Correspondence between lung function and symptom measures from the Cystic Fibrosis Respiratory Symptom Diary-Chronic Respiratory Infection Symptom Score (CFRSD-CRISS).


Journal

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
ISSN: 1873-5010
Titre abrégé: J Cyst Fibros
Pays: Netherlands
ID NLM: 101128966

Informations de publication

Date de publication:
11 2019
Historique:
received: 19 02 2019
revised: 17 04 2019
accepted: 13 05 2019
pubmed: 28 5 2019
medline: 11 11 2020
entrez: 26 5 2019
Statut: ppublish

Résumé

Pulmonary exacerbations (PEx) in cystic fibrosis (CF) patients reduce quality of life. Lung function, measured by the percent predicted forced expiratory volume in 1 s (ppFEV1), is widely used to evaluate PEx treatments. We analyzed the correspondence of ppFEV1 with 8 patient-reported symptom-based questions from the Cystic Fibrosis Respiratory Symptom Diary-Chronic Respiratory Infection Symptom Score (CFRSD-CRISS). Data were derived from the observational Standardized Treatment of Pulmonary Exacerbations (STOP) study. CF patients who had CFRSD-CRISS and ppFEV1 measurements on ≥2 timepoints were included: 1) day of initial PEx, 2) 7 days later, and/or 3) end of PEx. We calculated age-stratified Spearman correlation coefficients and 95% confidence intervals (95% CIs) between the change in ppFEV1 and change in CFRSD-CRISS items from index to day 7 and from index to the end of PEx treatment. Lung function and symptom scores improved by the end of treatment; however, correlations between ppFEV1 and the specific CFRSD-CRISS measures were mostly weak to moderate. An exception was that among patients <18, we observed moderately strong correlations between changes in ppFEV1 and cough severity (r = -0.58 (95% CI: -0.80, -0.21)), mucus quantity (r = -0.51 (-0.77, -0.11)), and wheezing (r = -0.53 (-0.78, -0.14)) from index until end of treatment. As novel treatments are developed for PEx, it is important to ensure that improvement is measured meaningfully. The generally weak associations between patient-reported symptoms and ppFEV1 that we found suggest that these measures capture different aspects of the disease and both metrics are important when evaluating new treatments.

Sections du résumé

BACKGROUND
Pulmonary exacerbations (PEx) in cystic fibrosis (CF) patients reduce quality of life. Lung function, measured by the percent predicted forced expiratory volume in 1 s (ppFEV1), is widely used to evaluate PEx treatments. We analyzed the correspondence of ppFEV1 with 8 patient-reported symptom-based questions from the Cystic Fibrosis Respiratory Symptom Diary-Chronic Respiratory Infection Symptom Score (CFRSD-CRISS).
METHODS
Data were derived from the observational Standardized Treatment of Pulmonary Exacerbations (STOP) study. CF patients who had CFRSD-CRISS and ppFEV1 measurements on ≥2 timepoints were included: 1) day of initial PEx, 2) 7 days later, and/or 3) end of PEx. We calculated age-stratified Spearman correlation coefficients and 95% confidence intervals (95% CIs) between the change in ppFEV1 and change in CFRSD-CRISS items from index to day 7 and from index to the end of PEx treatment.
RESULTS
Lung function and symptom scores improved by the end of treatment; however, correlations between ppFEV1 and the specific CFRSD-CRISS measures were mostly weak to moderate. An exception was that among patients <18, we observed moderately strong correlations between changes in ppFEV1 and cough severity (r = -0.58 (95% CI: -0.80, -0.21)), mucus quantity (r = -0.51 (-0.77, -0.11)), and wheezing (r = -0.53 (-0.78, -0.14)) from index until end of treatment.
CONCLUSIONS
As novel treatments are developed for PEx, it is important to ensure that improvement is measured meaningfully. The generally weak associations between patient-reported symptoms and ppFEV1 that we found suggest that these measures capture different aspects of the disease and both metrics are important when evaluating new treatments.

Identifiants

pubmed: 31126901
pii: S1569-1993(19)30113-4
doi: 10.1016/j.jcf.2019.05.009
pmc: PMC6868291
mid: NIHMS1033493
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

886-893

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK089507
Pays : United States

Informations de copyright

Copyright © 2019 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

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Auteurs

Laura S Gold (LS)

Department of Radiology, University of Washington, Seattle, Washington, United States. Electronic address: goldl@uw.edu.

Donald L Patrick (DL)

Department of Health Services, University of Washington, Seattle, Washington, United States. Electronic address: donald@uw.edu.

Ryan N Hansen (RN)

School of Pharmacy, University of Washington, Seattle, Washington, United States. Electronic address: rhansen@uw.edu.

Christopher H Goss (CH)

Departments of Medicine and Pediatrics, University of Washington, Seattle, Washington, United States. Electronic address: goss@uw.edu.

Larry Kessler (L)

Department of Health Services, University of Washington, Seattle, Washington, United States. Electronic address: esslerl@uw.edu.

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