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

Jamuna K. Krishnan; Kayley M. Ancy; Clara Oromendia; Katherine L. Hoffman; Imaani Easthausen; Nancy K. Leidy; MeiLan K. Han; Russell P. Bowler; Stephanie A. Christenson; David J. Couper; Gerard J. Criner; Jeffrey L. Curtis; Mark T. Dransfield; Nadia N. Hansel; Anand S. Iyer; Robert Paine III; Stephen P. Peters; Jadwiga A. Wedzicha; Prescott G. Woodruff; Karla V. Ballman; Fernando J. Martinez; SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators

doi:10.15326/jcopdf.2021.0263

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

Journal article

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

Jamuna K. Krishnan, Kayley M. Ancy, Clara Oromendia, Katherine L. Hoffman, Imaani Easthausen, Nancy K. Leidy, MeiLan K. Han, Russell P. Bowler, Stephanie A. Christenson, David J. Couper, …

Chronic obstructive pulmonary diseases, Vol.9(2), pp.195-208

04/09/2022

DOI: 10.15326/jcopdf.2021.0263

PMCID: PMC9166327

PMID: 35403414

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Abstract

Rationale: It has been suggested that patients with chronic obstructive pulmonary disease (COPD) experience considerable daily respiratory symptom fluctuation. A standardized measure is needed to quantify and understand the implications of day-to-day symptom variability. Objectives: To compare standard deviation with other statistical measures of symptom variability and identify characteristics of individuals with higher symptom variability. Methods: Individuals in the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Exacerbations sub-study completed an Evaluating Respiratory Symptoms in COPD (E-RS) daily questionnaire. We calculated within-subject standard deviation (WS-SD) for each patient at week 0 and correlated this with measurements obtained 4 weeks later using Pearson’s r and Bland Altman plots. Median WS-SD value dichotomized participants into higher versus lower variability groups. Association between WS-SD and exacerbation risk during 4 follow-up weeks was explored. Measurements and Main Results: Diary completion rates were sufficient in 140 (68%) of 205 sub-study participants. Reproducibility (r) of the WS-SD metric from baseline to week 4 was 0.32. Higher variability participants had higher St George’s Respiratory Questionnaire (SGRQ) scores (47.3 ± 20.3 versus 39.6 ± 21.5, p =.04) than lower variability participants. Exploratory analyses found no relationship between symptom variability and health care resource utilization-defined exacerbations. Conclusions: WS-SD of the E-RS can be used as a measure of symptom variability in studies of patients with COPD. Patients with higher variability have worse health-related quality of life. WS-SD should be further validated as a measure to understand the implications of symptom variability.

chronic obstructive pulmonary disease

exacerbations

EXACT

Origianl Research

patient-reported outcomes

symptom variation

Details

Title: Subtitle: Characterizing COPD Symptom Variability in the Stable State Utilizing the Evaluating Respiratory Symptoms in COPD Instrument
Creators: Jamuna K. Krishnan - Cornell University
Kayley M. Ancy - Cornell College
Clara Oromendia - Cornell University
Katherine L. Hoffman - Cornell University
Imaani Easthausen - Cornell University
Nancy K. Leidy - Evidera, Bethesda, Maryland, United States.
MeiLan K. Han - University of Michigan
Russell P. Bowler - National Jewish Health
Stephanie A. Christenson - University of California, San Francisco
David J. Couper - University of North Carolina at Chapel Hill
Gerard J. Criner - Temple University Hospital
Jeffrey L. Curtis - University of Michigan–Ann Arbor
Mark T. Dransfield - University of Alabama at Birmingham
Nadia N. Hansel - Johns Hopkins University
Anand S. Iyer - University of Alabama at Birmingham
Robert Paine III - Division of Pulmonary and Critical Care Medicine, Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City, Utah, United States
Stephen P. Peters - Wake Forest University
Jadwiga A. Wedzicha - National Heart and Lung Institute, Imperial College London, United Kingdom.
Prescott G. Woodruff - University of California, San Francisco
Karla V. Ballman - Cornell University
Fernando J. Martinez - Cornell University
SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators
Contributors: Eric A Hoffman (Contributor) - University of Iowa, Radiology
Resource Type: Journal article
Publication Details: Chronic obstructive pulmonary diseases, Vol.9(2), pp.195-208
DOI: 10.15326/jcopdf.2021.0263
PMID: 35403414
PMCID: PMC9166327
NLM abbreviation: Chronic Obstr Pulm Dis
ISSN: 2372-952X
eISSN: 2372-952X
Publisher: COPD Foundation Inc
Alternative title: COPD Symptom Variability and the E-RS COPD Instrument
Language: English
Date published: 04/09/2022
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984318780002771

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