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Interpreting quality-of-life data: methods for community consensus in asthma
Kathleen W Wyrwich1, Stacie M Metz, Kurt Kroenke
1Department of Research Methodology, Saint Louis University, St Louis, Missouri 63108, USA. wyrwichk@slu.edu
Summary
Consensus on health-related quality of life (HRQoL) thresholds for asthma treatment was not reached between patients, expert physicians, and primary care physicians. Patient perspectives were lower than physician estimates, highlighting a need for better dialogue.
Area of Science:
- Pulmonary Medicine
- Health Outcomes Research
- Patient-Centered Care
Background:
- Health-related quality of life (HRQoL) is a critical outcome in asthma management.
- Establishing consensus on clinically important difference (CID) thresholds for HRQoL changes remains a challenge.
Purpose of the Study:
- To seek consensus on CID thresholds for HRQoL changes from three distinct perspectives: expert physicians, asthma patients, and primary care physicians (PCPs).
Main Methods:
- An expert panel utilized Delphi and consensus methods to determine CID levels for the Asthma Quality of Life Questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey.
- 396 asthma patients and their 46 PCPs participated in bimonthly interviews and assessments over one year.
Main Results:
- Patient-perceived HRQoL estimates were lower than those from expert physicians and PCPs.
- The Short-Form Health Survey demonstrated limited sensitivity in detecting meaningful HRQoL changes.
Conclusions:
- Consensus on interpreting HRQoL measure changes was not achieved.
- This study underscores the importance of integrating patient and physician viewpoints to enhance asthma care and optimize HRQoL.
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