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Rehab Measures: Chronic Respiratory Disease Questionnaire

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Title of Assessment

Chronic Respiratory Disease Questionnaire 



Instrument Reviewer(s)

Initially reviewed by Jason Barbas, PT, DPT, NCS in 1/2010

Summary Date



The Chronic Respiratory Disease Questionnaire is a disease-specific health-related quality of life questionnaire.  It was developed to measure the impact of Chronic Obstructive Pulmonary Disease (COPD) on a person’s life.


  • Consists of 20 items across four dimensions: dyspnea, fatigue, emotional function, and mastery
  • Originally was administered by a clinician, but has since been modified to a self-report measure
  • The dyspnea portion is individualized to each person: the person is asked to select the 5 activities associated with breathlessness that they perform frequently and are most important to them
  • Dypnea items may be selected from a list of 26 suggested items or may be written in by the patients
  •  Items in each section are scored from 1 (most severe) to 7 (no impairment)

Area of Assessment

Quality of Life 

Body Part

Not Applicable 

ICF Domain

Body Function 


General Health 

Assessment Type

Patient Reported Outcomes 

Length of Test

06 to 30 Minutes 

Time to Administer

30  minutes for first administration; 15 min for subsequent administrations 

Number of Items


Equipment Required

Copy of questionnaire and pen/pencil

Training Required

No Training

Type of training required

No Training 


Not Free 

Actual Cost

License Agreement required.  Information can be found on the American Thoracic Society Website.

Age Range

Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode



Chronic Obstructive Pulmonary Disease; Geriatrics; Pulmonary Disease 

Populations Tested

Individuals with COPD and chronic airflow limiations

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Quality of life:(Jaeschke et al, 1989; a literature review of quality of life instruments)
  • A change in the score of 0.5 on the 7 point scale reflects a clinically significant small change
  • A change of 1.0 reflects a moderate change
  • A difference of 1.5 represents a large change

Minimally Clinically Important Difference (MCID)

COPD: (Redelmeier et al, 1996; n = 112 patients with COPD who were participating in a supervised respiratory rehabilitation and in stable health; mean age = 67 (10) years)

  • MCID = a change of 0.5 per item

Quality of life:(Jaeschke, 1989)

  • MCID = a change of 0.5 per item

Cut-Off Scores

Not Established

Normative Data

COPD:(Rutten-van Molken et al, 1999; n = 144 patients with COPD, broken into three treatment groups; n = 47 taking Salmeterol and Ipatropium Bromide, 47 taking Salmeterol and placebo, and 50 taking placebo and placebo; mean age by treatment group = 63(7.1), 65.4(5.8) and 63.2(7.4) years)

Baseline characteristics of the study population

Normative Data of Study Population:


Rehabilitation group

Control group




Gender M/F



Age yrs



FEV b l




FEV1a l




FEV1 % pred








IVC % pred




TLC %pred




RV/TLC % pred




Cst l·kPa-1




TLCO/VA % pred




All value are expressed as mean±SD. *: p<0.05 unpaired ttest. FEV1b: forced expiratory volume in one second before bronchodilation with two inhalations of 40 μg ipratropium bromide; FEV1a: FEV1 after bronchodilation; % pred: expressed as a percentage of the predicted value; FEV1/IVC %: FEV1 expressed as a percentage of the slow inspiratory vital capacity; TLC: total lung capacity; RV: residual volume; Cst: static lung compliance; TLCO/VA: transfer factor for carbon monoxide divided by alveolar volume.

Test-retest Reliability

COPD: (Wijkstra et al, 1994; n = 43 patient with severe airflow obstruction; mean age = 64(5) years for the rehab group and 62(5) for the control group)

  • Excellent test re-test reliability (rho = 0.90)

COPD: (Williams, 2001; n = 52 patients with COPD; mean age = 66.5(7.9) years)

  • Excellent test re-test reliability for all four dimensions (ICC = 0.83-0.95)

Interrater/Intrarater Reliability

Not Established

Internal Consistency

COPD: (Wijkstra et al, 1994)

  • Adequate to excellent internal consistency for all four dimensions (Cronbach's alpha = 0.71-0.88)

COPD:(Harper et al, 1997; n = 76 men and 80 women with COPD attending routine outpatient clinic; mean age = 67(10.4) years for men and 62(10.3) years for women)

  • Excellent internal consistency for all four dimensions (Cronbach's alpha = 0.8-0.85) 

COPD: (Rutten-van Molken et al, 1999)

  • Excellent internal consistency (Chronbach's alpha = 0.84)

COPD: (Hajiro et al, 1998; n = 143 men with COPD; mean age = 68.8(6.9) years)

  • Excellent internal consistency (Chronbach's alpha = 0.90)

Criterion Validity (Predictive/Concurrent)

Not Established

Construct Validity (Convergent/Discriminant)

COPD: (Hajiro et al, 1998)

  • Adequate construct validity with SCL-90 and SGR  (r = 0.74-0.86)


Content Validity

COPD:(Wijkstra et al, 1994)

  • Poor correlations between CRQ and lung function (PFTs)
  • Poor correlations between CRQ and exercise capacity (6MW, CPET)

Face Validity

Not Established

Floor/Ceiling Effects

Not Established


Chronic airflow limitation: (Guyatt et al, 1987; n = 100 patients with chronic airflow limitation)
  • Responsiveness was tested by administering the questionnaire to 13 patients before and after their drug treatment and to another 28 before and after participation in a respiratory rehabilitation program

  • There were statistically significant improvements in all four dimensions

Professional Association Recommendations


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Guyatt, G. H., Berman, L. B., et al. (1987). "A measure of quality of life for clinical trials in chronic lung disease." Thorax 42(10): 773-778. Find it on PubMed

Hajiro, T., Nishimura, K., et al. (1998). "Comparison of discriminative properties among disease-specific questionnaires for measuring health-related quality of life in patients with chronic obstructive pulmonary disease." Am J Respir Crit Care Med 157(3 Pt 1): 785-790. Find it on PubMed

Harper, R., Brazier, J. E., et al. (1997). "Comparison of outcome measures for patients with chronic obstructive pulmonary disease (COPD) in an outpatient setting." Thorax 52(10): 879-887. Find it on PubMed

Jaeschke, R., Singer, J., et al. (1989). "Measurement of health status. Ascertaining the minimal clinically important difference." Control Clin Trials 10(4): 407-415. Find it on PubMed

). "Assessing the minimal important difference in symptoms: a comparison of two techniques." J Clin Epidemiol 49(11): 1215-1219. Find it on PubMed

Rutten-van Molken, M., Roos, B., et al. (1999). "An empirical comparison of the St George's Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ) in a clinical trial setting." Thorax 54(11): 995-1003. Find it on PubMed

Wijkstra, P. J., TenVergert, E. M., et al. (1994). "Reliability and validity of the chronic respiratory questionnaire (CRQ)." Thorax 49(5): 465-467. Find it on PubMed

Williams, J. E., Singh, S. J., et al. (2001). "Development of a self-reported Chronic Respiratory Questionnaire (CRQ-SR)." Thorax 56(12): 954-959. Find it on PubMed

Year published


Instrument in PDF Format

Approval Status Approved 
Created at 8/2/2012 1:22 PM  by Jason Raad 
Last modified at 12/4/2013 6:00 PM  by Jason Raad