This meta-analysis assessed the relationship between change from baseline (CFB) in spirometric measurements (trough forced expiratory volume in 1 second [FEV] and FEV area under the curve [AUC]) and patient-reported outcomes (St. George's Respiratory Questionnaire total score [SGRQ] CFB, Transition Dyspnea Index [TDI] and exacerbation rates) after 6-12 months' follow-up, using study treatment-group level data. A systematic literature search was performed for randomized controlled trials of ≥24 weeks duration in adults with chronic obstructive pulmonary disease (COPD). Studies reporting ≥1 spirometric measurement and ≥1 patient-reported outcome (PRO) at baseline and at study endpoint were selected. The relationships between PROs and spirometric endpoints were assessed using Pearson correlation coefficient and meta-regression. Fifty-two studies (62,385 patients) were included. Primary weighted analysis conducted at the last assessment showed a large significant negative correlation (r, -0.68 [95% confidence interval (CI); -0.77, -0.57]) between trough FEV and SGRQ. Improvement of 100 mL in trough FEV corresponded to a 5.9 point reduction in SGRQ. Similarly, a reduction of 4 points on SGRQ corresponded to 40 mL improvement in trough FEV (<0.001). The weighted correlation coefficients of trough FEV with TDI, exacerbation rate (all) and exacerbation rate (moderate/severe) at last assessment point were 0.57, -0.69 and -0.57, respectively (all <0.05). For the analyses excluding placebo groups, the correlations of FEV with SGRQ and TDI were lower but significant. A strong association exists between changes in spirometric measurements and changes in PROs.

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This study identified the behavioural and organizational determinants influencing primary care physicians’ attitudes toward vaccination. These attitudes and determinants varied according to diseases and vaccines. The identified determinants and themes were used as a basis for the development of a questionnaire evaluating the Determinant of Vaccination Intentions (DIVA) of primary care physicians.

BackgroundPrimary care physicians (PCPs) play a key role regarding vaccination in France. The aims of the present study were to define the scoring rules and to assess the measurement properties of the ‘Determinants of Intentions to Vaccinate’ (DIVA©) questionnaire that aims to assess PCPs’ attitudes and beliefs toward vaccination.MethodsThe DIVA questionnaire was derived from a literature review and PCPs focus groups. Scoring and early validation of the DIVA questionnaire were determined during a cross-sectional study conducted in France. During the study, PCPs had to complete the DIVA questionnaire for any of the six vaccine-preventable diseases (VPDs) to which they were randomly assigned (measles, pertussis, pneumococcus infection, seasonal influenza, human papillomavirus -HPV- infection and tetanus). Descriptive analyses of items and the analysis of the grouping of items into domains were conducted. Internal consistency reliability and construct validity was assessed according to each VPD.ResultsThe DIVA questionnaire was completed by 1,069 PCPs and was well accepted. The ‘Commitment of the PCP to the vaccination approach’ score showed very good internal consistency reliability (Cronbach’s alpha >0.70 overall and for each VPD). The construct validity of the DIVA questionnaire was confirmed.ConclusionsThe DIVA questionnaire is a valid and reliable measure of PCPs’ attitudes and beliefs toward vaccination.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0539-3) contains supplementary material, which is available to authorized users.

The International Gas Questionnaire is a 2-part instrument, developed rigorously and simultaneously in three languages assessing seven symptoms (17 items) and their impact on 12 domains (26 items) in IBS and general population. It is now undergoing psychometric validation and should provide a unique tool for epidemiological surveys and clinical trials for developing new treatments for these symptoms.