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Validity of three asthma-specific quality of life questionnaires: the patients' perspective
  1. Christian J Apfelbacher1,2,
  2. Christina J Jones1,
  3. Anthony Frew3,
  4. Helen Smith1
  1. 1Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
  2. 2Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
  3. 3Department of Respiratory Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Christian Apfelbacher; christian.apfelbacher{at}


Objectives It is not known which of the many asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views of three commonly used asthma-specific QoL questionnaires.

Design Qualitative study using semistructured interviews.

Setting Primary and secondary care in Brighton and Hove, UK.

Participants 30 adult people with a physician-diagnosis of asthma who were asked to complete the Juniper Asthma Quality of Life Questionnaire (AQLQ-J), the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ) to elicit their views on the content validity of these.

Results Thematic content analysis revealed a lack of congruence between the concerns of people with asthma and the questionnaire content in terms of missing (eg, allergies) and irrelevant (eg, smoky restaurants) content. The AQLQ-J was perceived as a ‘narrow’, ‘medical’ questionnaire focused on symptoms, the environment and functional ability. In contrast, the LWAQ and the AQLQ-S were perceived to be ‘non-medical’. The LWAQ was described as a ‘test’ and as a wide-ranging, embracing and holistic questionnaire. Its strong emotional focus was irritating to some. The AQLQ-S was described as a simple, quick and easy questionnaire, although there was a perception that it was lacking in depth.

Conclusions Patient interviews highlighted strengths and shortcomings in the content validity of these three asthma-specific questionnaires. For patients, the AQLQ-S content seemed to be the most pertinent in its adequacy of coverage of medical, social and emotional aspects of health-related QoL in asthma.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors CA conceived and designed the study, conducted interviews, analysed and interpreted the data, wrote the manuscript and reviewed it for important intellectual content. CJ conducted interviews, interpreted the data, helped with writing the manuscript and reviewed it for important intellectual content. AF helped with patient recruitment and writing the manuscript and also reviewed it for important intellectual content. HS supervised the concept and design of the study, interpreted the data, wrote the manuscript and reviewed it for important intellectual content. All authors have read and approved the final version of manuscript.

  • Funding The work was supported by a PhD studentship from the University of Brighton, UK.

  • Competing interests None declared.

  • Ethics approval Brighton East Research Ethics Committee, reference number: 10/H1107/38.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data set is available from the authors on request.

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