The Assessment of Burden of COPD (ABC) Scale: A Reliable and Valid Questionnaire

Annerika Gidding - Slok*, Thomas C. H. Bemelmans, Daniel Kotz, Thys van der Molen, Huib A. M. Kerstjens, Johannes C. C. M. in 't Veen, Niels H. Chavannes, Guus M. Asijee, Maureen P. M. H. Rutten-van Molken, Onno C. P. van Schayck

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The newly developed Assessment of Burden of COPD (ABC) scale is a 14-item self-administered questionnaire which measures the physical, psychological, emotional and/or social burden as experienced by patients with chronic obstructive pulmonary disease (COPD). The ABC scale is part of the ABC tool that visualises the outcomes of the questionnaire. The aim of this study was to assess the reliability and construct validity of the ABC scale. This multi-centre survey study was conducted in the practices of 19 general practitioners and 9 pulmonologists throughout the Netherlands. Next to the ABC scale, patients with COPD completed the Saint George Respiratory Questionnaire (SGRQ). Reliability analyses were performed with data from 162 cases. Cronbach's alpha was 0.91 for the total scale. Test-retest reliability, measured at a two week interval (n = 137), had an intra-class correlation coefficient of 0.92. Analyses for convergent validity were performed with data from 133 cases. Discriminant and known-groups validity was analysed with data from 162 cases. The ABC scale total score had a strong correlation with the total score of the SGRQ (r = 0.72, p <0.001) but a weak correlation with the forced expired volume in 1 second predicted (r = -0.28, p <0.001). Subgroups with more severe disease, defined by GOLD-stage, frequency of exacerbations, activity level and depression scored statistically significantly (p <0.05) worse on almost all domains of the ABC scale than the less severe subgroups. The ABC scale seems a valid and reliable tool with good discriminative properties.
Original languageEnglish
Pages (from-to)431-438
JournalCopd-Journal of Chronic Obstructive Pulmonary Disease
Issue number4
Publication statusPublished - 2016


  • burden of disease
  • integrated health status
  • reliability
  • validity

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