Development and validation of The Cystic Fibrosis Questionnaire in the United States: a health-related quality-of-life measure for cystic fibrosis.

BACKGROUND The Cystic Fibrosis Questionnaire (CFQ) is a disease-specific instrument that measures health-related quality of life (HRQOL) for adolescents and adults with cystic fibrosis (CF) > or = 14 years, consisting of 44 items on 12 generic and disease-specific scales. Versions of the CFQ are also available for children with CF and their parents. This study evaluated the psychometric properties of the CFQ in a national study at 18 CF centers in the United States. PARTICIPANTS The CFQ-teen/adult was administered to 212 patients with CF ranging in age from 14 to 53 years. Test-retest reliability was assessed in a subset of patients over a 10- to 14-day interval. RESULTS Multitrait analysis indicated a majority of items (95%) correlated more highly with their intended scale than a competing scale, supporting the conceptual model. Internal consistency coefficients indicated the CFQ scales had good reliability (Cronbach alpha = 0.67 to 0.94), and test-retest stability was acceptable (rs = 0.45 to 0.90). Validity was demonstrated by examining relationships between the CFQ, age, pulmonary function, and body mass index. As expected, the CFQ was inversely correlated with age, with older adults reporting lower CFQ scores than younger adults, better nutritional status was positively correlated with several weight-related scales, and the measure differentiated between individuals with varying levels of disease severity. Strong associations were also found between the CFQ and similar scales on the Short Form-36 Health Questionnaire, a well-known generic HRQOL measure. CONCLUSIONS The results demonstrated that the CFQ-teen/adult is a reliable and valid measure of HRQOL for individuals with CF. It may be utilized in clinical trials to assess the effects of new therapies, to document the progression of disease, and to inform clinical practice.

[1]  L. Taussig Advances in cystic fibrosis: Bringing the bench to the bedside , 2005, European Journal of Pediatrics.

[2]  R. Willke,et al.  Measuring treatment impact: a review of patient-reported outcomes and other efficacy endpoints in approved product labels. , 2004, Controlled clinical trials.

[3]  D. Geddes,et al.  Advances in cystic fibrosis gene therapy , 2004, Current opinion in pulmonary medicine.

[4]  H. V. van Stel,et al.  Validation of the Dutch cystic fibrosis questionnaire (CFQ) in adolescents and adults. , 2004, Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society.

[5]  J. Goehrs,et al.  Development of the Cystic Fibrosis Questionnaire (CFQ) for assessing quality of life in pediatric and adult patients , 2003, Quality of Life Research.

[6]  D. Cella,et al.  Health status assessment for the twenty-first century: item response theory, item banking and computer adaptive testing , 1997, Quality of Life Research.

[7]  A. Quittner,et al.  Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. , 2003, Journal of pediatric psychology.

[8]  L. Saiman,et al.  Azithromycin in patients with cystic fibrosis chronically infected with Pseudomonas aeruginosa: a randomized controlled trial. , 2003, JAMA.

[9]  A. Quittner,et al.  Effects of tobramycin solution for inhalation on global ratings of quality of life in patients with cystic fibrosis and Pseudomonas aeruginosa infection * † , 2002, Pediatric pulmonology.

[10]  R. Kahn,et al.  Case‐mix adjustment for evaluation of mortality in cystic fibrosis * , 2002, Pediatric pulmonology.

[11]  R. Hornung,et al.  Impact of recent pulmonary exacerbations on quality of life in patients with cystic fibrosis. , 2002, Chest.

[12]  J. Abbott,et al.  Development of a disease specific health related quality of life measure for adults and adolescents with cystic fibrosis , 2000, Thorax.

[13]  P. Jones,et al.  American translation, modification, and validation of the St. George's Respiratory Questionnaire. , 2000, Clinical therapeutics.

[14]  A. Quittner,et al.  Translation and linguistic validation of a disease-specific quality of life measure for cystic fibrosis. , 2000, Journal of pediatric psychology.

[15]  T. Hazinski Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. , 1999, The Journal of pediatrics.

[16]  P. Walker,et al.  Quality of Life as a Treatment Outcome in Patients with Cystic Fibrosis , 1999, Pharmacotherapy.

[17]  P. Davis The gender gap in cystic fibrosis survival. , 1999, The journal of gender-specific medicine : JGSM : the official journal of the Partnership for Women's Health at Columbia.

[18]  D. Simonson,et al.  Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes mellitus: a randomized, controlled, double-blind trial. , 1998, JAMA.

[19]  A. Quittner Measurement of quality of life in cystic fibrosis. , 1998, Current opinion in pulmonary medicine.

[20]  D. French Quality of life in cystic fibrosis , 1998, Thorax.

[21]  D. Fryback,et al.  Toward consistency in cost-utility analyses: using national measures to create condition-specific values. , 1998, Medical care.

[22]  H. Lehmann A new tool for population-based quality-adjusted life years? , 1998, Medical care.

[23]  C. McHorney,et al.  Generic Health Measurement: Past Accomplishments and a Measurement Paradigm for the 21st Century , 1997, Annals of Internal Medicine.

[24]  J. Larson The MOS 36-Item Short form Health Survey , 1997, Evaluation & the health professions.

[25]  B. Gandek,et al.  MAP-R for windows: multitrait / multi-item analysis program - revised user's guide. , 1997 .

[26]  J. Pater Quality of life and pharmacoeconomics in clinical trials , 1996 .

[27]  J. Wright,et al.  The minimal important difference: who's to say what is important? , 1996, Journal of clinical epidemiology.

[28]  B. Spilker,et al.  Quality of life and pharmacoeconomics in clinical trials , 1996 .

[29]  L. K. Bartholomew,et al.  Measurement of quality of well being in a child and adolescent cystic fibrosis population. , 1994, Medical care.

[30]  T. Boat,et al.  Outcome measures for clinical trials in cystic fibrosis. Summary of a Cystic Fibrosis Foundation consensus conference. , 1994, The Journal of pediatrics.

[31]  G. Guyatt,et al.  Measuring quality of life in asthma. , 1993, The American review of respiratory disease.

[32]  D. Osoba,et al.  The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. , 1993, Journal of the National Cancer Institute.

[33]  C. McHorney,et al.  The MOS 36‐Item Short‐Form Health Survey (SF‐36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs , 1993, Medical care.

[34]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[35]  P. Jones,et al.  The St George's Respiratory Questionnaire. , 1991, Respiratory medicine.

[36]  Ron D. Hays,et al.  Beyond internal consistency reliability: Rationale and user’s guide for Multitrait Analysis Program on the microcomputer , 1990 .

[37]  R M Kaplan,et al.  The Quality of Well-Being Scale: Applications in AIDS, Cystic Fibrosis, and Arthritis , 1989, Medical care.

[38]  R M Kaplan,et al.  Health outcome models for policy analysis. , 1989, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[39]  N. Clark,et al.  Clinical-Behavioral Aspects of Cystic Fibrosis: Directions for Future Research , 1987 .

[40]  N. Clark,et al.  NHLBI workshop summary. Clinical-behavioral aspects of cystic fibrosis: directions for future research. , 1987, The American review of respiratory disease.

[41]  M. Lebowitz,et al.  The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. , 1976, The American review of respiratory disease.

[42]  J. Jerković [Maximal expiratory flow-volume curve]. , 1972, Plucne bolesti i tuberkuloza.

[43]  D. Campbell,et al.  Convergent and discriminant validation by the multitrait-multimethod matrix. , 1959, Psychological bulletin.