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. 2008 Mar 19;3(3):e1802.
doi: 10.1371/journal.pone.0001802.

Validity of the common cold questionnaire (CCQ) in asthma exacerbations

Heather Powell  1 , Joanne Smart, Lisa G Wood, Terry Grissell, Darren R Shafren, Michael J Hensley, Peter G Gibson
Affiliations

Validity of the common cold questionnaire (CCQ) in asthma exacerbations

Heather Powell et al. PLoS One. .

Abstract

Background: The common cold questionnaire (CCQ) is used to discriminate those with and without a viral infection. Its usefulness in people with acute asthma is unknown. Our aim was to assess the ability of the CCQ to detect viral infection and to monitor recovery during a viral induced asthma exacerbation and confirmed by virological testing.

Methodology/principal findings: We studied subjects (> or =7 yrs) admitted to hospital with acute asthma and diagnosed as positive (n = 63), or negative to viral infection (n = 27) according to molecular and virological testing from respiratory samples. CCQ, asthma history and asthma control questionnaires were completed and repeated 4-6 weeks later. Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively. The CCQ did not discriminate between viral and non-viral infection for subjects with asthma (sensitivity = 76.2%; specificity = 29.6%). ROC analysis could not differentiate between positive or negative virus in subjects with asthma. The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms. The CCQ reflected clinical improvement in these subjects, thus providing additional information to complement virological testing.

Conclusions/significance: The CCQ is a useful instrument for monitoring response to viral infection in people with asthma. Reliable differentiation between viral and non-viral asthma exacerbations was not achieved with the CCQ and requires specific virological testing. When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Correlation of Common Cold Total Score and Asthma Control Score for all Subjects
Figure 2
Figure 2. Receiver Operator Curves for Common Cold Score and Virus Result.
A: CCQ (all asthma); B: CCQ (adults); C: CCQ (children); D: CCQ (excl chest symptoms).
Figure 3
Figure 3. Common Cold Questionnaire Median (IQR) Total Score for Visits 1 & 2 for Subjects with Asthma Exacerbation and Viral Respiratory Infection.
* P = 0.0001
See this image and copyright information in PMC

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