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Evaluation of the questionnaires’ validity in assessing the severity of idiopathic pulmonary fibrosis in correlation with high-resolution computed tomography, lung diffusion, and cardiopulmonary exercise tests

Abstract

Introduction

Health-related quality-of-life questionnaires need to be incorporated into the evaluations of idiopathic pulmonary fibrosis (IPF) patients to assess their influence.

Aim

The aim of the study was to evaluate the validity of generic and specific questionnaires in assessing the severity of IPF in correlation with high-resolution computed tomography (HRCT), diffusion lung capacity for carbon monoxide (DLCO), and cardiopulmonary exercise testing (CPET).

Patients and methods

Forty stable IPF patients were prospectively recruited and categorized on the basis of spirometry, DLCO, HRCT, and CPET. The results were correlated with a generic International Physical Activity Questionnaire (IPAQ) and a Specific Saint George Respiratory Questionnaire (SGRQ).

Results

IPF patients showed restrictive pattern with impairment of diffusion capacity (forced vital capacity (FVC)= 56±14.8% and DLCO=48.5±20% of predicted value) with a total semiquantitative scoring of HRCT 16.6±8. The mean total score of the SGRQ questionnaire for all studied cases was 56.5+21 and categorical scoring of IPAQ showed that 45, 42.5, and 12.5% of patients were in moderate, severe, and mild categories, respectively. There was a negative correlation between the total score of SGRQ and VO2max (ml/kg/min) (maximum oxygen consumption) (r=−0.35) and VE’ (l/min) (minute ventilation) (r=−0.39) on CPET, as well as with DLCO (r=−0.53), and a positive correlation with HRCT score (r=0.63). There was a highly significant correlation between IPAQ and VO2max (χ2=28), VE’ (χ2=14.8) and desaturation percentage variables of CPET, DLCO (r=0.61), and HRCT score (r=−0.68).

Conclusion

Correlations between physiological parameters including DLCO and CPET, radiological parameters in the form of HRCT, and health-related quality-of-life assessment using SGRQ and IPAQ were strong and it was possible to distinguish IPF patients with severely impaired lung functions.

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Correspondence to Riham H. Raafat MD, PhD.

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El Naggar, T., Said, A.M., Sharkawy, S.H. et al. Evaluation of the questionnaires’ validity in assessing the severity of idiopathic pulmonary fibrosis in correlation with high-resolution computed tomography, lung diffusion, and cardiopulmonary exercise tests. Egypt J Bronchol 11, 141–148 (2017). https://doi.org/10.4103/1687-8426.203798

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Keywords

  • cardiopulmonary exercise test
  • diffusion lung capacity for carbon monoxide
  • International Physical Activity Questionnaire
  • interstitial pulmonary fibrosis
  • Saint George Respiratory Questionnaire