Development and validation of a lung transplant-specific disability questionnaire

Area of Science:

• Medical research
• Pulmonary medicine
• Transplant surgery

Background:

• Lung transplantation (LT) aims to improve patient survival and outcomes.
• Patient-centered outcomes (PCOs) like health-related quality of life (HRQL) are crucial post-LT.
• Existing PCO instruments lack validation in LT populations.

Purpose of the Study:

• To develop and validate a shortened, LT-specific version of the valued life activities (VLA) disability scale.
• To create a reliable and efficient measure for assessing PCOs in LT patients.

Main Methods:

• A 15-item LT-specific VLA (LT-VLA) was derived from a 32-item VLA battery using data from 140 LT patients.
• Validity was assessed by correlating LT-VLA scores with HRQL (SF-12 PF), forced vital capacity (FVC%), and 6-minute walk distance (6MWD).
• Responsiveness was evaluated in 84 patients before and after LT.

Main Results:

• The 15-item LT-VLA demonstrated high internal consistency (Cronbach's α=0.92) and correlated strongly with the original VLA (r≥0.96).
• LT-VLA scores showed significant correlations with FVC% (r=-0.30), 6MWD (r=-0.38), and SF-12 PF (r=-0.47) (p<0.01).
• The LT-VLA was responsive to changes post-LT, showing a 63% improvement with an effect size of 1.60.

Conclusions:

• The LT-VLA is a valid, responsive, and brief instrument for measuring PCOs in lung transplant recipients.
• This tool requires minimal administration time (≤3 min) and is suitable for clinical and research use.
• The LT-VLA can aid in evaluating the effectiveness of lung transplantation and guiding patient care.