The development and validation of the Bronchiectasis Health Questionnaire

Article


Spinou, A., Siegert, Richard J., Guan, Wei-jie, Patel, Amit S., Gosker, Harry R., Lee, Kai K., Elston, Caroline, Loebinger, Michael R., Wilson, Robert, Garrod, Rachel and Birring, Surinder S. 2017. The development and validation of the Bronchiectasis Health Questionnaire. European Respiratory Journal. 49 (5), p. 1601532.
AuthorsSpinou, A., Siegert, Richard J., Guan, Wei-jie, Patel, Amit S., Gosker, Harry R., Lee, Kai K., Elston, Caroline, Loebinger, Michael R., Wilson, Robert, Garrod, Rachel and Birring, Surinder S.
Abstract

Health-related quality of life or health status is significantly impaired in bronchiectasis. There is a paucity of brief, simple-to-use, disease-specific health status measures. The aim of this study was to develop and validate the Bronchiectasis Health Questionnaire (BHQ), a new health status measure that is brief and generates a single overall score.

Patients with bronchiectasis were recruited from two outpatient clinics, during a clinically stable stage. The development of the questionnaire followed three phases: item generation and item reduction using Rasch analysis, validation, and repeatability testing. The BHQ was translated into 11 languages using standardised methodology.

206 patients with bronchiectasis completed a preliminary 65-item questionnaire. 55 items were removed due to redundancy or poor fit to the Rasch model. The final version of the BHQ consisted of 10 items. Internal consistency was good (Cronbach's α=0.85). Convergent validity of the BHQ with the St George's Respiratory Questionnaire was high (r= −0.82; p<0.001) and moderate with lung function (forced expiratory volume in 1 s % predicted r= −0.27; p=0.001). There was a significant association between BHQ scores and number of exacerbations of bronchiectasis in the last 12 months (p<0.001), hospital admissions (p=0.001) and computed tomography scan bronchiectasis pulmonary lobe counts (p<0.001). BHQ scores were significantly worse in patients with sputum bacterial colonisation versus no colonisation (p=0.048). The BHQ was highly repeatable after 2 weeks (intraclass correlation coefficient 0.89).

The BHQ is a brief, valid and repeatable, self-completed health status questionnaire for bronchiectasis that generates a single total score. It can be used in the clinic to assess bronchiectasis from the patient's perspective.

JournalEuropean Respiratory Journal
Journal citation49 (5), p. 1601532
ISSN0903-1936
Year2017
PublisherEuropean Respiratory Society
Digital Object Identifier (DOI)doi:10.1183/13993003.01532-2016
Web address (URL)https://doi.org/10.1183/13993003.01532-2016
Publication dates
Online11 May 2017
Publication process dates
Deposited23 Feb 2018
Accepted23 Dec 2016
Accepted23 Dec 2016
Copyright information© 2017 ERS
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