title: Refinement of the Long-Term Conditions Questionnaire (LTCQ): patient and expert stakeholder opinion.
abstract: OBJECTIVE
  It is a key UK government priority to assess and improve outcomes in people with long-term conditions (LTCs). We are developing a new patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), for use among people with single or multiple LTCs. This study aimed to refine candidate LTCQ items that had previously been informed through literature reviews, interviews with professional stakeholders, and interviews with people with LTCs.
  
  
  METHODS
  Cognitive interviews (n=32) with people living with LTCs and consultations with professional stakeholders (n=13) and public representatives (n=5) were conducted to assess the suitability of 23 candidate items. Items were tested for content and comprehensibility and underwent a translatability assessment.
  
  
  RESULTS
  Four rounds of revisions took place, due to amendments to item structure, improvements to item clarity, item duplication, and recommendations for future translations. Twenty items were confirmed as relevant to living with LTCs and understandable to patients and professionals.
  
  
  CONCLUSIONS
  This study supports the content validity of the LTCQ items among people with LTCs and professional stakeholders. The final items are suitable to enter the next stage of psychometric refinement.
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Laura
authors.initials: L
authors.lastname: Kelly
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Potter
authors.affiliation: Academic Unit of Primary Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hunter
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gibbons
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Ray
authors.initials: R
authors.lastname: Fitzpatrick
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Crispin
authors.initials: C
authors.lastname: Jenkinson
authors.affiliation: Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford.
authors.forename: Michele
authors.initials: M
authors.lastname: Peters
keywords: chronic conditions; cognitive debrief interviews; long-term conditions; patient-reported