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Validity of the common cold questionnaire (CCQ) in asthma exacerbations.

Powell H, Smart J, Wood LG, Grissell T, Shafren DR, Hensley MJ, Gibson PG - PLoS ONE (2008)

Bottom Line: Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively.The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms.When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton, New South Wales, Australia.

ABSTRACT

Background: The common cold questionnaire (CCQ) is used to discriminate those with and without a viral infection. Its usefulness in people with acute asthma is unknown. Our aim was to assess the ability of the CCQ to detect viral infection and to monitor recovery during a viral induced asthma exacerbation and confirmed by virological testing.

Methodology/principal findings: We studied subjects (> or =7 yrs) admitted to hospital with acute asthma and diagnosed as positive (n = 63), or negative to viral infection (n = 27) according to molecular and virological testing from respiratory samples. CCQ, asthma history and asthma control questionnaires were completed and repeated 4-6 weeks later. Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively. The CCQ did not discriminate between viral and non-viral infection for subjects with asthma (sensitivity = 76.2%; specificity = 29.6%). ROC analysis could not differentiate between positive or negative virus in subjects with asthma. The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms. The CCQ reflected clinical improvement in these subjects, thus providing additional information to complement virological testing.

Conclusions/significance: The CCQ is a useful instrument for monitoring response to viral infection in people with asthma. Reliable differentiation between viral and non-viral asthma exacerbations was not achieved with the CCQ and requires specific virological testing. When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.

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Related in: MedlinePlus

Correlation of Common Cold Total Score and Asthma Control Score for all Subjects
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pone-0001802-g001: Correlation of Common Cold Total Score and Asthma Control Score for all Subjects

Mentions: The total CCQ score demonstrated a weak and clinically significant correlation to asthma control score (spearman's rho (95%CI) = 0.35 (0.14 to 0.53), Figure 1). There was no correlation between total CCQ score and percent-predicted FEV1 (spearman's rho = 0.03, p = 0.821) and no significant difference in score between exacerbations classified as mild, moderate, or severe based on their percent-predicted FEV1 at admission (≥80%; ≥60<80%; <60%) (p = 0.08).


Validity of the common cold questionnaire (CCQ) in asthma exacerbations.

Powell H, Smart J, Wood LG, Grissell T, Shafren DR, Hensley MJ, Gibson PG - PLoS ONE (2008)

Correlation of Common Cold Total Score and Asthma Control Score for all Subjects
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2266793&req=5

pone-0001802-g001: Correlation of Common Cold Total Score and Asthma Control Score for all Subjects
Mentions: The total CCQ score demonstrated a weak and clinically significant correlation to asthma control score (spearman's rho (95%CI) = 0.35 (0.14 to 0.53), Figure 1). There was no correlation between total CCQ score and percent-predicted FEV1 (spearman's rho = 0.03, p = 0.821) and no significant difference in score between exacerbations classified as mild, moderate, or severe based on their percent-predicted FEV1 at admission (≥80%; ≥60<80%; <60%) (p = 0.08).

Bottom Line: Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively.The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms.When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton, New South Wales, Australia.

ABSTRACT

Background: The common cold questionnaire (CCQ) is used to discriminate those with and without a viral infection. Its usefulness in people with acute asthma is unknown. Our aim was to assess the ability of the CCQ to detect viral infection and to monitor recovery during a viral induced asthma exacerbation and confirmed by virological testing.

Methodology/principal findings: We studied subjects (> or =7 yrs) admitted to hospital with acute asthma and diagnosed as positive (n = 63), or negative to viral infection (n = 27) according to molecular and virological testing from respiratory samples. CCQ, asthma history and asthma control questionnaires were completed and repeated 4-6 weeks later. Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively. The CCQ did not discriminate between viral and non-viral infection for subjects with asthma (sensitivity = 76.2%; specificity = 29.6%). ROC analysis could not differentiate between positive or negative virus in subjects with asthma. The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms. The CCQ reflected clinical improvement in these subjects, thus providing additional information to complement virological testing.

Conclusions/significance: The CCQ is a useful instrument for monitoring response to viral infection in people with asthma. Reliable differentiation between viral and non-viral asthma exacerbations was not achieved with the CCQ and requires specific virological testing. When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.

Show MeSH
Related in: MedlinePlus