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485 VALIDATION OF A MODIFIED VERSION OF THE AIRWAYS QUESTIONNAIRE 20 AMONG ADULTS WITH OBSTRUCTIVE AIRWAY DISEASE
  1. H. Chen,
  2. M. D. Eisner,
  3. P. P. Katz,
  4. P. D. Blanc
  1. San Francisco, CA.

Abstract

Purpose The Airways Questionnaire 20 (AQ20) is a concise, disease-specific health-related quality of life (HRQL) measure applicable to a spectrum of obstructive respiratory conditions ranging from asthma to emphysema. We wished to assess the performance characteristics of the AQ20 using a modified instrument that accounts for the complete cessation of certain activities, evaluating its cross-sectional and longitudinal performance among various subtypes of airway disease.

Methods We revised 7 of the 20 original items of the AQ20 (AQ20-R) to allow for an additional response category for those unable to perform certain activities due to a respiratory condition. We tested the performance characteristics of the AQ20-R among 352 adults with COPD, asthma, or chronic bronchitis identified in a national random telephone sample. Concurrent validity of the AQ20-R was assessed in relation to physical health status (Short Form 12, Physical Component Score [SF-12 PCS]), lung function (FEV1 % predicted), and therapies used. Predictive validity was assessed by examining the longitudinal relationship between the AQ20-R and utilization of health care services reported at one year follow-up.

Results Twenty-one of 352 subjects responded as being unable to participate in at least one of seven activities queried. Compared with others, these subjects had higher AQ20-R scores (p≤0.01), indicating worse HRQL, and poorer physical health status as measured by the SF-12 PCS (p≤0.01). Mean AQ20-R scores differed significantly (ANOVA, p≤0.01) among the subjects with COPD (8.9, SD 5.2), asthma (6.7, SD 5.0) and chronic bronchitis alone (4.7, SD 4.2). Overall, the AQ20-R correlated moderately with the SF-12 PCS (r = –0.55, p≤0.01) and FEV1 (r = –0.43, p≤0.01), and was significantly associated (p≤0.01) with the use of each of the following: inhaled bronchodilators, inhaled corticosteroids, home nebulizer, oral corticosteroids, antibiotics, and home oxygen. Adjusting for respiratory condition and demographics, the AQ20-R was an independent predictor of follow-up outpatient visits (OR 2.2, 95% CI 1.6–3.1), emergency department visits (OR 2.9, 95% CI 1.9–4.6), hospitalization (OR 2.8, 95% CI 1.6–4.9), and admission to an ICU (OR 3.0, 95% CI 1.2–7.3).

Conclusions The revised AQ20 (AQ20-R) is a simple, disease-specific HRQL measure that takes into account activity limitation in those with the most severe disease. It is valid for use among various subtypes of obstructive airway disease.

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