Health-related quality of life measures in chronic pulmonary aspergillosis: a systematic review of psychometric validity
4 affiliations
- 1Centre for Bacterial Resistance Biology, Department of Infectious Disease, Imperial College London, London, UK
- 2Imperial Fungal Science Network, Department of Infectious Disease, Imperial College London, London, UK
- 3Royal Brompton and Harefield Hospitals, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
- 4London In-Vitro Diagnostic Co-operative, Department of Surgery and Cancer, Imperial College London, London, UK
Abstract
Background/Objective: Chronic pulmonary aspergillosis (CPA) is a chronic progressive fungal lung infection associated with global mortality and impact on health-related quality of life (HRQoL). HRQoL tools are valuable in disease management and as trial end-points; however, use in CPA has not been systematically analysed. We analyse CPA-specific symptoms and strengths and limitations of currently used HRQoL tools focusing on psychometric validity.
Methods: A systematic review of studies reporting HRQoL tools or symptom scores in CPA and published in English (inception to May 2025) was conducted. Eligible studies were categorised into two groups, those employing HRQoL questionnaires (questionnaire-based studies (QBS) and those reporting CPA symptoms to analyse content validity. Narrative synthesis followed Synthesis Without Meta-analysis (SWiM) reporting guidance.
Results: Of 520 studies identified, 64 met inclusion criteria, including 18 QBS. Only generic tools have measured HRQoL in CPA, with St. George's Respiratory Questionnaire (SGRQ) the most common. SGRQ demonstrated excellent internal consistency (Cronbach's alpha 0.94), test–retest reliability (intraclass correlation coefficient 0.97) and an anchor-based minimal clinically important difference of 7.3 points; an >8-unit change in the SGRQ symptoms domain discriminated clinical recurrence at 12 months with 90.9% sensitivity and 87.0% specificity. Significant limitations however remain regarding content validity and usability. Other HRQoL tools or symptom scores used had minimal psychometric validity.
Conclusion: Current CPA HRQoL tools are generic with SGRQ the only tool with psychometric validity but limitations in content validity and usability highlighting the need for development of a CPA-specific HRQoL tool to aid clinical monitoring and standardisation of therapeutic end-points.
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BibTeX
@article{marghlani2026healthrelated,
title = {{Health-related quality of life measures in chronic pulmonary aspergillosis: a systematic review of psychometric validity}},
author = {Dareen Marghlani and Aran Singanayagam and Zhifang Melody Ni and Darius Armstrong-James and Anand Shah},
journal = {European Respiratory Review},
year = {2026},
month = nov,
doi = {10.1183/16000617.0039-2026},
url = {https://doi.org/10.1183/16000617.0039-2026},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Health-related quality of life measures in chronic pulmonary aspergillosis: a systematic review of psychometric validity
AU - Dareen Marghlani
AU - Aran Singanayagam
AU - Zhifang Melody Ni
AU - Darius Armstrong-James
AU - Anand Shah
PY - 2026
DA - 2026/11/04
JO - European Respiratory Review
DO - 10.1183/16000617.0039-2026
UR - https://doi.org/10.1183/16000617.0039-2026
AB - Background/Objective: Chronic pulmonary aspergillosis (CPA) is a chronic progressive fungal lung infection associated with global mortality and impact on health-related quality of life (HRQoL). HRQoL tools are valuable in disease management and as trial end-points; however, use in CPA has not been systematically analysed. We analyse CPA-specific symptoms and strengths and limitations of currently used HRQoL tools focusing on psychometric validity. Methods: A systematic review of studies reporting HRQoL tools or symptom scores in CPA and published in English (inception to May 2025) was conducted. Eligible studies were categorised into two groups, those employing HRQoL questionnaires (questionnaire-based studies (QBS) and those reporting CPA symptoms to analyse content validity. Narrative synthesis followed Synthesis Without Meta-analysis (SWiM) reporting guidance. Results: Of 520 studies identified, 64 met inclusion criteria, including 18 QBS. Only generic tools have measured HRQoL in CPA, with St. George's Respiratory Questionnaire (SGRQ) the most common. SGRQ demonstrated excellent internal consistency (Cronbach's alpha 0.94), test–retest reliability (intraclass correlation coefficient 0.97) and an anchor-based minimal clinically important difference of 7.3 points; an >8-unit change in the SGRQ symptoms domain discriminated clinical recurrence at 12 months with 90.9% sensitivity and 87.0% specificity. Significant limitations however remain regarding content validity and usability. Other HRQoL tools or symptom scores used had minimal psychometric validity. Conclusion: Current CPA HRQoL tools are generic with SGRQ the only tool with psychometric validity but limitations in content validity and usability highlighting the need for development of a CPA-specific HRQoL tool to aid clinical monitoring and standardisation of therapeutic end-points.
SN - 0905-9180
SN - 1600-0617
ER -