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Cross-Atlantic modification and validation of the A Tool to Assess Quality of Life in Idiopathic Pulmonary Fibrosis (ATAQ-IPF-cA)
  1. Janelle Yorke1,2,
  2. Lisa G Spencer3,
  3. Annette Duck2,
  4. Sarah Ratcliffe4,
  5. G NgMan Kwong5,
  6. Mark S Longshaw6,
  7. Amanda Belkin7 and
  8. Jeffrey J Swigris7
  1. 1School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
  2. 2University Hospital of South Manchester Foundation Trust, Manchester, UK
  3. 3Aintree University Hospital NHS Foundation Trust, Liverpool, UK
  4. 4School of Nursing, Midwifery, Social Work and Social Sciences, University of Salford, Salford, UK
  5. 5Pennine Acute NHS Hospitals Trust, Fairfield General Hospital, Bury, UK
  6. 6Intensive Care Unit, North Manchester General Hospital, Manchester, UK
  7. 7Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, , Denver, Colorado, USA
  1. Correspondence to Dr Jeff Swigris; swigrisj{at}


Rationale The A Tool to Assess Quality of Life in Idiopathic Pulmonary Fibrosis (ATAQ-IPF) was developed in the USA to assess health-related quality of life in patients with IPF. It is likely that some of the original ATAQ-IPF items perform differently when applied in different countries. This paper reports results of a study conducted to identify the need to refine the content of the ATAQ-IPF to minimise cross-country bias between the USA and the UK.

Methods The ATAQ-IPF and other study measures were completed by patients attending specialist IPF clinics in the USA and UK. Rasch analysis was used to determine which items performed differently across countries (USA vs UK) and refine the original ATAQ-IPF to an instrument without cross-country bias (ATAQ-IPF-cA). Preliminary validation of the modified instrument was examined by assessing correlations between ATAQ-IPF-cA scores and scores from dyspnoea-specific patient-reported outcome (PRO) measures.

Results 139 patients with IPF (USA=74; UK=65) participated in the study. A total of 41 items and 4 domains were removed from the original, 86-item instrument to yield the 43 items and 10 domains of the ATAQ-IPF-cA. Each domain had good fit to the Rasch model, internal consistency was comparable to the corresponding domains for the original ATAQ-IPF, and validity was supported by significant correlations between its scores and scores from dyspnoea-specific PROs.

Conclusions The reliability and validity of the substantially shortened ATAQ-IPF-cA are acceptable and comparable to the original instrument. We recommend use of the ATAQ-IPF-cA in IPF studies in which participants are enrolled from the USA and UK.

  • Interstitial Fibrosis

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