@article{discovery10129787,
           month = {August},
          number = {8},
           title = {The validity of health-related quality of life questionnaires in bronchiectasis: a systematic review and meta-analysis},
            year = {2016},
       publisher = {BMJ PUBLISHING GROUP},
         journal = {Thorax},
          volume = {71},
            note = {This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.},
           pages = {683--694},
        keywords = {health-related quality of life, questionnaire, bronchiectasis, systematic literature
review, meta-analysis},
        abstract = {Background: A range of questionnaires have been used to assess health-related quality of life (HRQOL) in bronchiectasis. A systematic review was conducted to evaluate their psychometric properties and assess associations between HRQOL and clinical measures.

Methods: Five electronic databases were searched. Studies eligible for inclusion were those that investigated the validity of HRQOL questionnaires and/or their association with other outcomes in adults with bronchiectasis. Patients with cystic fibrosis were excluded. The identified questionnaires were assessed for convergent, discriminant and cross-cultural translation validity; missing data, floor and ceiling effects, internal consistency, responsiveness and test-retest reliability. A meta-analysis was conducted to estimate the strength of associations between HRQOL and clinical measures.

Results: From 1918 studies identified, 43 studies were included in the systematic review, of which 38 were suitable for the meta-analysis. Nine HRQOL questionnaires were identified, with the most widely used being: St George's Respiratory Questionnaire, Leicester Cough Questionnaire, Quality of Life-Bronchiectasis and Short Form-36. HRQOL questionnaires had moderate to good internal consistency and good test-retest reliability. Only 8 of 18 studies that used translated HRQOL questionnaires reported or referred to the validity of the translated questionnaire. There was a stronger correlation (mean r (95\% CI)) between HRQOL and subjective outcome measures, such as dyspnoea (0.55 (0.41 to 0.68)) and fatigue (0.42 (0.23 to 0.58)) compared with objective measures; exercise capacity (?0.41 (?0.54 to ?0.24)), FEV1\% predicted (?0.31 (?0.40 to ?0.23)) and extent of bronchiectasis on CT scan (0.35 (0.03 to 0.61)); all p{\ensuremath{<}}0.001.

Conclusions: This review supports most HRQOL questionnaires used in bronchiectasis have good psychometric properties. There was a weak to moderate association between HRQOL and objective outcome measures. This suggests that HRQOL questionnaires assess a unique aspect of health not captured by objective measures.},
            issn = {1468-3296},
          author = {Spinou, A and Fragkos, KC and Lee, KK and Elston, C and Siegert, RJ and Loebinger, MR and Wilson, R and Garrod, R and Birring, SS},
             url = {https://doi.org/10.1136/thoraxjnl-2015-207315}
}