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Original Research: CYSTIC FIBROSIS |

Relationships Among Health-Related Quality of Life, Pulmonary Health, and Newborn Screening for Cystic FibrosisQuality of Life: Cystic Fibrosis Newborn Screening for Cystic Fibrosis

Audrey Tluczek, PhD, RN; Tara Becker, PhD; Anita Laxova, BS; Adam Grieve, MS; Caroline N. Racine Gilles, PhD; Michael J. Rock, MD; William M. Gershan, MD, FCCP; Christopher G. Green, MD; Philip M. Farrell, MD, PhD
Author and Funding Information

From the School of Nursing (Dr Tluczek), Department of Pediatrics (Drs Tluczek, Racine Gilles, Rock, Green, and Farrell; Ms Laxova; and Mr Grieve), and Department of Biostatistics and Medical Informatics (Dr Becker), School of Medicine and Public Health, University of Wisconsin, Madison; and Department of Pediatrics (Dr Gershan), Medical College of Wisconsin, Milwaukee, WI.

Correspondence to: Audrey Tluczek, PhD, RN, University of Wisconsin, School of Nursing, 600 Highland Ave, Madison, WI 53792; e-mail: atluczek@wisc.edu


Funding/Support: This work was supported by Cystic Fibrosis Foundation [A001-5-01], National Institutes of Health [DK 34108 and M01 RR03186], National Institutes of Health Clinical and Translational Science Award [1UL1RR025011], and the Children’s Hospital of Wisconsin General Clinical Research Center [M01 RR00058].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(1):170-177. doi:10.1378/chest.10-1504
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Background:  The objective of this study was to examine relationships between pulmonary health and health-related quality of life (HRQOL) in patients with cystic fibrosis (CF) evaluated longitudinally in the Wisconsin Newborn Screening Project.

Methods:  Patients aged 8 to 18 years (mean ± SD, 13.5 ± 2.8) in early diagnosis (n = 45) and control (n = 50) groups completed Cystic Fibrosis Questionnaires (CFQs) to measure HRQOL at three data points over a 2-year period. Pulmonary health was evaluated concurrently by the Wisconsin chest x-ray scoring system (WCXR) and pulmonary function tests (PFTs).

Results:  WCXR showed significant group differences (P ≤ .023), with the early diagnosis group showing more-severe lung disease. When adjusted for group differences in mucoid Pseudomonas aeruginosa status and pancreatic status, however, WCXR differences and PFT data were not significant. Most patients (74%) had FEV1 values ≥ 80% predicted (within normal range). For patients aged < 14 years, as WCXR scores worsened CFQ respiratory and physical domain scores decreased (both P ≤ .007). FEV1/FVC showed a positive relationship with the respiratory and physical domains (both P ≤ .006). WCXR scores for patients aged ≥ 14 years were associated with CFQ weight, respiratory, and health domains (all P ≤ .011). FEV1 was associated with CFQ weight, respiratory, health, and physical domains (all P ≤ .003). Changes in pulmonary health were not associated with changes in CFQ over time. Significant group differences on the CFQ-Child social functioning domain favored the control group.

Conclusions:  To our knowledge, this study is the first to compare pulmonary outcomes with HRQOL indicators assessed by serial, standardized, patient-reported outcome measures for patients with CF identified either through newborn screening or diagnosed by use of traditional methods. This study found no benefits of newborn screening for pulmonary health or HRQOL after controlling for risk factors. Using WCXR and PFT data collectively helped to identify associations between pulmonary health and HRQOL.

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