Search tips
Search criteria 


Logo of thoraxThoraxVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Thorax. 1987 October; 42(10): 773–778.
PMCID: PMC460950

A measure of quality of life for clinical trials in chronic lung disease.


Since the relationships between pulmonary function, exercise capacity, and functional state or quality of life are generally weak, a self report questionnaire has been developed to determine the effect of treatment on quality of life in clinical trials. One hundred patients with chronic airflow limitation were asked how their quality of life was affected by their illness, and how important their symptoms and limitations were. The most frequent and important items were used to construct a questionnaire evaluating four dimensions: dyspnoea, fatigue, emotional function, and the patient's feeling of control over the disease (mastery). Reproducibility, tested by repeated administration to patients in a stable condition, was excellent: the coefficient of variation was less than 12% for all four dimensions. Responsiveness (sensitivity to change) was tested by administering the questionnaire to 13 patients before and after optimisation of their drug treatment and to another 28 before and after participation in a respiratory rehabilitation programme. In both cases large, statistically significant improvements in all four dimensions were noted. Changes in questionnaire score were correlated with changes in spirometric values, exercise capacity, and patients' and physicians' global ratings. Thus it has been shown that the questionnaire is precise, valid, and responsive. It can therefore serve as a useful disease specific measure of quality of life for clinical trials.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (886K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Alexander MR, Dull WL, Kasik JE. Treatment of chronic obstructive pulmonary disease with orally administered theophylline. A double-blind, controlled study. JAMA. 1980 Nov 21;244(20):2286–2290. [PubMed]
  • Eaton ML, MacDonald FM, Church TR, Niewoehner DE. Effects of theophylline on breathlessness and exercise tolerance in patients with chronic airflow obstruction. Chest. 1982 Nov;82(5):538–542. [PubMed]
  • Haas A, Cardon H. Rehabilitation in chronic obstructive pulmonary disease: a 5-year study of 252 male patients. Med Clin North Am. 1969 May;53(3):593–606. [PubMed]
  • Petty TL, Brink GA, Miller MW, Corsello PR. Objective functional improvement in chronic airway obstruction. Chest. 1970 Mar;57(3):216–223. [PubMed]
  • Agle DP, Baum GL, Chester EH, Wendt M. Multidiscipline treatment of chronic pulmonary insufficiency. 1. Psychologic aspects of rehabilitation. Psychosom Med. 1973 Jan-Feb;35(1):41–49. [PubMed]
  • McGavin CR, Artvinli M, Naoe H, McHardy GJ. Dyspnoea, disability, and distance walked: comparison of estimates of exercise performance in respiratory disease. Br Med J. 1978 Jul 22;2(6132):241–243. [PMC free article] [PubMed]
  • Mahler DA, Weinberg DH, Wells CK, Feinstein AR. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest. 1984 Jun;85(6):751–758. [PubMed]
  • Kirshner B, Guyatt G. A methodological framework for assessing health indices. J Chronic Dis. 1985;38(1):27–36. [PubMed]
  • Fishman DB, Petty TL. Physical, symptomatic and psychological improvement in patients receiving comprehensive care for chronic airway obstruction. J Chronic Dis. 1971 Dec;24(12):775–785. [PubMed]
  • Moser KM, Bokinsky GE, Savage RT, Archibald CJ, Hansen PR. Results of a comprehensive rehabilitation program. Physiologic and functional effects on patients with chronic obstructive pulmonary disease. Arch Intern Med. 1980 Dec;140(12):1596–1601. [PubMed]
  • Dudley DL, Glaser EM, Jorgenson BN, Logan DL. Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. Part 2. Psychosocial treatment. Chest. 1980 Apr;77(4):544–551. [PubMed]
  • Dudley DL, Glaser EM, Jorgenson BN, Logan DL. Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. 3. Dealing with psychiatric disease (as distinguished from psychosocial or psychophysiologic problems). Chest. 1980 May;77(5):677–684. [PubMed]
  • Kinsman RA, Yaroush RA, Fernandez E, Dirks JF, Schocket M, Fukuhara J. Symptoms and experiences in chronic bronchitis and emphysema. Chest. 1983 May;83(5):755–761. [PubMed]
  • McSweeny AJ, Grant I, Heaton RK, Adams KM, Timms RM. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med. 1982 Mar;142(3):473–478. [PubMed]
  • Kaplan RM, Bush JW, Berry CC. Health status: types of validity and the index of well-being. Health Serv Res. 1976 Winter;11(4):478–507. [PMC free article] [PubMed]
  • Bergner M, Bobbitt RA, Carter WB, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981 Aug;19(8):787–805. [PubMed]
  • Guyatt GH, Townsend M, Berman LB, Pugsley SO. Quality of life in patients with chronic airflow limitation. Br J Dis Chest. 1987 Jan;81(1):45–54. [PubMed]
  • Guyatt GH, Thompson PJ, Berman LB, Sullivan MJ, Townsend M, Jones NL, Pugsley SO. How should we measure function in patients with chronic heart and lung disease? J Chronic Dis. 1985;38(6):517–524. [PubMed]
  • Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: characteristics and guidelines for use. Am J Public Health. 1984 Sep;74(9):979–983. [PubMed]

Articles from Thorax are provided here courtesy of BMJ Group