Instrument completion and validation of the patient-reported apnea questionnaire (PRAQ)

Background: We previously developed the preliminary version of the Patient-Reported Apnea Questionnaire (PRAQ), a questionnaire measuring health-related quality of life in patients with (suspected) obstructive sleep apnea (OSA). This questionnaire was developed for clinical practice, where it can potentially serve two goals: use on an individual patient level to improve patient care, and use on an aggregate level to measure outcomes for quality improvement at a sleep center. In this study we aim to finalize the PRAQ, make a subselection of items and domains specifically for outcome measurement, and assess the validity, reliability and responsiveness of the PRAQ. Methods: Patients with suspected OSA were included and asked to complete the PRAQ and additional questionnaires one or more times. The collected data was used to perform the final item selection for clinical practice and for outcome measurement, create the domains for outcome measurement, and assess the measurement properties internal consistency, test-retest reliability, convergent validity and responsiveness. Results: 180 patients were included in the study. The final version of the PRAQ for use in clinical practice contains 40 items and 10 domains. A subselection of 33 items in 5 domains was selected for optimal outcome measurement with the PRAQ. The results for the outcome measurement domains were: Cronbach's alpha 0.88-0.95, ICC 0.81-0.88, and > 75% of hypotheses correct for convergent validity and responsiveness. Conclusions: The PRAQ shows good measurement properties in patients with (suspected) OSA.