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Instrument Summary for COPD/Shortness of Breath

Please note that this section is an archive and is no longer being updated.

Development: Guyatt and colleagues reported the development of the Chronic Respiratory Questionnaire (CRQ) in 1987. An initial pool of 123 items was generated using a combination of literature review, consultation with clinicians, and interviews with patients. The questionnaire was reduced to 20 items after initial administration to 100 patients who chose the items that reflected their most important problems. The CRQ contains 5 items assessing degree of dyspnea in daily activities, as well as items assessing fatigue (4 items), emotional functioning (7 items), and mastery or sense of control over the disease (4 items). In the original version of the CRQ, the dyspnea items refer to shortness of breath during 5 activities identified by the respondent. A standardized version of the CRQ, developed later, lists 5 common activities instead, eliminating "individualized" items.

Purpose: The CRQ was designed to measure the effects of treatment on quality of life among persons with chronic airflow limitation.

Useful Facts: The original version of the CRQ was designed to be interviewer-administered; however, a self-report version of the instrument is now available. According to the developer, the self-report and interviewer-administered versions of the original (individualized) CRQ take up to 16 minutes to complete, although longer completion times have been reported in the literature. The standardized CRQ (interviewer- and self-administered versions) has an estimated completion time of 8 minutes. This instrument has also been referred to as the Chronic Respiratory Disease Questionnaire (CRDQ) in the literature. Spanish and German versions of the instrument have been developed.

VA Relevance: The CRQ has been used among the veteran population.

Availability: A signed license agreement is required to use the CRQ. License fees vary according to application. For further information, contact Ms. Peggy Austin, McMaster University Health Sciences Centre, austinp@mcmaster.ca.

References:

1. Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987;42:773-778. [Abstract ]
2. Wijkstra PJ, TenVergert EM, Van Altena R, Otten V, Postma DS, Kraan J, Koeter GH. Reliability and validity of the Chronic Respiratory Questionnaire (CRQ). Thorax 1994;49:465-467. [Abstract ]
3. Schünemann HJ, Griffith L, Jaeschkle R, Goldstein R, Stubbing D, Austin P, Guyatt GH. A comparison of the original Chronic Respiratory Questionnaire with a standardized version. Chest 2003;124:1421-1429. [Abstract ]

Development: Jones and colleagues reported the development of the St. George's Respiratory Questionnaire (SGRQ) in 1991 and 1992. The questionnaire contains 50 items (yielding 76 responses) divided into three sections. The first section assesses the frequency of 8 symptoms (e.g., wheezing) during the past year. The second section assesses 16 activities that cause breathing difficulties or that are limited by breathing difficulties. The remaining 26 items assess the impact of disease on social and emotional functioning.

Purpose: The SGRQ was developed to assess "the impact of diseases of chronic airflow limitation on health and well-being and to be sufficiently sensitive to respond to changes in disease activity."2

Useful Facts: The SGRQ is a self-administered questionnaire that requires approximately 10 minutes to complete. It was originally written in British English and has been translated to American English, Spanish, French, and other languages. Scoring is based on a set of item weights derived from previous studies in populations with respiratory diseases.

VA Relevance: The SGRQ has been used among the veteran population.

Availability: The American English version of the SGRQ is printed as an appendix to the 2000 article describing its translation. Note that the symptom reporting period in this version has also been changed from the past year to the past month. The original UK version of the SGRQ is available from the Medical Outcomes Trust for a fee of $125.00: http://www.outcomes-trust.org.

References:

1. Jones PW, Quirk FH, Baveystock CM. The St. George's Respiratory Questionnaire. Resp Med Suppl 1991;85:25-31. [Abstract ]
2. Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation: the St. George's Respiratory Questionnaire. Am Rev Respir Des 1992;145:1321-1327. [Abstract ]
3. Barr JT, Schumacher GE, Freeman S, LeMoine M, Bakst AW, Jones PW. American translation, modification, and validation of the St. George's Respiratory Questionnaire. Clin Ther 2000;22:1121-1145. [Abstract ]

Development: The Asthma Quality of Life Questionnaire (AQLQ) was developed by Juniper and colleagues in 1992. Items were generated through literature review, patient interviews, and consultation with clinicians. The AQLQ contains 32 items organized into four domains. The symptoms domain (12 items) assesses the frequency of problems experienced by persons with asthma, such as shortness of breath and coughing. Another domain assesses the extent to which the respondent is limited in various types of activities because of asthma (11 items). The emotion function domain (5 items) consists of items measuring distress or concern about having asthma. A fourth domain (4 items) assesses the extent to which environmental triggers (e.g., air pollution) are bothersome.

Purpose: The AQLQ assesses symptoms and functional impairments in adults with asthma.

Useful Facts: The AQLQ may be self-administered or administered by interviewer. Initial administration time is approximately 10 minutes, and follow-up assessment takes approximately 5 minutes. An abbreviated, 15-item version of the instrument, the MiniAQLQ, has been found to perform similarly to the 32-item version. The AQLQ and MiniAQLQ are available in English, Spanish, and numerous other languages.

VA Relevance: No published studies were found in which the AQLQ was used among the veteran population.

Availability: The AQLQ is available from its developer, Dr. Elizabeth Juniper (email: adultaqlqpack@qoltech.co.uk). The instrument is free of charge for clinicians, academic researchers, and non-profit organizations. A usage fee applies for commercial organizations. For more information about availability, see http://www.qoltech.co.uk/Asthma1.htm.

References:

1. Juniper EF, Guyatt GH, Epistein RS, Ferrie PJ, Jaeschkle R, Hiller TK. Evaluation of impairment of health-related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax 1992;47:76-83. [Abstract ]
2. Juniper EF, Guyatt GH, Ferrie PJ, Griffith LE. Measuring quality of life in asthma. Am Rev Respir Dis 1993;147:832-838. [Abstract ]
3. Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and validation of the Mini Asthma Quality of Life Questionnaire. Eur Respir J. 1999 Jul;14(1):32-8. [Abstract ]