Validity, reliability, and responsiveness of a new shortVisual Simplified Respiratory Questionnaire (VSRQ^©) for health-related quality of life assessment in chronic obstructive pulmonary disease

Abstract

The Visual Simplified Respiratory Questionnaire (VSRQ) was designed to assess health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). It contains eight items: dyspnea, anxiety, depressed mood, sleep, energy, daily activities, social activities and sexual life. Psychometric properties were assessed during a clinical trial that evaluated the impact of tiotropium on HRQoL of COPD patients. These included the determination of structure, internal consistency reliability, concurrent validity with the St George’s Respiratory Questionnaire (SGRQ), test – retest reliability, clinical validity and responsiveness to change over two weeks. Minimal important difference (MID) was calculated; cumulative response curves (CRC) were based on the dyspnea item. Psychometric analyses showed that VSRQ structure was unidimensional. The questionnaire demonstrated good internal consistency reliability (Cronbach’s alpha = 0.84), good concurrent validity with SGRQ (Spearman = −0.70) and clinical validity, good test-retest reproducibility (ICC = 0.77), and satisfactory responsiveness (standardized response mean = 0.57; Guyatt’s statistic = 0.63). MID was 3.4; CRC median value of the ‘minimally improved’ patients was 3.5. In conclusion, VSRQ brevity and satisfactory psychometric properties make it a good candidate for large studies to assess HRQoL in COPD patients. Further validation is needed to extend its use in clinical practice.

Keywords:

• chronic obstructive pulmonary disease
• VSRQ
• SGRQ
• health-related quality of life
• minimal important difference

Acknowledgments

The authors would like to thank Muriel Viala (Mapi Values) for her contribution to the statistical analyses and manuscript reviewing, and François Denis and Maryse Mueser (Boehringer-Ingelheim) for their thorough reviewing of the manuscript. We would also like to thank Nicola Barnes (Mapi Values) for her contribution in reviewing the English language editing of the the manuscript.

Disclosure

The work was funded by Boehringer Ingelheim France. Professor Tonnel serves on the French Advisory Board Committees for Boehringer Ingelheim France, AstraZeneca, GlaxoSmithKline and Novartis. Dr Perez received research support from Boehringer Ingelheim. Drs Marie-Laure Bravo and Michèle Brun are employees of Boehringer Ingelheim. Benoit Arnould, Valérie Bosch and Isabelle Guillemin were paid consultants to Boehringer Ingelheim France.

Copyrights

The VSRQ is protected by copyright with all rights reserved to Boehringer Ingelheim, France. Do not use without permission. Boehringer Ingelheim kindly encourages the use of the questionnaire by clinicians, researchers and pharmaceutical industries. For information on, or permission to use the VSRQ, please contact Boehringer Ingelheim, France.