Adaptation and validation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for the Netherlands

Abstract

BackgroundThe Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the first disease-specific instrument for pulmonary arterial hypertension (PAH) to assess patient-perceived symptoms, activity limitations and quality of life. To be able to use this questionnaire in the Netherlands, the aim of the study was to translate and validate this instrument for the Dutch-speaking population.MethodsFirst the CAMPHOR was translated into Dutch (by means of a bilingual and a lay panel) and field-tested by means of cognitive debriefing interviews with ten PAH patients. For psychometric evaluation, 80 patients with PAH or chronic thromboembolic pulmonary hypertension (CTEPH) were asked to complete the CAMPHOR twice over a two-week period. To test for construct validity, participants also completed the Nottingham Health Profile (NHP).ResultsThe Dutch version of the CAMPHOR showed high internal consistency for all scales (Cronbach’s alpha 0.89–0.91) and excellent reproducibility over two weeks (reliability coefficients 0.87–0.91). Concurrent validity showed that the CAMPHOR scales correlated as expected with the NHP scales. The CAMPHOR was able to distinguish between patient groups based on self-reported general health status, disease severity and NYHA classification demonstrating evidence of known group validity. The CAMPHOR activity limitations scale correlated moderately with the distance walked during the 6‑minute walk test (r = −0.47, p < 0.01) and the symptoms scale with the Borg dyspnoea score (r = 0.51, p < 0.01).ConclusionThe Dutch version of the CAMPHOR is a reliable and valid measure of quality of life and health status in patients with PAH and CTEPH is recommended for use in routine care and in clinical research.

A minimal clinically important difference measured by the Cambridge Pulmonary Hypertension Outcome Review for patients with idiopathic pulmonary arterial hypertension

“…Whilst this study has a number of strengths, we acknowledge that although patient characteristics were similar to those of well-published PAH cohorts, data from this study originate from a single pulmonary hypertension centre and may therefore be subject to bias. CAMPHOR has also received criticism for being more time intensive than other available pulmonary hypertension QOL measures, however remains the most validated with adaption for use in, but not limited to, the: United States, 39 Australia/New Zealand, 40 Portugal, 41 Germany, 42 Netherlands, 43 Poland, 44 Brazil, 45 Croatia, 46 French/English Canada 47 and Columbia. 48 This provides plentiful opportunity for the external validation of MCID estimates to assess their robustness which is unafforded by other measures at present.…”

Cross-cultural adaptation of the Cambridge Pulmonary Hypertension Outcome Review for use in patients with pulmonary hypertension in Colombia

“…The CAMPHOR has been adapted and validated for use in the United States, 19 Canada, 20 Australia/New Zealand, 21 Germany/Switzerland/Austria, 22 Sweden, 23 Portugal, 24 the Netherlands, 25 and recently in Spain, 26 with all versions having good psychometric properties.…”

Pulmonary hypertension: the importance of a multidisciplinary approach

“…Wapenaar et al. describe the validation of the disease-specific Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for the Dutch population [ 10 ]. Different standard generic questionnaires for heart and lung diseases have been used to report QoL in PH.…”