Measuring disease-specific quality of life in obstructive airway disease: validation of a modified version of the airways questionnaire 20

Chest. 2006 Jun;129(6):1644-52. doi: 10.1378/chest.129.6.1644.


Background: The Airways Questionnaire 20 (AQ20) is a concise measure of health-related quality of life (HRQL) in obstructive airway disease; however, its original format may underestimate impairment due to the complete cessation of certain activities.

Methods: We revised seven items of the original AQ20 (revised AQ20 [AQ20-R]), adding response options for inability to perform certain activities. We assessed the performance of the AQ20-R among 352 adults with various airway conditions identified through a random telephone sample. Concurrent validity of the AQ20-R was assessed relative to the Short Form-12 (SF-12) physical component summary (PCS), FEV(1), and medication use. Predictive validity was assessed relative to health-care utilization among 278 subjects studied longitudinally.

Results: Twenty-one of 352 subjects were unable to perform at least one activity. These subjects demonstrated higher AQ20-R scores (p < 0.001) indicating worse HRQL. Mean (+/- SD) AQ20-R scores differed significantly (p < 0.001) among subjects with COPD (8.9 +/- 5.2), asthma (6.7 +/- 5.0), and chronic bronchitis (4.7 +/- 4.2). At baseline, the AQ20-R correlated with the SF-12 PCS (r = - 0.55, p < 0.001) and FEV(1) (r = - 0.43, p < 0.001), and was associated with the use of respiratory-specific therapies (p </= 0.001). In multivariate models, the AQ20-R was an independent predictor of outpatient visits (odds ratio, 2.2; 95% confidence interval, 1.6 to 3.1), emergency department visits (odds ratio, 2.9; 95% confidence interval, 1.9 to 4.6), hospitalization (odds ratio, 2.8; 95% confidence interval, 1.6 to 4.9), and ICU admission (odds ratio, 3.0; 95% confidence interval, 1.2 to 7.3) during the following year.

Conclusions: The AQ20-R is a valid respiratory-specific HRQL measure that accounts for activity cessation among the most impaired and can be used across various airway conditions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Female
  • Forced Expiratory Volume
  • Health Services / statistics & numerical data
  • Health Status*
  • Humans
  • Lung Diseases, Obstructive / physiopathology*
  • Lung Diseases, Obstructive / psychology
  • Lung Diseases, Obstructive / therapy
  • Male
  • Middle Aged
  • Peak Expiratory Flow Rate
  • Quality of Life*
  • Reproducibility of Results
  • Respiratory System Agents / administration & dosage
  • Severity of Illness Index
  • Surveys and Questionnaires*


  • Respiratory System Agents