Pulmonology · 2026
Measurement properties of the Canadian occupational performance measure and the pulmonary functional status and dyspnea questionnaire-modified version in interstitial lung disease.
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Dias Cíntia, Marinho Raquel, Joaquim Alvarelhão José, Tinoco Eduarda, Alfaro Tiago, Fernandes Vânia, Campainha Sérgio, Burtin Chris, Marques Alda
Аннотация
BACKGROUND: Measurement properties of patient-reported outcome measures assessing functional performance and activity limitations in interstitial lung disease (ILD) are often unknown.
RESEARCH QUESTION: To evaluate the reliability and validity of the Canadian Occupational Performance Measure (COPM) and the Pulmonary Functional Status and Dyspnea Questionnaire-Modified version (PFSDQ-M) in European Portuguese among people with ILD, and to explore differences between fibrotic and non-fibrotic ILD.
STUDY DESIGN AND METHODS: Cross-sectional study. Internal consistency (Cronbach's α), test-retest/intra-rater and inter-rater reliability assessed using intraclass correlation coefficients [ICC2,1[95%CI]], standard error of measurement (SEM), minimal detectable change at 95% confidence level (MDC95) and Bland-Altman analysis, and floor/ceiling effects were evaluated. Construct validity was explored with correlations: convergent validity with the LCADL, CIS-8, 6MWT and 1-minSTS, only for PFSDQ-M; divergent validity with age and lung function for both instruments. Subgroup analyses compared fibrotic and non-fibrotic ILD.
RESULTS: A total of 334 participants were included. The COPM showed moderate test-retest/intra-rater and inter-rater reliability (ICC2,1 = 0.68[0.57-0.77]-0.72[0.63-0.80]), with SEM = 1.08-1.42 and MDC95 = 3.00-3.94, and no floor/ceiling effects. The PFSDQ-M demonstrated excellent internal consistency (α = 0.90-0.96) and good test-retest and inter-rater reliability (ICC2,1 = 0.80[0.74-0.85]-0.92[0.89-0.94]), with SEM = 15.80 and MDC95 = 43.80 for total score. Bland-Altman analysis showed no systematic bias for the COPM and a small bias for the PFSDQ-M test-retest. Moderate-to-strong correlations with LCADL/CIS-8 and weak-to-moderate with 6MWT/1-minSTS supported convergent validity for PFSDQ-M. Negligible-to-weak correlations with age and lung function for COPM and PFSDQ-M supported divergent validity. Subgroup results were similar.
CONCLUSION: The European Portuguese COPM and PFSDQ-M demonstrated reliability. The COPM showed evidence of divergent validity, whereas the PFSDQ-M demonstrated both convergent and divergent validity. These findings support their use for assessing functional performance in people with ILD.
RESEARCH QUESTION: To evaluate the reliability and validity of the Canadian Occupational Performance Measure (COPM) and the Pulmonary Functional Status and Dyspnea Questionnaire-Modified version (PFSDQ-M) in European Portuguese among people with ILD, and to explore differences between fibrotic and non-fibrotic ILD.
STUDY DESIGN AND METHODS: Cross-sectional study. Internal consistency (Cronbach's α), test-retest/intra-rater and inter-rater reliability assessed using intraclass correlation coefficients [ICC2,1[95%CI]], standard error of measurement (SEM), minimal detectable change at 95% confidence level (MDC95) and Bland-Altman analysis, and floor/ceiling effects were evaluated. Construct validity was explored with correlations: convergent validity with the LCADL, CIS-8, 6MWT and 1-minSTS, only for PFSDQ-M; divergent validity with age and lung function for both instruments. Subgroup analyses compared fibrotic and non-fibrotic ILD.
RESULTS: A total of 334 participants were included. The COPM showed moderate test-retest/intra-rater and inter-rater reliability (ICC2,1 = 0.68[0.57-0.77]-0.72[0.63-0.80]), with SEM = 1.08-1.42 and MDC95 = 3.00-3.94, and no floor/ceiling effects. The PFSDQ-M demonstrated excellent internal consistency (α = 0.90-0.96) and good test-retest and inter-rater reliability (ICC2,1 = 0.80[0.74-0.85]-0.92[0.89-0.94]), with SEM = 15.80 and MDC95 = 43.80 for total score. Bland-Altman analysis showed no systematic bias for the COPM and a small bias for the PFSDQ-M test-retest. Moderate-to-strong correlations with LCADL/CIS-8 and weak-to-moderate with 6MWT/1-minSTS supported convergent validity for PFSDQ-M. Negligible-to-weak correlations with age and lung function for COPM and PFSDQ-M supported divergent validity. Subgroup results were similar.
CONCLUSION: The European Portuguese COPM and PFSDQ-M demonstrated reliability. The COPM showed evidence of divergent validity, whereas the PFSDQ-M demonstrated both convergent and divergent validity. These findings support their use for assessing functional performance in people with ILD.