Association between health-related quality of life outcomes and pulmonary function testing

Abstract

Introduction

Investigations in associations between subjective health-related quality of life (HRQoL) measures and objective clinical assessments in patients with early-onset scoliosis (EOS) are limited. The purpose of this study is to investigate the association between pulmonary function rated by parents and pulmonary function testing (PFT) in patients with EOS.

Materials/methods

In this cross-sectional study, patients with EOS at any stage of treatment from 2011 to 2018 were identified in 2 registries including 33 centers. Parents’ perception of pulmonary function was evaluated using pulmonary function (PF) domain in the Early-Onset Scoliosis 24 item Questionnaire (EOSQ-24). PFT measures included FVC% predicted, FEV1/FVC, and TLC% predicted. All PFT predicted values utilized arm span. PFT and EOSQ-24 questionnaire were completed within 180 days of each other with an average day difference of 26 days.

Results

176 patients (mean age: 10.4 years old, female: 56%) were identified. 33% of patients were of congenital/structural etiology, 27% neuromuscular, 26% syndromic, and 14% idiopathic. Wide variance and lower scores of PF domain were reported by parents at lower FVC% predicted values (< 50%). As FVC% predicted values increased, PFD scores increased with simultaneous decreases in variance with few exceptions.

Conclusion

More variability and frequent lower pulmonary function values are reported by parents when percent forced vital capacity (FVC%) is < 50%. This likely reflects the degree to which children adapt to restrictive lung disease and the limits on adaptation that occur increasingly as lung function falls below 50% predicted. As a direct linear association with high correlation was expected, more research into the character of what the PF domain is measuring is necessary.

Level of evidence

IV.

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Acknowledgements

Pediatric Spine Study Group: Children’s Spine Foundation, Valley Forge, PA, USA.

Funding

This work was conducted without the support of additional funding.

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HM: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. GM: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. GR: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. JH: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. SL: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. SG: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. DR: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. KW: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. Growing Spine Study Group: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published. Children’s Spine Study Group: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or reviewing it critically for important intellectual content. Final approval of the version to be published.

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Correspondence to Hiroko Matsumoto.

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This work is approved by the Institutional Review Boards at all sites, including Columbia University (Protocol AAA9019).

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Matsumoto, H., Marciano, G., Redding, G. et al. Association between health-related quality of life outcomes and pulmonary function testing. Spine Deform 9, 99–104 (2021). https://doi.org/10.1007/s43390-020-00190-6

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keywords

  • Early-onset scoliosis (EOS)
  • Pulmonary function
  • Early-onset scoliosis 24 item questionnaire (EOSQ-24)
  • Health related quality of life (HRQoL)
  • Forced vitale capacity (FVC)
  • Pulmonary function testing (PFT)