Sarah Wilke1,2, Dionne E Smid1,2, Martijn A Spruit2, Daisy J A Janssen2,3, Jean W M Muris4, Thys van der Molen5, Marjan van den Akker4,6, Paul W Jones7, Emiel F M Wouters2,8, Frits M E Franssen2. 1. Joint first author. 2. Department of Research and Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands. 3. Centre of Expertise for Palliative Care, Maastricht University Medical Centre, the Netherlands. 4. Caphri School of Public Health and Primary Care, Department of Family Medicine, Maastricht University, the Netherlands. 5. Department of General Practice, University of Groningen, University Medical Centre Groningen, the Netherlands. 6. Department of General Practice, KU Leuven, Leuven, Belgium. 7. Division of Clinical Science, St. George's University of London, United Kingdom. 8. Department of Respiratory Medicine, Maastricht University Medical Centre, the Netherlands.
Abstract
Background: The 2014 updated Global initiative for chronic Obstructive Lung Disease (GOLD) strategy added the St. George's Respiratory Questionnaire (SGRQ) as the fourth possible symptoms measure. The impact of the suggested tools for symptoms of COPD and the different definitions of future risk on the frequency distribution and clinical characteristics of the GOLD groups remain unknown. Methods: Demographic and clinical characteristics were assessed in 542 patients with COPD (57.7% male, age 64.6 [9.0] years, FEV1 54.7 [22.3]% predicted). Health status was assessed by the COPD-specific SGRQ and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale, anxiety (HADS-A) and depression (HADS-D) subscale. Cohen's Kappa was used to assess agreement between groups. Results: Level of agreement in frequency distribution using the modified Medical Research Council dyspnea (mMRC) scale ≥2, COPD Assessment Test (CAT) ≥10, Clinical COPD Questionnaire (CCQ) ≥1 and SGRQ ≥25 was moderate to very good. Best agreement was reached between CCQ and SGRQ (К = 0.838 or 0.851, p<0.001). Patients classified in mMRC GOLD A reported higher SGRQ scores, higher HADS-A and HADS-D scores compared to patients classified in CAT GOLD A or SGRQ GOLD A. Outcomes were comparable between the risk assessment groups. Conclusions: Choice of the symptom measure impacts GOLD groups more than choice of the exacerbation risk assessment. Health care professionals should be aware that patients are heterogeneous in terms of health status and symptoms of anxiety and depression based on the symptom measure used.
Background: The 2014 updated Global initiative for chronic Obstructive Lung Disease (GOLD) strategy added the St. George's Respiratory Questionnaire (SGRQ) as the fourth possible symptoms measure. The impact of the suggested tools for symptoms of COPD and the different definitions of future risk on the frequency distribution and clinical characteristics of the GOLD groups remain unknown. Methods: Demographic and clinical characteristics were assessed in 542 patients with COPD (57.7% male, age 64.6 [9.0] years, FEV1 54.7 [22.3]% predicted). Health status was assessed by the COPD-specific SGRQ and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale, anxiety (HADS-A) and depression (HADS-D) subscale. Cohen's Kappa was used to assess agreement between groups. Results: Level of agreement in frequency distribution using the modified Medical Research Council dyspnea (mMRC) scale ≥2, COPD Assessment Test (CAT) ≥10, Clinical COPD Questionnaire (CCQ) ≥1 and SGRQ ≥25 was moderate to very good. Best agreement was reached between CCQ and SGRQ (К = 0.838 or 0.851, p<0.001). Patients classified in mMRC GOLD A reported higher SGRQ scores, higher HADS-A and HADS-D scores compared to patients classified in CAT GOLD A or SGRQ GOLD A. Outcomes were comparable between the risk assessment groups. Conclusions: Choice of the symptom measure impacts GOLD groups more than choice of the exacerbation risk assessment. Health care professionals should be aware that patients are heterogeneous in terms of health status and symptoms of anxiety and depression based on the symptom measure used.
Entities:
Keywords:
CAT; CCQ; COPD Assessment Test; GOLD; Global initiative for chronic Obstructive Lung Dis; SGRQ; St. George’s Respiratory Questionnaire; chronic obstructive pulmonary disease; clinical COPD questionnaire; copd
Authors: Christina W Hilmarsen; Sarah Wilke; Harald Engan; Martijn A Spruit; Johan Rodenburg; Daisy J A Janssen; Sigurd Steinshamn; Paul W Jones; Emiel F M Wouters; Line Oldervoll; Frits M E Franssen Journal: Eur Respir J Date: 2013-10-10 Impact factor: 16.671
Authors: Alvar Agusti; Lisa D Edwards; Bartolomé Celli; William Macnee; Peter M A Calverley; Hana Müllerova; David A Lomas; Emiel Wouters; Per Bakke; Steve Rennard; Courtney Crim; Bruce E Miller; Harvey O Coxson; Julie C Yates; Ruth Tal-Singer; Jørgen Vestbo Journal: Eur Respir J Date: 2013-06-13 Impact factor: 16.671
Authors: Sarah Houben-Wilke; Daisy J A Janssen; Frits M E Franssen; Lowie E G W Vanfleteren; Emiel F M Wouters; Martijn A Spruit Journal: Health Qual Life Outcomes Date: 2018-10-30 Impact factor: 3.186