Development and validation of a cough and sputum assessment questionnaire

Abstract

Although cough and sputum production may impact patients' well being and functioning in COPD and chronic bronchitis, there is no validated instrument for cough and sputum symptoms and their impact on patients' daily activities. To fill that gap, we developed and validated a specific, multilingual Cough and Sputum Assessment Questionnaire (CASA-Q) that evaluates clinical symptoms and their impact on patients with COPD or chronic bronchitis. In a three-country validation study (n=671), there was adequate internal consistency (Cronbach's alphas, 0.80-0.91) and test-retest reliability (correlation coefficients>0.70) for the CASA-Q. The cough impact and sputum impact domains correlated with the SGRQ impact domain and SGRQ total score, as did the cough impact domain with the SF-36 social functioning domain. The cough symptom and sputum symptom domains correlated with sputum wet weight (p<0.05; r=-0.56), but not with cough recordings. The mean CASA-Q cough symptom and sputum symptom domain scores indicated responsiveness towards both worse and improved symptoms, whereas the impact domains scored already in the upper third of the scale range, indicating the need for further improvement of its properties. Differences in the CASA-Q domain scores by smoking status (current vs. former smokers) were highest for cough symptoms and lowest for sputum impact. These data indicate that the CASA-Q may be a useful measure of cough and sputum production, and their impact in patients with COPD and/or chronic bronchitis. Further validation will need to assess the responsiveness of the CASA-Q to changes in symptoms.

Validation of the French version of the Leicester Cough Questionnaire in chronic obstructive pulmonary disease

“…This questionnaire was previously validated for cough evaluation. 11 Even though a significant correlation was found between all domains of LCQ and CASA-Q, the hypothesized relationship of LCQ with sputumrelated domains of CASA-Q should be discussed. Indeed, LCQ is specific to cough and its impact on daily life, whilst CASA-Q includes two domains related to sputum symptoms and their impact on daily life.…”

“…For this purpose, the multilingual Cough and Sputum Assessment Questionnaire (CASA-Q) seems the better one as suggested by its name, and it includes evaluation of cough and sputum symptoms and their impact in patients with COPD. 11 Its psychometric properties were assessed. 12 It was validated in seven languages including French.…”

“…12 It was validated in seven languages including French. 11 Nevertheless, LCQ remains the international reference questionnaire for cough evaluation. Then, it is interesting to have a French version of this frequently used questionnaire.…”

Recent advances in COPD: pathophysiology, respiratory physiology and clinical aspects, including comorbidities

“…Studying its relationship with exacerbations is also difficult, since cough and sputum production are themselves features of exacerbations [85]. Finally, there are few tools to assess their clinical impact on patients [88].…”

Validation of a Spanish version of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis

“…Other cough questionnaires have been designed but validation has not been performed in bronchiectasis. [8][9][10] Given that coughing is one of the most frequent symptoms of patients with bronchiectasis 11 and that the LCQ 6 is included as a variable in the studies of these patients, 2,[12][13][14][15][16] and, furthermore, that no Spanish version of the LCQ (LCQ-Sp) has previously been available, the objectives of this study were to create a LCQ-Sp 17,18 and to validate it in patients with NCFBC.…”