Conclusion Our findings suggest that people with low literacy skills or learning disabilities are left out of the development of PROMs .
Background  Patient-reported outcome measures ( PROMs ) are intended to reflect outcomes relevant to patients .
They are increasingly used for healthcare quality improvement .
To produce valid measures , patients should be involved in the development process but it is unclear whether this usually includes people with low literacy skills or learning disabilities .
The short-form chronic respiratory disease questionnaire was a valid, reliable, and responsive quality-of-life instrument in acute exacerbations of chronic obstructive pulmonary disease.
OBJECTIVE To assess the psychometric properties of the short-form chronic respiratory disease question naire ( SF-CRQ ) as a quality -of-life ( QOL ) instrument in chronic obstructive pulmonary disease ( COPD ) exacerbations . STUDY DESIGN AND SETTING In a prospect i ve multicenter cohort study , consecutive emergency department ( ED ) patients with COPD exacerbation were interviewed using the SF-CRQ and other instruments . Baseline information was collected in the ED and from follow-up data 2 weeks later . The results of the SF-CRQ were compared with the results of the other instruments and clinical variables by correlation and factor analyses . RESULTS Of the 301 enrolled patients , 80 % reported improvements across each of the domains of the SF-CRQ over the 2-week post-ED period . Overall median changes for the dyspnea , fatigue , emotional function , and mastery domains were 2 , 1 , 1 , and 1.5 , respectively ( P<0.001 for each domain ) . Correlation and factor analyses support their convergent/divergent validity and construct validity . The reliability for the change score of the SF-CRQ was high ( Cronbach 's alpha coefficient , 0.82 ) . Overall minimal clinical ly important difference for improvement in the SF-CRQ was 1.01 ( 95 % confidence interval , 0.72 - 1.31 ) . CONCLUSION SF-CRQ is a valid , reliable , and responsive instrument for the assessment of short-term QOL change in patients with COPD exacerbations
Conclusion Our findings suggest that people with low literacy skills or learning disabilities are left out of the development of PROMs .
Background  Patient-reported outcome measures ( PROMs ) are intended to reflect outcomes relevant to patients .
They are increasingly used for healthcare quality improvement .
To produce valid measures , patients should be involved in the development process but it is unclear whether this usually includes people with low literacy skills or learning disabilities .