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Observational Study
. 2015 Mar;12(3):332-9.
doi: 10.1513/AnnalsATS.201411-518OC.

Comparison between an alternative and the classic definition of chronic bronchitis in COPDGene

Victor Kim  1 , James Crapo, Huaqing Zhao, Paul W Jones, Edwin K Silverman, Alejandro Comellas, Barry J Make, Gerard J Criner; COPDGene Investigators
Collaborators, Affiliations
Observational Study

Comparison between an alternative and the classic definition of chronic bronchitis in COPDGene

Victor Kim et al. Ann Am Thorac Soc. 2015 Mar.

Abstract

Rationale: Previous studies on chronic bronchitis (CB) have used varying definitions.

Objectives: We sought to compare an alternative CB definition, using the St. George's Respiratory Questionnaire (SGRQ), a commonly used assessment tool, with the classic definition and to investigate if it had independent or additive value.

Methods: We analyzed data from 4,513 subjects from Global Initiative for Chronic Obstructive Lung Disease groups 1 to 4 in the COPDGene cohort. We compared the classic definition of CB with the SGRQ definition, defined by their answers to the questions about both cough and phlegm. We compared the Classic CB+ versus CB- groups, and the SGRQ CB+ and CB- groups. We also analyzed the cohort split into four groups: Classic CB+/SGRQ CB+, Classic CB+/SGRQ CB-, Classic CB-/SGRQ CB+, Classic CB-/SGRQ CB-.

Measurements and main results: A total of 26.1% subjects were Classic CB+, whereas 39.9% were SGRQ CB+. When the SGRQ definition was compared with the Classic CB definition, using this as the gold standard, the SGRQ CB definition had a sensitivity and specificity of 0.87 and 0.77, respectively. The SGRQ CB+ and Classic CB+ groups were strikingly similar, with more respiratory symptoms and exacerbations, worse lung function, and greater airway wall thickness. In addition, the Classic CB+/SGRQ CB+, Classic CB+/SGRQ CB-, and Classic CB-/SGRQ CB+ groups shared similar characteristics as well.

Conclusions: The SGRQ CB definition identifies more subjects with chronic cough and sputum who share a similar phenotype identified by the Classic CB definition. The addition of the SGRQ CB definition to the classic one can be used to identify more patients with chronic obstructive pulmonary disease at risk for poor outcomes.

Keywords: Saint George’s Respiratory Questionnaire; chronic bronchitis; chronic obstructive pulmonary disease.

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Figures

Figure 1.
Figure 1.
Breakdown of patients according to St. George’s Respiratory Questionnaire (SGRQ) and Classic chronic bronchitis (CB) definitions in the entire cohort.
Figure 2.
Figure 2.
Clinical characteristics of each group. CB = chronic bronchitis; GERD = gastroesophageal reflux disease; SOB = shortness of breath; SGRQ = St. George’s Respiratory Questionnaire.
Figure 3.
Figure 3.
Clinical characteristics of groups A (SGRQ+/Classic CB+), B (Classic CB+/SGRQ CB−), C (Classic CB−/SGRQ CB+), and D (SGRQ-/Classic CB−). CB = chronic bronchitis; GERD = gastroesophageal reflux disease; SOB = shortness of breath; SGRQ = St. George’s Respiratory Questionnaire.
See this image and copyright information in PMC

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