Quality of life measured by the St George's Respiratory Questionnaire and spirometry

Abstract

The present authors aimed to determine if the criteria for the diagnosis of chronic obstructive pulmonary disease (COPD) and its classification by severity as recommended by the Global Initiative for Chronic Obstructive Lung Disease are supported by measurements of respiratory health-related quality of life.A community-based sample of adults aged 25-75 yrs had pre-and post-bronchodilator spirometry and completed the St George's Respiratory Questionnaire (SGRQ). Loess scatter plot smoothers of the SGRQ versus post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio and post-bronchodilator FEV1 % predicted together with receiver operating characteristic (ROC) curve analysis were used to determine the relationship between spirometric variables and clinically important differences in the SGRQ score.The scatter plot smoother and ROC curve analyses supported the value of 0.7 for postbronchodilator FEV1/FVC ratio, which was ,4 units higher than the nadir of the SGRQ. To represent a distance of 8 units on the SGRQ, the cut-off points for post-bronchodilator FEV1 that delimit COPD severity stages were 80, 60 and 40% pred for mild, moderate and severe COPD, respectively.To diagnose chronic obstructive pulmonary disease the use of post-bronchodilator forced expiratory volume in one second/forced vital capacity ratio of 0.7 is supported by health-related quality of life measurements. There may be advantages in using forced expiratory volume in one second cut-off points of 80, 60 and 40% predicted for the classification of mild, moderate and severe chronic obstructive pulmonary disease, respectively, similar to the approach recommended for asthma.

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

“…In addition to impact on survival, it is also well recognized that along with increasing severity, COPD has progressive adverse effects on daily symptoms, functional capacity, and health-related quality of life (3,4). Considering these unquestionable aspects of COPD, the patient reported daily symptoms and function status in assessment of the disease has been included in the new Global Initiative on Obstructive Lung Disease (GOLD) classification (5 Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9)(10)(11).…”

“…Significant negative correlation between ∆VO 2 /∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought. Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9-11).…”

Computed tomography (CT) predicts accurately the pathologic tumour size in stage I non-small-cell lung cancer (NSCLC)

“…According to the 7th TNM classifi cation, tumour size was divided into fi ve groups: I tumour <2 cm, II tumour size 2-3 cm, III 3-5 cm, IV 5-7 cm and V >7 cm ( Table 1). The severity of the lung capacity was classifi ed by FEV1 as mild (FEV1<80%), moderate (FEV1 80-60%) or severe (FEV1<40%) [24]. All patients underwent surveillance with CT scan every 3-4 months during the fi rst two years and then every 6 months.…”

Update on the roles of distal airways in COPD

“…In the Wellington Respiratory Survey, WEATHERALL et al [162] compared HRQoL (measured using the St George's Respiratory Questionnaire) and spirometry in .700 subjects selected from a population-based study. Airflow limitation (diagnosed by a post-bronchodilator FEV1/FVC ,0.7) was associated with clinically significant changes in health status [162]. Importantly, HRQoL was significantly altered in COPD subjects with airflow limitation but FEV1 .80%, indicating that many subjects with predominant distal airway impairment have reduced HRQoL.…”