Cited by 585Chronic Obstructive Pulmonary Disease (COPD) ResearchHealth Systems, Economic Evaluations, Quality of LifeAsthma and respiratory diseases

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Interpreting thresholds for a clinically significant change in health status in asthma and COPD

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Jones, P.W.·2002·European Respiratory Journal

DOI 10.1183/09031936.02.00063702

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Abstract

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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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
DOI: 10.1183/09031936.02.00063702
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

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Interpreting thresholds for a clinically significant change in health status in asthma and COPD

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