title: Development of ATAQ-LAM: a tool to assess quality of life in Lymphangioleiomyomatosis.
abstract: BACKGROUND
  Lymphangioleiomyomatosis (LAM) is a progressive lung disease that impairs health-related quality of life (HRQL).
  
  
  OBJECTIVE
  To develop and conduct initial testing of ATAQ-LAM (A Tool to Assess Quality of Life in LAM).
  
  
  METHODS
  A pilot version of the questionnaire was administered to respondents with LAM. We used a deletion algorithm to retain items and then applied multi-trait scaling to place retained items into appropriate domains, thus generating the ATAQ-LAM. Rasch analysis was used to assess item fit to a unidimensional model of HRQL. We determined internal consistency (IC) and floor and ceiling effects of ATAQ-LAM scores and conducted analyses aimed at supporting the validity of ATAQ-LAM.
  
  
  RESULTS
  Sixty-nine LAM patients provided response data. Thirty-two items survived the deletion algorithm. Scaling suggested ATAQ-LAM should have a four-domain structure (Exertional dyspnea, IC = 0.94; Cough, IC = 0.91; Fatigue, IC = 0.91; Emotional Well-Being, IC = 0.89). All items fit the Rasch model. Among 17 respondents with spirometry within three months of questionnaire completion, three of five ATAQ-LAM scores correlated with FEV1% (Exertional Dyspnea: r = -0.72, p = 0.001; Fatigue: r = -0.62, p = 0.007 and total: r = -0.53, p = 0.02). Compared with those in the highest tertile of FEV1%, subjects in the lowest tertile had greater ATAQ-LAM total (121.8 ± 14.3 vs. 79.8 ± 13.1, p = 0.04), Exertional Dyspnea (54.4 ± 6.3 vs. 25.5 ± 5.8, p = 0.005) and Fatigue (2.8 ± 2.4 vs. 14.8 ± 2.3, p = 0.03) scores, indicating greater impairment in HRQL.
  
  
  CONCLUSIONS
  ATAQ-LAM is a disease-specific instrument designed to assess HRQL in LAM patients. Additional studies are needed to generate data in support of its validity as an instrument capable of assessing HRQL over time in LAM patients.
authors.affiliation: Department of Pediatric Infectious Disease, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Tarik D
authors.initials: TD
authors.lastname: Walker
authors.affiliation: Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Desserich
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health and Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Sleep and Behavioral Health Sciences Section, National Jewish Health, Denver, CO, USA.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Wamboldt
authors.affiliation: Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Belkin
authors.affiliation: Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Fier
authors.affiliation: Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA. swigrisj@njc.org.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Swigris
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D018192:Lymphangioleiomyomatosis / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*