Validation of the St. George’s Respiratory Questionnaire in Nepal

Sherpa, Chundak T; LeClerq, Steven L; Singh, Shakuntala A; Naithani, Neha; Pangeni, Raju; Karki, Arjun; Chokhani, Ramesh; Han, MeiLan K.; Gyetko, Margaret R.; Tielsch, James M.; Checkley, William

doi:10.15326/jcopdf.2.4.2014.0156

Cited by 12 publications

(16 citation statements)

References 9 publications

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“…The cross-validated score remained much higher than the 0.77 found by Sherpa et al and the 0.69 found by Weatherall et al . 12 18 One potential contributing factor is that those studies used a fixed cut-off of 70% for FEV 1 /FVC ratio to define COPD whereas we chose to use the lower limit of normal based on the NHANES African-American reference population. 15 …”

Section: Discussionmentioning

confidence: 99%

“…We aimed to collect at least 30 SGRQ tests in each group in order to detect the 16.5-point difference reported in the Nepali SGRQ validation. 12 Finally, a fieldworker was sent to the lung clinic of Mulago National Referral Hospital to recruit a set of 50 individuals with clinic-confirmed COPD. Inclusion criteria included age ≥30 years and ability to provide informed consent.…”

Section: Methodsmentioning

confidence: 99%

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Validation of the Saint George’s Respiratory Questionnaire in Uganda

et al. 2018

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IntroductionChronic obstructive pulmonary disease (COPD) will soon be the third leading global cause of death and is increasing rapidly in low/middle-income countries. There is a need for local validation of the Saint George’s Respiratory Questionnaire (SGRQ), which can be used to identify those experiencing lifestyle impairment due to their breathing.MethodsThe SGRQ was professionally translated into Luganda and reviewed by our field staff and a local pulmonologist. Participants included a COPD-confirmed clinic sample and COPD-positive and negative members of the community who were enrolled in the Lung Function in Nakaseke and Kampala (LiNK) Study. SGRQs were assembled from all participants, while demographic and spirometry data were additionally collected from LiNK participants.ResultsIn total, 103 questionnaires were included in analysis: 49 with COPD from clinic, 34 community COPD-negative and 20 community COPD-positive. SGRQ score varied by group: 53.5 for clinic, 34.4 for community COPD-positive and 4.1 for community COPD-negative (p<0.001). The cross-validated c statistic for SGRQ total score predicting COPD was 0.87 (95% CI 0.75 to 1.00). SGRQ total score was associated with COPD severity (forced expiratory volume in 1 s per cent of predicted), with an r coefficient of −0.60 (−0.75, −0.39). SGRQ score was associated with dyspnoea (OR 1.05/point; 1.01, 1.09) and cough (1.07; 1.03, 1.11).ConclusionOur Luganda language SGRQ accurately distinguishes between COPD-positive and negative community members in rural Uganda. Scores were correlated with COPD severity and were associated with odds of dyspnoea and cough. We find that it can be successfully used as a respiratory questionnaire for obstructed adults in Uganda.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Validation of the Saint George’s Respiratory Questionnaire in Uganda

et al. 2018

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“…(1) can be used to quantify changes in health following treatment, (2) it is not limited to individuals with COPD and (3) it provides a standard metric that can be used for easy comparison across our three diverse settings [33,34]. The EuroQol-5D (EQ-5D) questionnaire will be collected at baseline and quarterly through the trial period.…”

Section: Follow-up Data Collectionmentioning

confidence: 99%

Effectiveness-implementation of COPD case finding and self-management action plans in low- and middle-income countries: global excellence in COPD outcomes (GECo) study protocol

Siddharthan

Pollard²,

Quaderi

et al. 2018

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BackgroundChronic obstructive pulmonary disease (COPD) is the end result of a susceptible individual being exposed to sufficiently deleterious environmental stimuli. More than 90% of COPD-related deaths occur in low- and middle-income countries (LMICs). LMICs face unique challenges in managing COPD; for example, deficient primary care systems present challenges for proper diagnosis and management. Formal diagnosis of COPD requires quality-assured spirometry, which is often limited to urban health centres. Similarly, standard treatment options for COPD remain limited where few providers are trained to manage COPD. The Global Excellence in COPD Outcomes (GECo) studies aim to assess the performance of a COPD case-finding questionnaire with and without peak expiratory flow (PEF) to diagnose COPD, and inform the effectiveness and implementation of COPD self-management Action Plans in LMIC settings. The ultimate goal is to develop simple, low-cost models of care that can be implemented in LMICs. This study will be carried out in Nepal, Peru and Uganda, three distinct LMIC settings.Methods/designWe aim to assess the diagnostic accuracy of a simple questionnaire with and without PEF to case-find COPD (GECo1), and examine the effectiveness, cost-effectiveness and implementation of a community-health-worker-supported self-management Action Plan strategy for managing exacerbations of COPD (GECo2). To achieve the first aim, we will enrol a randomly selected sample of up to 10,500 adults aged ≥ 40 years across our three sites, with the goal to enrol 240 participants with moderate-to-severe COPD in to GECo2. We will apply two case-finding questionnaires (Lung Function Questionnaire and CAPTURE) with and without PEF and compare performance against spirometry. We will report ROC areas, sensitivity and specificity. Individuals who are identified as having COPD grades B–D will be invited to enrol in an effectiveness-implementation hybrid randomised trial of a multi-faceted COPD self-management Action Plan intervention delivered by CHWs. The intervention group will receive (1) COPD education, (2) facilitated-self management Action Plans for COPD exacerbations and (3) monthly visits by community health workers. The control group will receive COPD education and standard of care treatment provided by local health providers. Beginning at baseline, we will measure quality of life with the EuroQol-5D (EQ-5D) and St. George’s Respiratory Questionnaire (SGRQ) every 3 months over a period of 1 year. The primary endpoint is SGRQ at 12 months. Quality-adjusted life years (QALYs) using the Short-Form 36 version 2 will also be calculated. We will additionally assess the acceptability and feasibility of implementing COPD Action Plans in each setting among providers and individuals with COPD.DiscussionThis study should provide evidence to inform the use of pragmatic models of COPD diagnosis and management in LMIC settings.Trial registrationNCT03359915 (GECo1). Registered on 2 December 2017 and NCT03365713 (GECo2). Registered on 7 December 2017. T...

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“…It also correlates well with the SGRQ, and it shows excellent responsiveness before and after chest rehabilitation 10 ) . The SGRQ translated into Nepali has been effectively used in clinical practice in Nepal 11 ) . However, the CAT has not yet been translated into Nepali.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a chest rehabilitation project in Nepal using the St. George’s Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test

et al. 2020

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[Purpose] The incidence of chronic obstructive pulmonary disease is rapidly increasing worldwide. In Nepal, it has the highest mortality rate among all noninfectious diseases. Since 2015, we have been involved in a project that aims to facilitate chest rehabilitation for patients with chronic obstructive pulmonary disease in Nepal. We compared the Nepali version of the St. George’s Respiratory Questionnaire with the Chronic Obstructive Pulmonary Disease Assessment Test, the latter of which was translated into Nepali for this project. We also evaluated the extent to which patient quality of life improved after the rehabilitation program. [Participants and Methods] The Nepali St. George’s Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test were used to assess the health status of patients both before the intervention’s initiation and one year after it. Between May and September of 2016, 122 patients with chronic obstructive pulmonary disease participated in this program. [Results] We collected valid responses from 57 patients both before and after the intervention. The scores of both screening tools were significantly lower after the intervention than before and showed a significant correlation with one another. [Conclusion] These results suggest that the Nepali version of the Chronic Obstructive Pulmonary Disease Assessment Test is a reliable tool for the evaluation of chronic obstructive pulmonary disease and that the intervention used in the project might be effective for patients afflicted with the disease. However, there are limitations to the research design, such as the limited number of participants used in the study.

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Validation of the St. George’s Respiratory Questionnaire in Nepal

Cited by 12 publications

References 9 publications

Validation of the Saint George’s Respiratory Questionnaire in Uganda

Validation of the Saint George’s Respiratory Questionnaire in Uganda

Effectiveness-implementation of COPD case finding and self-management action plans in low- and middle-income countries: global excellence in COPD outcomes (GECo) study protocol

Evaluation of a chest rehabilitation project in Nepal using the St. George’s Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test

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