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Interpreting thresholds for a clinically significant change in health status in asthma and COPD
Open accessAbstract
Health status (or Health-Related Quality of Life) measurement is an established method for assessing the overall efficacy of treatments for asthma and chronic obstructive pulmonary disease (COPD). Such measurements can indicate the potential clinical significance of a treatment's effect. This paper is concerned with methods of estimating the threshold of clinical significance for three widely used health status questionnaires for asthma and COPD: the Asthma Quality of Life Questionnaire, Chronic Respiratory Questionnaire and St George's Respiratory Questionnaire. It discusses the methodology used to obtain such estimates and shows that the estimates appear to be fairly reliable; i.e. for a given questionnaire, similar estimates may be obtained in different studies. These empirically derived thresholds are all mean estimates with confidence intervals around them. The presence of these confidence intervals affects the way in which the thresholds may be used to draw inferences concerning the clinical relevance of clinical trial results. A new system of judging the magnitude of clinically significant results is proposed. Finally, an attempt is made to translate these thresholds into scenarios that illustrate what a clinically significant change with treatment may mean to an individual patient.
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“SGRQ total score (minimum clinically important difference of 4 units).17”
From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [17]
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“The minimal clinically important difference accepted for this instrument is 0.5 points (26).”
From Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization: A Randomized Study (2016) · cites this paper as [26]
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Long-acting anticholinergic use in chronic obstructive pulmonary disease: efficacy and safety
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The clinical utility of the GOLD classification of COPD disease severity in pulmonary rehabilitation
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Metadata
- Authors
- Jones, P. W.
- Affiliations
- St George's, University of London (GB)
- Corresponding author
- Jones, P.W.
- ORCID
- Jones, P.W.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2002-03
- Volume
- 19
- Issue
- 3
- Pages
- 398-404
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2141887601
- Cited by
- 585
- References
- 22
- Citations by year
- 2026: 12 · 2025: 8 · 2024: 5 · 2023: 11 · 2022: 17 · 2021: 26 · 2020: 40 · 2019: 30 · 2018: 21 · 2017: 33 · 2016: 22 · 2015: 32 · 2014: 40 · 2013: 37 · 2012: 22
- FWCI
- 22.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- clinically significant change, health-related quality of life, asthma, chronic obstructive pulmonary disease, Asthma Quality of Life Questionnaire, Chronic Respiratory Questionnaire, St George's Respiratory Questionnaire, confidence intervals
- MeSH terms
- Asthma, Female, Health Status, Health Status Indicators, Humans, Male, Prognosis, Quality of Life, Surveys and Questionnaires, Respiratory Function Tests, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Confidence Intervals, Treatment Outcome, Patient Satisfaction, Pulmonary Disease, Chronic Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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