RT Journal Article
SR Electronic
T1 How different are COPD-specific patient reported outcomes, health status, dyspnoea and respiratory symptoms? An observational study in a working population
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e025132
DO 10.1136/bmjopen-2018-025132
VO 9
IS 7
A1 Koichi Nishimura
A1 Toru Oga
A1 Kazuhito Nakayasu
A1 Miyoko Ogasawara
A1 Yoshinori Hasegawa
A1 Satoshi Mitsuma
YR 2019
UL http://bmjopen.bmj.com/content/9/7/e025132.abstract
AB Objectives We hypothesised that chronic obstructive pulmonary disease (COPD)-specific health status measured by the COPD assessment test (CAT), respiratory symptoms by the evaluating respiratory symptoms in COPD (E-RS) and dyspnoea by Dyspnoea-12 (D-12) are independently based on specific conceptual frameworks and are not interchangeable. We aimed to discover whether health status, dyspnoea or respiratory symptoms could be related to smoking status and airflow limitation in a working population.Design This is an observational, cross-sectional study.Participants 1566 healthy industrial workers were analysed.Results Relationships between D-12, CAT and E-RS total were statistically significant but weak (Spearman’s correlation coefficient=0.274 to 0.446). In 646 healthy non-smoking subjects, as the reference scores for healthy non-smoking subjects, that is, upper threshold, the bootstrap 95th percentile values were 1.00 for D-12, 9.88 for CAT and 4.44 for E-RS. Of the 1566 workers, 85 (5.4%) were diagnosed with COPD using the fixed ratio of the forced expiratory volume in one second/forced vital capacity <0.7, and 34 (2.2%) using the lower limit of normal. The CAT and E-RS total were significantly worse in non-COPD smokers and subjects with COPD than non-COPD never smokers, although the D-12 was not as sensitive. There were no significant differences between non-COPD smokers and subjects with COPD on any of the measures.Conclusions Assessment of health status and respiratory symptoms would be preferable to dyspnoea in view of smoking status and airflow limitation in a working population. However, these patient-reported measures were inadequate in differentiating between smokers and subjects with COPD identified by spirometry.