Abstract
Aim: In COPD early morning symptoms (EMS) are associated with poorer health status, impaired daily activities and increased exacerbation risk. We are currently developing a new measure to quantify EMS in COPD – the Manchester EMS Index in COPD (MEMSI-C). Methods: Identification of potential items was guided by interviews and focus groups with COPD patients. Potential items for inclusion in the final questionnaire were extracted from focus group transcripts. Cognitive interviewing was then used with a different group of patients to assess the relevance and understanding of the different items. A cross-sectional study then identified items for final inclusion. Participants completed the draft item list twice (day 0 and day 7) and the St George's Respiratory Questionnaire (SGRQ). Hierarchical methods were used to inform stage one of item deletion. Rasch analysis is now planned to enable the development of a unidimensional scale. Results: Qualitative data from 45 patients with COPD informed the initial item-list (items = 22). The cross sectional study included 204 COPD patients (GOLD: 1: 17% 2:48% 3:26% 4: 9% ; male 62%, mean age 65 sd 7 years). Eight items were removed during hierarchical methods. Provisional results suggest that the MEMSI-C demonstrates good internal consistency (Cronbach's alpha 0.9) and test-retest repeatability (>0.7). Conclusion: The MEMSI-C shows good internal consistency and stability over time. Rash analysis will be used to assess the unidimentionality of the index. The final instrument should lead to a better understanding of the impact that EMS have on patients with COPD.
- © 2014 ERS