A symptom-based measure of the severity of chronic lung disease: results from the Veterans Health Study.
OBJECTIVE
We developed a symptom-based measure of severity for chronic lung disease (CLD) that can be readily administered in ambulatory care settings and be used to supplement general health-related quality of life (HRQoL) assessments and pathophysiologic indicators in research and clinical care.


METHODS
Cross-sectional data from the Veterans Health Study, an observational study of health outcomes in patients receiving Veterans Affairs (VA) ambulatory care.


METHODS
Four VA outpatient clinics.


METHODS
Two hundred ninety-two participants with CLD were identified on the basis of patient report of having a physician's diagnosis of chronic bronchitis, emphysema, or asthma and either using inhaled medications or having a productive cough on most days for 3 months.


RESULTS
Participants were scheduled for an in-person interview in which they completed a CLD questionnaire and measurements of peak expiratory flow rate (PEFR). They were also mailed an HRQoL questionnaire, the Short Form Health Survey (SF-36). The CLD questionnaire included six symptom items chosen by an expert panel (two items each for dyspnea, wheezing, and productive cough). The combination of these items yielded a CLD severity index that correlated significantly with all eight scales of the SF-36 (range of r, -0.19 to -0.37; p<0.01). In contrast, PEFR had statistically significant correlations only with two SF-36 scales: physical functioning and bodily pain.


CONCLUSIONS
The CLD severity index is a reliable and valid patient-administered instrument that may be used to evaluate the effects of CLD on general HRQoL and predict future health services utilization.
Selim
A J
AJ
Center for Health Quality, Outcomes, and Economic Research, Bedford Health Services Research and Development Field Program, VA Medical Center, Bedford, Mass 02130, USA.
Ren
X S
XS
Fincke
G
G
Rogers
W
W
Lee
A
A
Kazis
L
L
D000368:Aged; D001900:Boston; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006787:Hospitals, Veterans; D006801:Humans; D016018:Least-Squares Analysis; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires