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====== Bronchial Hyperresponsiveness (BHQ) ======

The Bronchial Hyperresponsiveness Questionnaire (BHQ) aims to assess bronchial hyperresponsiveness in patients with asthma ([[sections|section]]: [[diseases & symptoms]]). It is implemented in the [[start|Lifelines]] cohort to assess bronchial hyperresponsiveness in the general population.\\
Note that respiratory symptoms were also assessed using the [[respiratory problems (ELON)|ELON]] instrument and several [[respiratory problems (general)|general questions]]. [[Respiratory diseases]] are also assessed.  


===== Background =====
BHQ is a 34-item condition-specific questionnaire including 15 questions on respiratory symptoms and 19 on provoking stimuli during the past three months. Each question is scored on a 7-point Likert scale ranging from no complaints (1) to severe complaints (7).\\ 
The questionnaire was originally developed in Dutch and was translated in English. It was developed based on a literature review (English), in-depth interviews (Dutch), and a focus group discussion (Dutch) with asthma patients. The questionnaire was based on the PC20-histamine test as the gold standard. Factor analysis was conducted to identify clusters of interrelated questionnaire items. Spearman rank correlation tests were performed to investigate the relation between PC20-histamine levels and the item results ((Riemersma et al. (2009) Development of a questionnaire for the assessment of bronchial hyperresponsiveness. Primary Care Respiratory Medicine 18(4): 287–293)).

===== Variables =====
| **Questions English**                                                                                                     | **Questions Dutch**                                                                                |                        | **Variable**  | **Assessment**  |
| To what extent have you been affected by the following complaints in the past three months?                               | in welke mate heeft u de afgelopen drie maanden last gehad van onderstaande klachten               |                        |               |                 |
| Breathlessness.                                                                                                           | Benauwdheid                                                                                        | bhq_symptoms_adu_q_01  | BHQ1          | [[1C]]          |
| Sleep problems caused by breathlessness.                                                                                  | Slaapproblemen door benauwdheid                                                                    | bhq_symptoms_adu_q_02  | BHQ2          | [[1C]]          |
| Shortness of breath.                                                                                                      | Kortademigheid                                                                                     | bhq_symptoms_adu_q_03  | BHQ3          | [[1C]]          |
| Airway complaints when walking briskly or walking uphill.                                                                 | Luchtwegklachten bij lopen in stevige wandelpas of heuvel op                                       | bhq_symptoms_adu_q_04  | BHQ4          | [[1C]]          |
| Sensation of pressure on the chest.                                                                                       | Gevoel van een band of druk op de borst                                                            | bhq_symptoms_adu_q_05  | BHQ5          | [[1C]]          |
| Chest tightness.                                                                                                          | Beklemmend gevoel                                                                                  | bhq_symptoms_adu_q_06  | BHQ6          | [[1C]]          |
| Pain in the chest.                                                                                                        | Pijn op de borst                                                                                   | bhq_symptoms_adu_q_07  | BHQ7          | [[1C]]          |
| Inability to breathe deeply.                                                                                              | Niet diep kunnen inademen                                                                          | bhq_symptoms_adu_q_08  | BHQ8          | [[1C]]          |
| Breathing consciously and with difficulty.                                                                                | Bewust en met moeite ademen                                                                        | bhq_symptoms_adu_q_09  | BHQ9          | [[1C]]          |
| Throat closing up.                                                                                                        | Dichtslaan                                                                                         | bhq_symptoms_adu_q_10  | BHQ10         | [[1C]]          |
| Wheezing.                                                                                                                 | Piepende ademhaling                                                                                | bhq_symptoms_adu_q_11  | BHQ11         | [[1C]]          |
| Panting.                                                                                                                  | Hijgen                                                                                             | bhq_symptoms_adu_q_12  | BHQ12         | [[1C]]          |
| Hoarseness.                                                                                                               | Heesheid                                                                                           | bhq_symptoms_adu_q_13  | BHQ13         | [[1C]]          |
| Palpitation or fast heart rate.                                                                                           | Hartkloppingen of snelle pols                                                                      | bhq_symptoms_adu_q_14  | BHQ14         | [[1C]]          |
| Hyperventilation or fast breathing.                                                                                       | Hyperventilatie of snelle ademhaling                                                               | bhq_symptoms_adu_q_15  | BHQ15         | [[1C]]          |
| To what extent have the following odors, substances or situations caused you airway complaints in the past three months?  | Bij welke van de onderstaande luchtjes, stoffen of situaties krijgt u klachten van uw luchtwegen?  |                        |               |                 |
| Cat.                                                                                                                      | Kat                                                                                                | bhq_stimuli_adu_q_16   | BHQ16         | [[1C]]          |
| Rodents, such as rabbit, quinea pig, hamster.                                                                             | Knaagdieren, zoals konijn, cavia, hamster                                                          | bhq_stimuli_adu_q_17   | BHQ17         | [[1C]]          |
| Household dust.                                                                                                           | Huisstof                                                                                           | bhq_stimuli_adu_q_18   | BHQ18         | [[1C]]          |
| Mould.                                                                                                                    | Schimmel                                                                                           | bhq_stimuli_adu_q_19   | BHQ19         | [[1C]]          |
| Wool (for example in clothing).                                                                                           | Wol, bijvoorbeeld in kleding                                                                       | bhq_stimuli_adu_q_20   | BHQ20         | [[1C]]          |
| Down pillow/duvet.                                                                                                        | Donzen kussen/dekbed                                                                               | bhq_stimuli_adu_q_21   | BHQ21         | [[1C]]          |
| Grass or hay.                                                                                                             | Gras of hooi                                                                                       | bhq_stimuli_adu_q_22   | BHQ22         | [[1C]]          |
| Pollen.                                                                                                                   | Pollen of stuifmeel                                                                                | bhq_stimuli_adu_q_23   | BHQ23         | [[1C]]          |
| Trees, such as birch, poplar, elm, pine, willow catkins.                                                                  | Bomen, zoals berk, populier, iep, den, wilgekatjes                                                 | bhq_stimuli_adu_q_24   | BHQ24         | [[1C]]          |
| Dusty space.                                                                                                              | Stoffige ruimte                                                                                    | bhq_stimuli_adu_q_25   | BHQ25         | [[1C]]          |
| Moist space indoors, for example an old cellar.                                                                           | Vochtige ruimte binnenshuis, bijvoorbeeld oude kelder                                              | bhq_stimuli_adu_q_26   | BHQ26         | [[1C]]          |
| Fog.                                                                                                                      | Mist                                                                                               | bhq_stimuli_adu_q_27   | BHQ27         | [[1C]]          |
| Change from warm to cold environment.                                                                                     | Overgang van warme naar koude omgeving                                                             | bhq_stimuli_adu_q_28   | BHQ28         | [[1C]]          |
| Change of weather.                                                                                                        | Verandering van weertype                                                                           | bhq_stimuli_adu_q_29   | BHQ29         | [[1C]]          |
| Scent of building materials.                                                                                              | Lucht van bouwstoffen                                                                              | bhq_stimuli_adu_q_30   | BHQ30         | [[1C]]          |
| Scent of petrol.                                                                                                          | Petroleumlucht of olielucht                                                                        | bhq_stimuli_adu_q_31   | BHQ31         | [[1C]]          |
| Scent of ammonia.                                                                                                         | Ammoniakgeur                                                                                       | bhq_stimuli_adu_q_32   | BHQ32         | [[1C]]          |
| Lavatory air freshener.                                                                                                   | Wc-verfrisser                                                                                      | bhq_stimuli_adu_q_33   | BHQ33         | [[1C]]          |
| Hair spray.                                                                                                               | Haarlak                                                                                            | bhq_stimuli_adu_q_34   | BHQ34         | [[1C]]          |
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