Reliability, Validity and Responsiveness of E-RS:COPD in Patients with Spirometric Asthma-COPD Overlap

Overview

Journal Respir Res

Specialty Pulmonary Medicine

Date 2019 Jun 2

PMID 31151458

Citations 7

Authors

Linda M Nelsen

Laurie A Lee

Wei Wu

Xiwu Lin

Lindsey Murray

Steven J Pascoe

Nancy K Leidy

Affiliations

Soon will be listed here.

Abstract

Background: The Evaluating Respiratory Symptoms in Chronic Obstructive Pulmonary Disease (E-RS:COPD) is a patient-reported diary that assesses respiratory symptoms in stable COPD.

Methods: This post hoc analysis of a randomized, double-blind, parallel-arm trial (GSK ID: 200699; NCT02164539) assessed the structure, reliability, validity and responsiveness of the E-RS, and a separate wheeze item, for use in patients with a primary diagnosis of asthma or COPD, but with spirometric characteristics of both (fixed airflow obstruction and reversibility to salbutamol; a subset of patients referred to as spirometric asthma-COPD overlap [ACO]; N = 338).

Results: Factor analysis demonstrated that E-RS included Cough and Sputum, Chest Symptoms, and Breathlessness domains, with a Total score suitable for quantifying overall respiratory symptoms (comparative fit index: 0.9), consistent with the structure shown in COPD. The wheeze item did not fit the model. Total and domain scores were internally consistent (Cronbach's alpha: 0.7-0.9) and reproducible (intra-class correlations > 0.7). Moderate correlations between RS-Total and RS-Breathlessness scores were observed with St George's Respiratory Questionnaire (SGRQ) Total and Activity domain scores at baseline (r = 0.43 and r = 0.48, respectively). E-RS scores were sensitive to change when a patient global impression of change and SGRQ change scores were used to define responders, with changes of ≥ - 1.4 in RS-Total score interpreted as clinically meaningful.

Conclusions: E-RS:COPD scores were reliable, valid and responsive in this sample, suggesting the measure may be suitable for evaluating the severity of respiratory symptoms and the effects of treatment in patients with asthma and COPD that exhibit spirometric characteristics of both fixed airflow obstruction and reversibility. Further study of this instrument and wheeze in new samples of patients with ACO is warranted.

Citing Articles

Interpreting Evaluating Respiratory Symptoms in COPD Diary Scores in Clinical Trials: Terminology, Methods, and Recommendations.

Leidy N, Bushnell D, Thach C, Hache C, Gutzwiller F Chronic Obstr Pulm Dis. 2022; 9(4):576-590.

PMID: 36130315 PMC: 9718578. DOI: 10.15326/jcopdf.2022.0307.

Characterizing COPD Symptom Variability in the Stable State Utilizing the Evaluating Respiratory Symptoms in COPD Instrument.

Krishnan J, Ancy K, Oromendia C, Hoffman K, Easthausen I, Leidy N Chronic Obstr Pulm Dis. 2022; 9(2):195-208.

PMID: 35403414 PMC: 9166327. DOI: 10.15326/jcopdf.2021.0263.

Measuring respiratory symptoms in moderate/severe asthma: evaluation of a respiratory symptom tool, the E-RS®: COPD in asthma populations.

Tabberer M, von Maltzahn R, Bacci E, Karn H, Hsieh R, Howell T J Patient Rep Outcomes. 2021; 5(1):104.

PMID: 34632556 PMC: 8502721. DOI: 10.1186/s41687-021-00338-6.

Use of the Evaluating Respiratory Symptoms™ in COPD as an Outcome Measure in Clinical Trials: A Rapid Systematic Review.

Bushnell D, Wilson R, Gutzwiller F, Leidy N, Hache C, Thach C Chronic Obstr Pulm Dis. 2021; 8(4):551-571.

PMID: 34614551 PMC: 8686855. DOI: 10.15326/jcopdf.2021.0235.

ACO (Asthma-COPD Overlap) Is Independent from COPD: The Case in Favour.

Calverley P, Walker P Diagnostics (Basel). 2021; 11(7).

PMID: 34208874 PMC: 8304638. DOI: 10.3390/diagnostics11071189.

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