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Eur Respir J 2005; 25:31-40
Copyright ©ERS Journals Ltd 2005

A randomised trial to evaluate the self-administered standardised chronic respiratory questionnaire

H. J. Schünemann1,2,4, R. Goldstein6, M. J. Mador1,3, D. McKim7, E. Stahl8, M. Puhan9, L. E. Griffith4, B. Grant1,3, P. Austin4, R. Collins6 and G. H. Guyatt4,5

Depts of 1 Medicine and 2 Social and Preventive Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, and 3 Veteran Affairs Medical Center, Buffalo, NY, USA. Depts of 4 Clinical Epidemiology and Biostatistics, and 5 Medicine, McMaster University, Hamilton, 6 Dept of Medicine, University of Toronto, Toronto, and 7 University of Ottawa, Ottawa, ON, Canada. 8 AstraZeneca R&D, Lund, Sweden. 9 Horten Center, Zurich, Switzerland

CORRESPONDENCE: H. J. Schünemann, University Health Sciences Centre, Room 2C12, Hamilton, Ontario L8N 3Z5, Canada. Fax: 1 9055770017. E-mail: schuneh@mcmaster.ca

Keywords: Chronic obstructive pulmonary disease, health-related quality of life, pulmonary rehabilitation, randomised controlled trial, standardised administration

Received: March 9, 2004
Accepted September 1, 2004

The original chronic respiratory questionnaire (CRQ), one of the most widely used measures of health-related quality of life (HRQL) in chronic respiratory disease (CRD), is traditionally interviewer administered (IA) and includes an individualised dyspnoea domain. The present authors studied the impact of self-administered (SA) and standardised dyspnoea questions on CRQ measurement properties.

In a factorial design multicentre trial, 177 patients with CRD (mean age 67.7 yrs; mean forced expiratory volume in one second per cent predicted 44.6%) were randomised to CRQ-IA (n = 86) or CRQ-SA (n = 91), and to initially complete the standardised or individualised items before and after respiratory rehabilitation.

While maintaining validity, the CRQ-SA proved more responsive to changes in HRQL than the CRQ-IA in all domains. Compared with the standardised dyspnoea domain, the individualised dyspnoea domain indicated greater responsiveness. The correlations of baseline scores and change scores with other HRQL instruments indicated good validity of the CRQ-SA.

In conclusion, self-administration and standardisation of the chronic respiratory questionnaire maintains validity and responsiveness relative to the interviewer-administered chronic respiratory questionnaire. These results challenge the assumption that interviewer-administered questionnaires are superior to self-administered questionnaires in older patients with chronic respiratory disease.




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