Why generic and disease-specific quality-of-life instruments should be used together for the evaluation of patients with persistent allergic rhinitis
Article first published online: 21 MAR 2005
Clinical & Experimental Allergy
Volume 35, Issue 3, pages 288–298, March 2005
How to Cite
Leong, K. P., L. Yeak, S. C., M. Saurajen, A. S., H. Mok, P. K., Earnest, A., Siow, J. K., C. Chee, N. W., Yeo, S. B., Khoo, M. L., Y. Lee, J. C., Seshadri, R., Chan, S. P., Tang, C. Y. and Chng, H. H. (2005), Why generic and disease-specific quality-of-life instruments should be used together for the evaluation of patients with persistent allergic rhinitis. Clinical & Experimental Allergy, 35: 288–298. doi: 10.1111/j.1365-2222.2005.02201.x
- Issue published online: 21 MAR 2005
- Article first published online: 21 MAR 2005
- Submitted 24 September 2003; Revised 23 April 2004; Accepted 14 December 2004
- factor analysis;
- Medical Outcome Short-Form 36;
- persistent allergic rhinitis;
- quality of life;
- Rasch modelling;
- Rhinoconjunctivitis Quality-of-Life Questionnaire;
- symptom score
Background The importance of assessing health-related quality of life (HRQL) of patients with allergic rhinitis (AR) has been well established, but the specific roles of rhinitis-specific or general health instruments have not been delineated.
Objective We analysed the psychometric properties of a disease-specific instrument, the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ) and the general health instrument, the Medical Outcome Short-Form 36 (SF-36) as they are employed in combination in patients with persistent AR in clinical practice.
We analysed the data collected from a prospective study of 43 newly diagnosed patients with persistent AR and 44 controls. We interviewed the patients four times, at baseline, weeks 4, 8 and 10.
Results The RQLQ and SF-36 have good discriminative property, internal consistency, and test–retest reliability. The RQLQ is superior to the SF-36 as an evaluative instrument because more of its domains respond to change, the magnitude of change was greater, and the response was faster. The SF-36 is more susceptible to floor and ceiling effects. Both instruments are unsuitable for mildly symptomatic patients based on Rasch model analysis. Each questionnaire assesses a distinct and significant portion of the total HRQL of persistent AR.
Conclusion The SF-36 and RQLQ are good for discriminating rhinitis patients from controls, but the former is poor for detecting changes in QOL. Both are inappropriate for mildly symptomatic patients. Each instrument measures non-overlapping halves of the measurable HRQL. For an assessment of the HRQL in persistent AR that is complete and responsive both instruments should be employed together.