The following is a summary of “Responsiveness of the late life disability instrument to pulmonary rehabilitation in people with COPD,” published in the FEBRUARY 2023 issue of Pulmonology by O’Hoski, et al.
For a study, researchers sought to determine in patients with chronic obstructive pulmonary disease (COPD) whether the impairment component of the Late Life Function and Disability Instrument (LLDI) and its computer adaptive test (LLDI-CAT) was responsive.
The LLDI, LLDI-CAT, and scales for assessing physical function, health-related quality of life (HRQOL), and symptom severity were completed by participants before and after pulmonary rehabilitation (PR), as well as the global rating of change (GRC) scale after the conclusion of PR. The LLDI and LLDI-CAT to distinguish between improved versus unchanged participants were examined by calculating correlations between LLDI and LLDI-CAT change scores and change scores on the other measures and by calculating the area under the receiver operating characteristic curve (AUC). They anticipated reasonable correlations (−0.3 to −0.5 or 0.3 to 0.5) with other metrics and thought an AUC of ≥ 0.7 was acceptable. Minimally important differences (MIDs) were assessed using distribution- and anchor-based methods.
The study was completed by 50 individuals with an average age (SD) of 69.8 (7.9) years. Only the limitation dimension of the LLDI showed improvement at follow-up (z = 2.4, P = 0.018), and it was also able to distinguish between individuals who had improved against those who had not (AUC 0.7 (95% CI 0.6-0.9). There were correlations between the change scores for the involvement measures and scores for at least two other variables, as was predicted.
For the LLDI and LLDI-CAT, the study gave MID values to support their clinical applicability. The LLDI’s restriction dimension seemed particularly sensitive to PR in persons with COPD.