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King's Brief Interstitial Lung Disease questionnaire: responsiveness and minimum clinically important difference
Claire M Nolan1,2, Surinder S Birring3, Matthew Maddocks4
1Harefield Pulmonary Rehabilitation and Muscle Research Laboratory, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK c.nolan@rbht.nhs.uk.
The European Respiratory Journal
|June 22, 2019
Summary
The King's Brief Interstitial Lung Disease (KBILD) questionnaire is responsive to pulmonary rehabilitation in patients with interstitial lung disease (ILD). The minimum clinically important difference for the KBILD total score was estimated at 3.9 points.
Area of Science:
- Pulmonary Medicine
- Clinical Trials
- Health Outcomes Research
Background:
- Health status is crucial for assessing symptom burden and clinical trial outcomes in interstitial lung disease (ILD).
- The King's Brief Interstitial Lung Disease (KBILD) questionnaire is a validated tool for measuring health-related quality of life in ILD patients.
- Limited data exist on the minimum clinically important difference (MCID) for the KBILD questionnaire.
Purpose of the Study:
- To determine the responsiveness of the KBILD questionnaire to an intervention.
- To estimate the minimum clinically important difference (MCID) for KBILD scores in patients with ILD.
- To utilize pulmonary rehabilitation as a model to assess KBILD responsiveness and MCID.
Main Methods:
- 209 ILD patients (105 with idiopathic pulmonary fibrosis) completed KBILD, CRQ, MRC Dyspnoea score, and ISWT before and after pulmonary rehabilitation.
- Responsiveness was assessed by changes with intervention and Cohen's effect size.
- MCID estimates were derived using anchor-based and distribution-based approaches.
Main Results:
- KBILD, CRQ, MRC Dyspnoea, and ISWT all showed significant improvement post-intervention.
- KBILD domain and total scores demonstrated effect sizes ranging from 0.28 to 0.38.
- Anchor-based MCID estimates for KBILD-Psychological, KBILD-Breathlessness and activities, and KBILD-Total were 5.4, 4.4, and 3.9 points, respectively.
Conclusions:
- The KBILD questionnaire is responsive to interventions like pulmonary rehabilitation in patients with ILD, including idiopathic pulmonary fibrosis.
- An estimated MCID of 3.9 points for the KBILD total score provides a benchmark for clinical interpretation.
- These findings support the use of KBILD in clinical trials to evaluate treatment effects on health status in ILD.