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The King’s Brief Interstitial Lung Disease (KBILD) questionnaire: an updated minimal clinically important difference
  1. Aish Sinha1,2,
  2. Amit Suresh Patel2,
  3. Richard J Siegert3,
  4. Sabrina Bajwah4,
  5. Toby M Maher5,6,
  6. Elizabeth A Renzoni5,
  7. Athol U Wells5,
  8. Irene J Higginson4 and
  9. Surinder S Birring1,2
  1. 1 Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
  2. 2 Department of Respiratory Medicine, King’s College Hospital, London, UK
  3. 3 Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
  4. 4 Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
  5. 5 Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
  6. 6 National Heart and Lung Institute, Imperial College London, London, UK
  1. Correspondence to Surinder S Birring; surinder.birring{at}


Introduction The King’s Brief Interstitial Lung Disease (KBILD) is a 15-item validated health-related quality of life (HRQOL) questionnaire. The method of scoring the KBILD has recently changed to incorporate a logit-scale transformation from one that used raw item responses, as this is potentially a more linear scale. The aim of this study was to re-evaluate the KBILD minimal clinically important difference (MCID) using the new logit -transformed scoring.

Methods 57 patients with interstitial lung disease (17 idiopathic pulmonary fibrosis, IPF) were asked to complete the KBILD questionnaire on two occasions in outpatient clinics. At the second visit, patients also completed a 15-item global rating of change of health status questionnaire (GRCQ). The MCID was calculated as the mean of four different methods: the change in KBILD for patients indicating a small change in GRCQ, patients with a 7%–12% change in FVC, 1 SE of measurement of baseline KBILD and effect size (ES) of 0.3.

Results The mean (SD) KBILD total score for all patients was 55.3 (15.6). 16 patients underwent a therapeutic intervention. 36 patients reported a change in their condition on the GRCQ; 22 deteriorated, 14 improved and 21 were unchanged. There was a significant change in KBILD total score in patients reporting a change in GRCQ; mean (SD) 57.0 (13.6) versus 50.0 (9.7); mean difference 7.0; 95% CI of difference 3.0 to 11.0; p<0.01. The change in KBILD total score correlated with the GRCQ scale; r=−0.49, p<0.01. The mean KBILD total score MCID was 5. The MCID of KBILD domains were 6 for Psychological, 7 for Breathlessness and Activities, and 11 for Chest Symptoms.

Conclusion The KBILD is a responsive tool for longitudinal assessment of HRQOL in patients with ILD. The MCID of the KBILD total score is a 5-unit change.

  • king’s brief Interstitial lung disease questionnaire
  • minimal clinically important difference
  • interstitial lung disease
  • health related quality of life
  • global rating of change questionnaire

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  • Contributors Conception and design: ASP, SB. Analysis and interpretation: AS, ASP, SB. Drafting of the manuscript for important intellectual content: AS, SB. Revision of manuscript: AS, ASP, RJS, SB, TMM, EAR, AUW, IJH, SSB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests TMM has, via his institution, received industry-academic funding from GlaxoSmithKline R&D and UCB and has received consultancy or speaker's fees from Apellis, Astra Zeneca, Bayer, Biogen Idec, Boehringer Ingelheim, Galapagos, GlaxoSmithKline R&D, Indalo, Pliant, ProMetic, Roche, Samumed and UCB.

  • Patient consent for publication Obtained.

  • Ethics approval This study was approved by London-Surrey Borders research ethics committee (ref: 09/H0806/74).

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

  • Data sharing statement No additional data are available.

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