Figure 3. Changes in health-related quality of life and FEV₁ over 1 year. Top. Scores on the St. George's Respiratory Questionnaire (SGRQ). Lower scores indicate improvements in quality of life. P = 0.02 for tiotropium plus placebo versus tiotropium plus salmeterol at 52 weeks; P = 0.01 for tiotropium plus placebo versus tiotropium plus fluticasone–salmeterol at 52 weeks. Bottom. Mean prebronchodilator FEV₁. P = 0.87 tiotropium plus placebo versus tiotropium plus salmeterol at 52 weeks; P = 0.049 tiotropium plus placebo versus tiotropium plus fluticasone–salmeterol at 52 weeks.