Severe Asthma Questionnaire (SAQ)

1. Developed with patients

• Interviews. We spoke to people with severe asthma using semi-structured interviews exploring the impact of their condition on daily life¹. This shaped the first draft of the questionnaire.
• Focus groups. The draft was refined through patient focus groups, improving question wording, structure, number of items, and recall period (e.g. “last 2 weeks” rather than “last 4 weeks”)².

As a result, the SAQ assesses what matters most to patients with severe asthma, in language they find clear and easy to understand.

2. Statistically validated

• Construct validity, internal consistency, discriminant validity and test-retest reliability were established³
• Three subscales — MyLife, MyMind, MyBody — were confirmed through exploratory factor analysis⁴
• Sensitivity to change and Minimum Clinically Important Difference (MCID) were determined⁵
• Early prediction of biologic response. SAQ data can assist earlier assessment (4–8 weeks) of response to biologic treatments for severe asthma⁶

3. Included in the core outcome set for severe asthma

• COMSA. The SAQ is the patient-reported quality-of-life measure in the Core Outcome Measures Set for Severe Asthma (COMSA) — developed by international consensus among clinicians, researchers, patients and pharmaceutical representatives⁷,⁸
• CONFiRM. The SAQ contributes to the CompOsite iNdex For Response in asthMa (CONFiRM), a composite score combining clinical parameters and patient-reported quality of life to quantify individual response to biologic therapy⁹

References

1. Hyland ME, Whalley B, Jones RC, Masoli M. A qualitative study of the impact of severe asthma and its treatment showing that treatment burden is neglected in existing asthma assessment scales. Qual Life Res. 2015;24:631-9. https://doi.org/10.1007/s11136-014-0801-x
2. Hyland ME, Lanario JW, Pooler J, Masoli M, Jones RC. How patient participation was used to develop a questionnaire that is fit for purpose for assessing quality of life in severe asthma. Health Qual Life Outcomes. 2018;16(1):24. https://doi.org/10.1186/s12955-018-0851-9
3. Hyland ME, Jones RC, Lanario JW, Masoli M. The construction and validation of the severe asthma questionnaire (SAQ). Eur Respir J. 2018. https://doi.org/10.1183/13993003.00618-2018
4. Lanario JW, Hyland ME, Menzies-Gow A, Mansur AH, Dodd JW, Fowler SJ, et al. Validation of subscales of the Severe Asthma Questionnaire (SAQ) using exploratory factor analysis (EFA). Health Qual Life Outcomes. 2020 Dec. https://doi.org/10.1186/s12955-020-01593-9
5. Masoli M, Lanario JW, Hyland ME, Menzies-Gow A, Mansur AH, Allen D, et al. The Severe Asthma Questionnaire: sensitivity to change and minimal clinically important difference. Eur Respir J. 2021 Jun 25;57(6):2100300. https://doi.org/10.1183/13993003.00300-2021
6. Davies D, Lanario JW, Hyland ME, Masoli M. Severe Asthma Questionnaire (SAQ) and Asthma Control Questionnaire (ACQ) as Early Predictors of Biologic Response in Severe Asthma. J Asthma Allergy. 2025 Dec 31:743-52. https://doi.org/10.2147/JAA.S490267
7. Khaleva E, Rattu A, Brightling C, Bush A, Bossios A, Bourdin A, et al. Development of Core Outcome Measures sets for paediatric and adult Severe Asthma (COMSA). Eur Respir J. 2023 Apr;61(4):2200606. https://doi.org/10.1183/13993003.00606-2022
8. European Lung Foundation. 3TR researchers have developed the Core Outcome Measures sets for children and adults with Severe Asthma (COMSA). https://europeanlung.org/en/news-and-blog/3tr-researchers-have-developed-the-core-outcome-measures-sets-for-children-and-adults-with-severe-asthma-comsa/
9. Khaleva E, Brightling C, Eiwegger T, Altraja A, Bégin P, Blumchen K, et al. Patient-centred composite scores as tools for assessment of response to biological therapy for paediatric and adult severe asthma. Eur Respir J. 2025;65(3):2400691. https://doi.org/10.1183/13993003.00691-2024