Multicentre development and two-stage validation of a patient-reported outcome measure for chronic obstructive pulmonary disease

> 0.7 across domains except social. Confirmatory factor analysis indicated acceptable model fit (pre-pandemic: CFI = 0.993, RMSEA = 0.014; post-pandemic: CFI = 0.934, RMSEA = 0.054). The COPD-PROM provides a reliable and interpretable measure of health-related quality of life in COPD, supporting patient-centred assessment and individualized management across healthcare settings.