title: Adaptation and validation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for the Netherlands.
abstract: BACKGROUND
  The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the first disease-specific instrument for pulmonary arterial hypertension (PAH) to assess patient-perceived symptoms, activity limitations and quality of life. To be able to use this questionnaire in the Netherlands, the aim of the study was to translate and validate this instrument for the Dutch-speaking population.
  
  
  METHODS
  First the CAMPHOR was translated into Dutch (by means of a bilingual and a lay panel) and field-tested by means of cognitive debriefing interviews with ten PAH patients. For psychometric evaluation, 80 patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH) were asked to complete the CAMPHOR twice over a two-week period. To test for construct validity, participants also completed the Nottingham Health Profile (NHP).
  
  
  RESULTS
  The Dutch version of the CAMPHOR showed high internal consistency for all scales (Cronbach's alpha 0.89-0.91) and excellent reproducibility over two weeks (reliability coefficients 0.87-0.91). Concurrent validity showed that the CAMPHOR scales correlated as expected with the NHP scales. The CAMPHOR was able to distinguish between patient groups based on self-reported general health status, disease severity and NYHA classification demonstrating evidence of known group validity. The CAMPHOR activity limitations scale correlated moderately with the distance walked during the 6‑minute walk test (r = -0.47, p < 0.01) and the symptoms scale with the Borg dyspnoea score (r = 0.51, p < 0.01).
  
  
  CONCLUSIONS
  The Dutch version of the CAMPHOR is a reliable and valid measure of quality of life and health status in patients with PAH and CTEPH is recommended for use in routine care and in clinical research.
authors.affiliation: Department of Pulmonary Medicine, Erasmus Medical University Center, Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Wapenaar
authors.affiliation: Galen Research Ltd, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Twiss
authors.affiliation: Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Wagenaar
authors.affiliation: Department of Pulmonary Medicine, Erasmus Medical University Center, Rotterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Seijkens
authors.affiliation: Department of Pulmonary Medicine, Erasmus Medical University Center, Rotterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: van den Toorn
authors.affiliation: Galen Research Ltd, Manchester, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stepanous
authors.affiliation: Galen Research Ltd, Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Heaney
authors.affiliation: Department of Cardiology, Erasmus Medical University Center, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van den Bosch
authors.affiliation: Department of Pulmonary Medicine, Erasmus Medical University Center, Rotterdam, The Netherlands. k.boomars@erasmusmc.nl.
authors.forename: K A
authors.initials: KA
authors.lastname: Boomars
keywords: CAMPHOR health questionnaire; Chronic thromboembolic pulmonary hypertension; Health-related quality of life; Pulmonary arterial hypertension