Volume 18 Issue 3 September 2009
Development and validation of the Chronic Obstructive
Pulmonary Disease Assessment Questionnaire (COPD-AQ)
Pages 198-207
*William C Baileya, Frank C Sciurbab, Nicola A Hananiac, James F Donohued, Gary T Fergusone, Joseph D Zibrakf, Amir Sharafkhanehc,g, Philip Marcush,i, Kathleen Rosaj, Elisabeth C Piaultj, Fernando J Martinezk
a
University of Alabama Lung Health Center, University of Alabama, Birmingham, AL, USA.
b
Emphysema/COPD Research Center, Division of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
c
Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
d
Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
e
Pulmonary Research Institute of Southeast Michigan, Livonia, MI, USA.
f
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
g
Michael E. Debakey VA Medical Center, Houston, TX, USA.
h
Division of Pulmonary Medicine, St Francis Hospital, Roslyn, NY, USA.
i
New York College of Osteopathic Medicine, Old Westbury, NY, USA
j
Mapi Values, Boston, MA, USA.
k
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
Received 27 February 2009 • Accepted 25 April 2009 • Online 3 June 2009
Abstract
AIMS: To develop a practical patient-completed chronic obstructive pulmonary disease assessment questionnaire (COPD-AQ) to improve
COPD assessment and management in primary care, based on the concept of COPD stability.
METHODS: An Expert Working Group defined parameters of COPD stability and a 10-item Physician’s Global Assessment was established.
A 21-item COPD-AQ was developed and validated in a cross-sectional, non-randomised study of patients with COPD (n=395). Items most
discriminative of stability status (stable/unstable) were selected to produce a 5-item COPD-AQ, which was then validated.
RESULTS: In the development sample, internal consistency reliability of the 5-item COPD-AQ was 0.74 (n=296). The COPD-AQ
discriminated between stability groups based on physician assessment (F=44.26; p<0.0001) and post-bronchodilator spirometry measures
(F=2.92; p<0.05). A questionnaire score >20 (range: 5.0–25.0) had a specificity of 82.9% and sensitivity of 64.7%.
CONCLUSIONS: The 5-item COPD-AQ proved a practical tool for assessing COPD status and was sufficiently simple for routine clinical use.
However, overall validation was limited by small numbers of patients in the validation sample. Difficulties also existed over using the term
‘stability’ to define COPD status. COPD-AQ was not progressed further, but this work will prove valuable in the future development of a
global questionnaire to improve COPD management in primary care.
Cite as: Bailey WC, Sciurba FC, Hanania NA, Donohue JF, Ferguson GT, Zibrak JD, Sharafkhaneh A, Marcus P, Rosa K, Piault EC, Martinez FJ. Development and validation of the Chronic Obstructive
Pulmonary Disease Assessment Questionnaire (COPD-AQ). Prim Care Respir J 2009;18(3):198-207. DOI: http://dx.doi.org/10.4104/pcrj.2009.00032
Keywords
Chronic obstructive pulmonary disease (COPD), patient-reported questionnaire, chronic bronchitis, symptom,
predictive validity
* Corresponding author. William C Bailey Tel: +1 205-934-3915 Fax: +1 205-996-6340 Email: wcbailey@uab.edu | |
