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The validity of generic and condition-specific preference-based instruments: the ability to discriminate asthma control status

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Abstract

Objective

A goal of asthma management is to improve the patient’s health-related quality of life (HRQL). However, it is unclear whether HRQL instruments can discriminate across asthma control measures. The objective of this study was to evaluate the validity of generic and condition-specific preference-based instruments, in terms of their ability to distinguish asthma control.

Methods

Asthma patients (n = 157) completed three generic preference-based instruments: the Health Utility Index Mark 3 (HUI-3), the EuroQol (EQ-5D), and the Short Form 6D (SF-6D) and two condition-specific questionnaires: the standardized Asthma Quality of Life Questionnaire (AQLQ(S)) and the Asthma Control Questionnaire (ACQ). The AQLQ(S) scores were converted into the condition-specific preference-based scores: the Asthma Quality of Life Utility Index (AQL-5D).

Results

The preference-based instruments were generally able to discriminate across control measures, such as ACQ scores and magnitude of asthma medication, but were not able to discriminate for self-reported control and severity levels. These instruments also correlated with most control measures (r = 0.32–0.37). Significant relationships between AQL-5D scores and all control variables were observed.

Conclusions

Overall, the AQL-5D discriminated across all levels of asthma control. The HUI-3, the EQ-5D, and the SF-6D differentiated between the highest and lowest levels of control but could not discriminate between the moderate levels.

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Abbreviations

ACQ:

Asthma control questionnaire

ANOVA:

Analysis of variance

AQL-5D:

Asthma quality of life utility index

AQLQ:

Asthma quality of life questionnaire

AQLQ(S):

Standardized version of the asthma quality of life questionnaire

BC:

British Columbia

EQ-5D:

EuroQol

FEV1 :

Forced expired volume in the first second

HRQL:

Health-related quality of life

HUI:

Health utility index

QALY:

Quality-adjusted life year

QOL:

Quality of life

SA:

Short-acting

SF-6D:

Short Form 6D

SG:

Standard gamble

SGRQ:

St. George’s respiratory questionnaire

TTO:

Time trade-off

VAS:

Visual analogue scale

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Acknowledgements

We would like to acknowledge the British Columbia Lung Association and the Michael Smith Foundation for Health Research for their financial support of this study. Presently, Drs. Lynd and Marra are both recipients of a Michael Smith Foundation for Health Research scholar award. In addition, Dr. Lynd is a Canadian Institute for Health Research new investigator award recipient and Dr. Marra holds a Government of Canada Research Chair in Pharmaceutical Outcomes. Drs. Kopec and FitzGerald hold a Senior Scholar Award and a Distinguished Scholar Award, both from the Michael Smith Foundation for Health Research, respectively. At the time of the study, Ms. McTaggart-Cowan was a recipient of a Michael Smith Foundation for Health Research trainee award. We would also like to thank the participation of the asthma patients in this study and the clinical support by the following respiratory therapists and technicians: Bev Beaudin, Linda Hui, Louella Markortoff, and Tanja Teofilovic. Finally, we acknowledge the reviewers for their constructive comments.

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Authors and Affiliations

  1. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 7th Floor, 828 West 10th Avenue, Vancouver, BC, Canada, V5Z 1L8

    Helen M. McTaggart-Cowan, Carlo A. Marra, J. Mark FitzGerald & Larry D. Lynd

  2. Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada, V6T 1Z3

    Helen M. McTaggart-Cowan, Jacek A. Kopec & Aslam H. Anis

  3. Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 East Mall, University of British Columbia, Vancouver, BC, Canada, V6T 1Z3

    Carlo A. Marra & Larry D. Lynd

  4. School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK

    Yaling Yang & John E. Brazier

  5. Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, Canada, V6T 1Z3

    J. Mark FitzGerald

Authors
  1. Helen M. McTaggart-Cowan
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  8. Larry D. Lynd
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Correspondence to Larry D. Lynd.

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McTaggart-Cowan, H.M., Marra, C.A., Yang, Y. et al. The validity of generic and condition-specific preference-based instruments: the ability to discriminate asthma control status. Qual Life Res 17, 453–462 (2008). https://doi.org/10.1007/s11136-008-9309-6

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