title: A symptom-based measure of the severity of chronic lung disease: results from the Veterans Health Study.
abstract: 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.
authors.affiliation: Center for Health Quality, Outcomes, and Economic Research, Bedford Health Services Research and Development Field Program, VA Medical Center, Bedford, Mass 02130, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Selim
authors.forename: X S
authors.initials: XS
authors.lastname: Ren
authors.forename: G
authors.initials: G
authors.lastname: Fincke
authors.forename: W
authors.initials: W
authors.lastname: Rogers
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.forename: L
authors.initials: L
authors.lastname: Kazis
mesh_terms: 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