Score the LINQ using the scoring template
There are three possible uses:
1)Clinical practice. Preconsulation in routine practice to guide the clinician in guiding optimal education for the patient. Typically the questionnaire will be used on one occasion with the patient, with possible follow up at a later date. The domain scores provide the clinician with guidance about the specific education required for that patient.
2)Audit/quality assurance. In assessing the impact of educational initiatives, such as specialist nurse clinics and pulmonary rehabilitation. When used for this purpose, the LINQ is used before and after the intervention and has been shown to be highly responsive to change. The change between initial and final scores provides information about the population of patients and the effectiveness of the education provided.
3)Health services research. Research into educational policy and management.
1)Responsive to change. The LINQ has been shown to be highly responsive to change compared to health status and exercise tests which are widely used in COPD.
2)It is important. It is an important aspect of patient management which is seldom assessed in contrast to health status and lung function.
3)It is an explanatory variable. It is sometimes difficult to know why an intervention has the effect it does. The use of the LINQ can show whether the effect of the intervention is associated with a reduction in information needs. For example, reduction in hospital admissions in one study of a nurse-led case management programme was shown to be associated with a change in the self-management domain of the LINQ (Gruffydd-Jones K, Richmann J, Jones R, Wang X. The impact of case management of high risk COPD patients, identified by the DOSE index, in a general practice: a pilot study. Family Practice 2010; 27 : 494-498)
We have carried out an informal assessment of Minimal Clinically Important Difference (MCID) for the LINQ. Reports from people with COPD shows that a change of one scale point along in the LINQ, either for any domain score or the total is significant. Thus, MCID – 1 for domain and total scores.
The LINQ is freely available for clinical use and not-for-profit research. It can be downloaded without charge and without the need for permission from this site. For commercial use contact This email address is being protected from spambots. You need JavaScript enabled to view it. .
The questions in the LINQ sometimes refer to information given by health professionals. The word health professional is not a common word to patients (it is to health professionals!). Therefore, we have used the words doctor or nurse as the descriptor of health professional, as this is the description we obtained from patients. We understand that some users of the scale would like to use health professional specific labels (e.g., physiotherapist). We allow common sense modifications of this nature if it is necessary for your purpose, but please be aware that patients are often very ignorant about health professionals affiliations. One cannot rely on patients to accurately know the affiliation of a health professional.
The management of COPD varies slightly between different countries. The questionnaire can be modified, following discussion with Professor Michael Hyland to incorporate local self-management practice.
We allow and encourage translations, and some have already been done and are available on this site
Please follow the following procedures for translations as this will help capture the original spirit of the scale, which is that it should be easy to understand by patients not health professionals!
1. You will need two bilingual people. One translates the questionnaire into the target language and the other translates it back into English (the second should not have seen the original English). Then the two translators meet and discuss discrepancies with the original English and how this can be improved.
2. The translated questionnaire is shown to a focus group of 4-8 patients. Each person completes the questionnaire. Then the moderator asks the patients to discuss each item in turn, to explore whether it is clear, and if not how it can be improved. This procedure may lead to a modification of the questionnaire. A second focus group should then be held to evaluate this modified questionnaire, and so on, until patients are satisfied with the questionnaire.