Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)
Abstract Background Recurrent bronchiectasis exacerbations are related to deterioration of lung function, progression of the disease, impairment of quality of life, and to an increased mortality. Improved detection of exacerbations has been accomplished in chronic obstructive pulmonary disease throu...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-01-01
|
| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-019-1272-y |
| _version_ | 1818595711608946688 |
|---|---|
| author | Amaia Artaraz Megan L. Crichton Simon Finch Hani Abo-Leyah Pieter Goeminne Stefano Aliberti Thomas Fardon James D. Chalmers |
| author_facet | Amaia Artaraz Megan L. Crichton Simon Finch Hani Abo-Leyah Pieter Goeminne Stefano Aliberti Thomas Fardon James D. Chalmers |
| author_sort | Amaia Artaraz |
| collection | DOAJ |
| description | Abstract Background Recurrent bronchiectasis exacerbations are related to deterioration of lung function, progression of the disease, impairment of quality of life, and to an increased mortality. Improved detection of exacerbations has been accomplished in chronic obstructive pulmonary disease through the use of patient completed diaries. These tools may enhance exacerbation reporting and identification. The aim of this study was to develop a novel symptom diary for bronchiectasis symptom burden and detection of exacerbations, named the BEST diary. Methods Prospective observational study of patients with bronchiectasis conducted at Ninewells Hospital, Dundee. We included patients with confirmed bronchiectasis by computed tomography, who were symptomatic and had at least 1 documented exacerbation of bronchiectasis in the previous 12 months to participate. Symptoms were recorded daily in a diary incorporating cough, sputum volume, sputum colour, dyspnoea, fatigue and systemic disturbance scored from 0 to 26. Results Twenty-one patients were included in the study. We identified 29 reported (treated exacerbations) and 23 unreported (untreated) exacerbations over 6-month follow-up. The BEST diary score showed a good correlation with the established and validated questionnaires and measures of health status (COPD Assessment Test, r = 0.61, p = 0.0037, Leicester Cough Questionnaire, r = − 0.52,p = 0.0015, St Georges Respiratory Questionnaire, r = 0.61,p < 0.0001 and 6 min walk test, r = − 0.46,p = 0.037). The mean BEST score at baseline was 7.1 points (SD 2.2). The peak symptom score during exacerbation was a mean of 16.4 (3.1), and the change from baseline to exacerbation was a mean of 9.1 points (SD 2.5). Mean duration of exacerbations based on time for a return to baseline symptoms was 15.3 days (SD 5.7). A minimum clinically important difference of 4 points is proposed. Conclusions The BEST symptom diary has shown concurrent validity with current health questionnaires and is responsive at onset and recovery from exacerbation. The BEST diary may be useful to detect and characterise exacerbations in bronchiectasis clinical trials. |
| first_indexed | 2024-12-16T11:20:22Z |
| format | Article |
| id | doaj.art-9cc83ac0fc9a427883a6b9a85063b66c |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-16T11:20:22Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-9cc83ac0fc9a427883a6b9a85063b66c2022-12-21T22:33:29ZengBMCRespiratory Research1465-993X2020-01-012111910.1186/s12931-019-1272-yDevelopment and initial validation of the bronchiectasis exacerbation and symptom tool (BEST)Amaia Artaraz0Megan L. Crichton1Simon Finch2Hani Abo-Leyah3Pieter Goeminne4Stefano Aliberti5Thomas Fardon6James D. Chalmers7Department of Respiratory Medicine, Galdakao-Usansolo HospitalScottish Centre for Respiratory Research, Ninewells Hospital and Medical School, Division of Molecular and Clinical Medicine, University of DundeeScottish Centre for Respiratory Research, Ninewells Hospital and Medical School, Division of Molecular and Clinical Medicine, University of DundeeScottish Centre for Respiratory Research, Ninewells Hospital and Medical School, Division of Molecular and Clinical Medicine, University of DundeeAZ NikolaasDepartment of Pathophysiology and Transplantation, University of MilanScottish Centre for Respiratory Research, Ninewells Hospital and Medical School, Division of Molecular and Clinical Medicine, University of DundeeScottish Centre for Respiratory Research, Ninewells Hospital and Medical School, Division of Molecular and Clinical Medicine, University of DundeeAbstract Background Recurrent bronchiectasis exacerbations are related to deterioration of lung function, progression of the disease, impairment of quality of life, and to an increased mortality. Improved detection of exacerbations has been accomplished in chronic obstructive pulmonary disease through the use of patient completed diaries. These tools may enhance exacerbation reporting and identification. The aim of this study was to develop a novel symptom diary for bronchiectasis symptom burden and detection of exacerbations, named the BEST diary. Methods Prospective observational study of patients with bronchiectasis conducted at Ninewells Hospital, Dundee. We included patients with confirmed bronchiectasis by computed tomography, who were symptomatic and had at least 1 documented exacerbation of bronchiectasis in the previous 12 months to participate. Symptoms were recorded daily in a diary incorporating cough, sputum volume, sputum colour, dyspnoea, fatigue and systemic disturbance scored from 0 to 26. Results Twenty-one patients were included in the study. We identified 29 reported (treated exacerbations) and 23 unreported (untreated) exacerbations over 6-month follow-up. The BEST diary score showed a good correlation with the established and validated questionnaires and measures of health status (COPD Assessment Test, r = 0.61, p = 0.0037, Leicester Cough Questionnaire, r = − 0.52,p = 0.0015, St Georges Respiratory Questionnaire, r = 0.61,p < 0.0001 and 6 min walk test, r = − 0.46,p = 0.037). The mean BEST score at baseline was 7.1 points (SD 2.2). The peak symptom score during exacerbation was a mean of 16.4 (3.1), and the change from baseline to exacerbation was a mean of 9.1 points (SD 2.5). Mean duration of exacerbations based on time for a return to baseline symptoms was 15.3 days (SD 5.7). A minimum clinically important difference of 4 points is proposed. Conclusions The BEST symptom diary has shown concurrent validity with current health questionnaires and is responsive at onset and recovery from exacerbation. The BEST diary may be useful to detect and characterise exacerbations in bronchiectasis clinical trials.https://doi.org/10.1186/s12931-019-1272-yBronchiectasisExacerbationsUnreported exacerbationsSymptom diary |
| spellingShingle | Amaia Artaraz Megan L. Crichton Simon Finch Hani Abo-Leyah Pieter Goeminne Stefano Aliberti Thomas Fardon James D. Chalmers Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) Respiratory Research Bronchiectasis Exacerbations Unreported exacerbations Symptom diary |
| title | Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) |
| title_full | Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) |
| title_fullStr | Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) |
| title_full_unstemmed | Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) |
| title_short | Development and initial validation of the bronchiectasis exacerbation and symptom tool (BEST) |
| title_sort | development and initial validation of the bronchiectasis exacerbation and symptom tool best |
| topic | Bronchiectasis Exacerbations Unreported exacerbations Symptom diary |
| url | https://doi.org/10.1186/s12931-019-1272-y |
| work_keys_str_mv | AT amaiaartaraz developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT meganlcrichton developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT simonfinch developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT haniaboleyah developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT pietergoeminne developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT stefanoaliberti developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT thomasfardon developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest AT jamesdchalmers developmentandinitialvalidationofthebronchiectasisexacerbationandsymptomtoolbest |