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Original Research: QUALITY OF LIFE |

Measuring Disease-Specific Quality of Life in Obstructive Airway Disease*: Validation of a Modified Version of the Airways Questionnaire 20

Hubert Chen, MD, MPH; Mark D. Eisner, MD, MPH; Patricia P. Katz, PhD; Edward H. Yelin, PhD; Paul D. Blanc, MD, MSPH
Author and Funding Information

*From the Cardiovascular Research Institute (Dr. Chen), Division of Occupational and Environmental Medicine (Drs. Blanc and Eisner), and Division of Rheumatology (Drs. Katz and Yelin), University of California, San Francisco, San Francisco, CA.

Correspondence to: Hubert Chen, MD, MPH, 350 Parnassus Ave, Suite 609, San Francisco, CA 94143-0924; e-mail: hubert.chen@ucsf.edu



Chest. 2006;129(6):1644-1652. doi:10.1378/chest.129.6.1644
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Background: The Airways Questionnaire 20 (AQ20) is a concise measure of health-related quality of life (HRQL) in obstructive airway disease; however, its original format may underestimate impairment due to the complete cessation of certain activities.

Methods: We revised seven items of the original AQ20 (revised AQ20 [AQ20-R]), adding response options for inability to perform certain activities. We assessed the performance of the AQ20-R among 352 adults with various airway conditions identified through a random telephone sample. Concurrent validity of the AQ20-R was assessed relative to the Short Form-12 (SF-12) physical component summary (PCS), FEV1, and medication use. Predictive validity was assessed relative to health-care utilization among 278 subjects studied longitudinally.

Results: Twenty-one of 352 subjects were unable to perform at least one activity. These subjects demonstrated higher AQ20-R scores (p < 0.001) indicating worse HRQL. Mean (± SD) AQ20-R scores differed significantly (p < 0.001) among subjects with COPD (8.9 ± 5.2), asthma (6.7 ± 5.0), and chronic bronchitis (4.7 ± 4.2). At baseline, the AQ20-R correlated with the SF-12 PCS (r = − 0.55, p < 0.001) and FEV1 (r = − 0.43, p < 0.001), and was associated with the use of respiratory-specific therapies (p ≤ 0.001). In multivariate models, the AQ20-R was an independent predictor of outpatient visits (odds ratio, 2.2; 95% confidence interval, 1.6 to 3.1), emergency department visits (odds ratio, 2.9; 95% confidence interval, 1.9 to 4.6), hospitalization (odds ratio, 2.8; 95% confidence interval, 1.6 to 4.9), and ICU admission (odds ratio, 3.0; 95% confidence interval, 1.2 to 7.3) during the following year.

Conclusions: The AQ20-R is a valid respiratory-specific HRQL measure that accounts for activity cessation among the most impaired and can be used across various airway conditions.

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