BMC Pulm Med. 2018;18(1):38.

The cutoff point of clinical chronic obstructive pulmonary disease questionnaire for more symptomatic patients.

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제1저자 조용숙 · 교신저자 이창훈

PMID 29482616 PMC5828492 DOI 10.1186/s12890-018-0601-0 IF 3.1 호흡기내과

소속 (5)

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea.
Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea. kauri670@empal.com.

Abstract

BACKGROUND An adequate threshold for the Clinical Chronic Obstructive Pulmonary Disease (COPD) Questionnaire (CCQ) defining more symptomatic COPD patients has not been determined. We aimed to determine the efficacy of the CCQ and the appropriate CCQ threshold for more symptomatic COPD patients.

METHODS COPD patients aged > 40 years who smoked/had smoked ≥10 packs/year were prospectively enrolled over 1 year from three South Korean hospitals (n = 126). Correlations between the CCQ and St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), the modified Medical Round Council (mMRC) scale, lung function, and exercise capacity were evaluated. "More symptomatic patients" were those with an SGRQ score ≥ 25. Area under the receiver operating curve and classification and regression tree analyses were performed to determine the CCQ threshold equivalent to an SGRQ score ≥ 25.

RESULTS The CCQ significantly correlated with the SGRQ, CAT, and mMRC scale (r = 0.76, 0.69, and 0.53, respectively). A CCQ cutoff of 1.4 predicted an SGRQ score of 25 better than others. A CCQ score of 1.4 was a significant determinant of an SGRQ score ≥ 25 even after adjusting for potential confounders.

CONCLUSIONS The CCQ was correlated with other symptom indicators, lung function, and exercise capacity. A CCQ cutoff of 1.4 agreed better than CCQ cutoff of 1.0, suggested by guideline, and this cutoff value may identify more symptomatic COPD patients well.

TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02527486 . Date of registration: December 19, 2014, retrospectively registered.

Keywords

Chronic Obstructive Pulmonary DiseaseClinical QuestionnairesCorrelation studyHealth related quality of life

Figures

**Fig. 1** Patient disposition. Abbreviations: CCQ, Clinical COPD Questionnaire; COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 s; FVC, forced vital capacity; SGRQ, St. George’s Respiratory Disease Questionnaire

**Fig. 2** Correlation between the CCQ and the (a) SGRQ, (b) CAT, and (c) mMRC. a, b CCQ value for SGRQ score of 25, 20 and for CAT score of 10 determined by an area under the receiver operating curve (AUROC) analysis

**Fig. 3** Correlation between the CCQ and the (a) FEV₁% and (b) 6MWD. Abbreviations: CCQ, Clinical Chronic Obstructive Pulmonary Disease Questionnaire; FEV₁, forced expiratory volume in 1 s; 6MWT, 6-min walk test

**Fig. 4** The area under the receiver operating curve to compare the concordance of SGRQ according to CCQ cut-off level. Abbreviations: AUC, area under curve; CCQ, Clinical Chronic Obstructive Pulmonary Disease Questionnaire; SGRQ, St. George’s Respiratory Disease Questionnaire

**Fig. 5** Classification and regression tree analysis of agreement with an SGRQ score ≥ 25 (adjusted by age, sex, body mass index, and FEV₁). Abbreviations: FEV₁, forced expiratory volume in 1 s; SGRQ, St. George’s Respiratory Disease Questionnaire

그림 출처: PubMed Central 공개 논문 (PMC5828492)

Conflict of interest statement

ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This study was approved by the Institutional Review Board (IRB) of Seoul National University Hospital (IRB no. 1602-122-743). CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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