Work

Health-related quality of life measures in chronic pulmonary aspergillosis: a systematic review of psychometric validity

Year: 2026

Type: review

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.

Source: European Respiratory Review

DOI: 10.1183/16000617.0039-2026

Authors: Dareen Marghlani, Aran Singanayagam, Zhifang Melody Ni, Darius Armstrong-James, Anand Shah

Institutions: Imperial College London, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7225229296