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RehabMeasures Instrument

Chronic Respiratory Disease Questionnaire

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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.

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Instrument Details

Acronym CRQ

Area of Assessment

Quality of Life

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil


Not Free

Cost Description

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


  • Pulmonary Disorders

Key Descriptions

  • 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.
  • Dyspnea 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).

Number of Items


Equipment Required

  • Copy of questionnaire
  • pen/pencil

Time to Administer

15-30 minutes

30 minutes for first administration
15 minutes for subsequent administrations

Required Training

No Training

Age Ranges


18 - 64


Elderly Adult

65 +


Instrument Reviewers

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

ICF Domain

Body Function

Measurement Domain

General Health


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Pulmonary Diseases

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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

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; = 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)

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; = 143 men with COPD; mean age = 68.8(6.9) years)

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

Construct Validity

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)


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

Non-Specific Patient Population

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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)

Quality of life:(Jaeschke, 1989)

  • MCID = a change of 0.5 per item


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

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