Confirmatory Evaluation of the Modified Medical Research Council Questionnaire for Assessment of Dyspnea in Patients with Chronic Obstructive Pulmonary Disease in Portugal

Abstract

The Modified British Medical Research Council Questionnaire is considered an adequate and simple measure of breathlessness in chronic obstructive pulmonary disease. It is widely used in clinical practice in Portugal, but it still lacks confirmatory evaluation for the Portuguese setting. The aim of this study was to perform a cultural adaptation and validation of the Modified British Medical Research Council Questionnaire so that its most suitable version can be made available to researchers and clinicians in Portugal. Material and Methods: We performed a cross-sectional descriptive study involving patients with chronic obstructive pulmonary disease aged 40 years or older. We applied the Modified British Medical Research Council Questionnaire and the previously validated Portuguese-language version of the clinical questionnaire for chronic obstructive pulmonary disease between January and June 2019. We determined the agreement between the two questionnaires with kappa agreement, with a 95% confidence interval, and we used Spearman correlation to find a correlation between two scores. Results: The study included 65 patients managed in a hospital pulmonology clinic (aged 68 ± 7 years; with predicted FEV1 of 49.86% ± 16.5%). The Modified British Medical Research Council scale correlated significantly with all the domains and the overall score of the clinical questionnaire for chronic obstructive pulmonary disease (0.46 < r < 0.68; p < 0.001). In bilingual patients, interclass correlation coefficient was 0.912 (p < 0.001). Conclusion: The Portuguese version of the Modified British Medical Research Council Questionnaire is a valid instrument for measurement of breathlessness in chronic obstructive pulmonary disease.

Introdução: O Questionário British Medical Research Council (mMRC) Modificado é considerado um instrumento adequado e simples para a medição da dispneia na doença pulmonar obstrutiva crónica (DPOC). Tem sido amplamente usado na prática clínica em Portugal, mas carece de avaliação confirmatória para o cenário português. O objetivo deste estudo é realizar a adaptação cultural e validação do Questionário British Medical Research Council Modificado para que a versão mais adequada possa estar disponível a investigadores e clínicos em Portugal. Material e Métodos: Realizamos um estudo descritivo e transversal com doentes com doença pulmonar obstrutiva crónica e idade ≥ 40 anos. Aplicamos o Questionário British Medical Research Council Modificado e o questionário clínico para a doença pulmonar obstrutiva crónica previamente validado para a língua portuguesa, entre janeiro e junho de 2019. Determinámos a concordância entre os dois questionários com kappa agreement, com 95% de intervalo de confiança, e usámos o coeficiente de correlação de Spearman para determinar a correlação entre os dois scores. Resultados: O estudo incluiu 65 doentes seguidos em consulta hospitalar de Pneumologia (idades de 68 ± 7 anos; com FEV1 49,86% ± 16,5% do predito). A Escala Modificada do British Medical Research Council correlacionou-se significativamente com todos os domínios e pontuação total do questionário clínico (0,46 < r < 0,68; p < 0,001). Nos doentes bilingues, o coeficiente de correlação interclasse foi 0,912 (p < 0,001). Conclusão: A versão portuguesa do Questionário Modificado do British Medical Research Council é um instrumento válido para a medição da dispneia na doença pulmonar obstrutiva crónica.