allem 2 multidimensionale Verfahren die For− schung: der Chronic Respiratory Questionnaire (CRQ) [7,8] und der St. George Respiratory Questionnaire (SGRQ) [9,10]. Beide Fragebogen zeichnen sich durch vergleichbare, zufriedenstellen− de psychometrische Kennwerte in Bezug auf Reliabilität und Va− lidität aus [11,12], benötigen jedoch aufgrund ihrer Länge zwi− schen 15 und 20 Minuten Durchführungszeit und konnten sich in der alltäglichen pneumologischen Praxis nicht durchsetzen.…”