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Development and the initial validation of a new selfadministered questionnaire for an early detection of health status changes in smokers at risk for chronic obstructive pulmonary disease (MARKO questionnaire)

Žarko Vrbica ; Department of Pulmonology and Immunology, General HospitalDubrovnik, Dubrovnik, Croatia
Marina Labor ; Department of Pulmonology University Hospital Center Osijek, Osijek, Croatia
Adrijana Košćec Đuknić ; University of Zagreb Centre for Croatian Studies, Borongaj Campus Zagreb, Croatia
Biserka Radošević-Vidaček ; Institute for Medical Research and Occupational Health, Zagreb, Croatia
Ivan Gudelj ; Department of Pulmonology University Hospital Center Split,Split, Croatia
Slavica Labor ; Department of Pulmonology University Hospital Center Osijek, Osijek, Croatia
Iva Jurić ; Department of Internal Medicine, University Hospital Center Osijek, Osijek, Croatia
Peter MA Calverley ; University of Liverpool, Liverpool, UK
Davor Plavec orcid id ; Research Department, Children’s Hospital Srebrnjak, Zagreb, Croatia

Puni tekst: engleski pdf 132 Kb

str. 425-433

preuzimanja: 421



Aim To develop and do an initial validation of a new simple
tool (self-administered questionnaire) that would be sensitive
and specific enough to detect early changes in smokers
leading to future development of chronic obstructive pulmonary
disease (COPD).
Methods 224 consecutive participants (50.9% women), with
mean ± standard deviation age of 52.3 ± 6.7 years, 37.5 ± 16.7
pack-years smoking history (85.8% active smokers), and no
prior diagnosis of COPD were recruited. The MARKO questionnaire
was self-administered twice; at the general practitioner’s
office and after 2-4 weeks at the tertiary care hospital.
Participants were assessed for COPD by a pulmonologist
after filling in a quality of life (QoL) questionnaires, historytaking,
physical examination, lung function test, 6-minute
walk test, and laboratory tests. They were divided into four
subgroups: “healthy” smokers, symptomatic smokers, and
smokers with mild and moderately severe COPD.
Results Psychometric analyses indicated that the 18-item
questionnaire had a very good internal consistency (Cronbach’s
alpha = 0.91) and test-retest reliability for a four week
period (ρc = 0.89, 95% confidence interval [CI] 0.85-0.92, Lin’s
concordance). A significant correlations of MARKO scores
were found with two QoL questionnaires; r = 0.69 (P < 0.001)
and r = 0.81 (P < 0.001). Receiver operating characteristic
curve analysis showed an area under the curve of 0.753
(95% CI 0.691-0.808, P < 0.001), with a sensitivity of 71.83%
and specificity of 64.24% to discriminate “healthy” smokers
from other subgroups.
Conclusion Based on psychometric analyses and high convergent
validity correlation with already validated QoL questionnaires,
the newly developed MARKO questionnaire was
shown to be a reliable self-administered short health status
assessment tool.

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