The St. George's Respiratory Questionnaire (SGRQ) is a standardized questionnaire for measuring impaired health and perceived well-being in chronic airway disease, but it is not available in the Nepali language. We translated the original SGRQ into Nepali and validated its use in 150 individuals aged 40 to 80 years with and without COPD.We also examined if the SGRQ could be used as a screening tool to identify individuals at risk for COPD. We translated the SGRQ following a standard protocol. The validation study was then conducted in both community and hospital-based settings in Nepal. We enrolled 100 participants from a community setting who were not actively seeking medical care, 50 of which met criteria for chronic obstructive pulmonary disease (COPD) (post-bronchodilator forced expiratory volume in 1 second [FEV1]/ forced vital capacity [FVC]<70%) and 50 who did not. We also enrolled 50 participants with an established diagnosis of COPD who attended outpatient pulmonary clinics. All participants completed the questionnaire. We used linear regressions to compare average SGRQ scores by disease status categories and by lung function values, adjusted for age, sex, height and body mass index (BMI).All 150 participants (mean age 59.8 years, 48% male, mean BMI 20.5 kg/m2) completed the SGRQ. In multivariable regression, the average SGRQ total score was 23.9 points higher in established cases of COPD and 18.1 points higher in community cases of COPD when compared to participants without COPD living in the community (all p<0.001). The SGRQ total score also increased by an average of 2.1 points for each 100 mL decrease in post-FEV1 (p<0.001). The area-under-the-curve for the SGRQ total score as a predictor of COPD was 0.77 (95% confidence interval [CI] 0.68 to 0.85) and the optimal cutoff to identify COPD was 33 points.We developed a Nepali-validated version of SGRQ, which correlated well with both disease status and severity.

https://journal.copdfoundation.org/Portals/0/JCOPDF/Files/Volume2-Issue4/JCOPDF-2014-0156-Sherpa.pdf

Validation of the St. George's Respiratory Questionnaire in Nepal.

Introduction Chronic obstructive pulmonary disease (COPD) will soon be the third leading global cause of death and is increasing rapidly in low/middle-income countries There is a need for local validation of the Saint George’s Respiratory Questionnaire (SGRQ), which can be used to identify those experiencing lifestyle impairment due to their breathing Methods The SGRQ was professionally translated into Luganda and reviewed by our field staff and a local pulmonologist Participants included a COPD-confirmed clinic sample and COPD-positive and negative members of the community who were enrolled in the Lung Function in Nakaseke and Kampala (LiNK) Study SGRQs were assembled from all participants, while demographic and spirometry data were additionally collected from LiNK participants Results In total, 103 questionnaires were included in analysis: 49 with COPD from clinic, 34 community COPD-negative and 20 community COPD-positive SGRQ score varied by group: 535 for clinic, 344 for community COPD-positive and 41 for community COPD-negative (p c statistic for SGRQ total score predicting COPD was 087 (95% CI 075 to 100) SGRQ total score was associated with COPD severity (forced expiratory volume in 1 s per cent of predicted), with an r coefficient of −060 (−075, −039) SGRQ score was associated with dyspnoea (OR 105/point; 101, 109) and cough (107; 103, 111) Conclusion Our Luganda language SGRQ accurately distinguishes between COPD-positive and negative community members in rural Uganda Scores were correlated with COPD severity and were associated with odds of dyspnoea and cough We find that it can be successfully used as a respiratory questionnaire for obstructed adults in Uganda

https://bmjopenrespres.bmj.com/content/bmjresp/5/1/e000276.full.pdf

Validation of the Saint George's Respiratory Questionnaire in Uganda

We performed a 1-year cluster-randomized field trial to assess the effect of standardized management of chronic obstructive pulmonary disease (COPD) on lung function and quality of life (QOL) measures in patients in China. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines and assessed indexes including pulmonary function, QOL, quality-adjusted life years (QALY), Medical Research Council (MRC) dyspnea scale, 6-min walk distance (6-MWD), number of emergency visits, and frequency of hospitalization. Of a total of 711 patients with chronic cough and asthma, 132 were diagnosed as having COPD and 102 participated in this study [intervention group (N = 47); control group (N = 55)]. We found that adherence to GOLD guidelines had a perceivable impact on 6-MWD, MRC dyspnea scale score, and QOL. The average QALY increased by 1.42/person/year in the intervention group, but declined by 0.95/person/year in the control group. We conclude that standardized management improves disease severity, QOL, and QALY in COPD patients when treatment protocols adhere to GOLD guidelines.

/pdf/impact-of-adherence-to-gold-guidelines-on-6-minute-walk-1wej6wbjei.pdf

Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb.

The St. George's Respiratory Questionnaire in lymphangioleiomyomatosis.

BACKGROUND Evidence suggests that systemic inflammation may play an important role in the progression and morbidity of chronic obstructive pulmonary disease. It remains controversial whether inhaled corticosteroid in combination with a long-acting beta(2)-adrenoceptor agonist can attenuate systemic inflammation. We evaluated the effect of salmeterol/fluticasone propionate on circulating C-reactive protein level in stable chronic obstructive pulmonary disease patients. METHODS An open-label clinical trial was conducted to recruit 122 outpatients with stable moderate-to-severe chronic obstructive pulmonary disease from department of respiratory medicine in two teaching hospitals between June 2007 and March 2008. Patients were randomized into two groups (1:1) to receive either the combination of 50 microg salmeterol and 500 microg fluticasone twice daily (n = 61), or the combination of 206 microg albuterol and 36 microg ipratropium q.i.d (n = 61) over 6 months. Circulating C-reactive protein concentrations were measured before randomization and during the follow-up. The efficacy of treatment was also assessed by spirometry, as well as health status and dyspnea score at baseline and after 6-month treatment. RESULTS Baseline characteristics of two groups were similar. Compared with ipratropium/albuterol, the combination of salmeterol/fluticasone significantly reduced circulating level of C-reactive protein (-1.73 vs. 0.08 mg/L, respectively, P < 0.05) after 6-month treatment. Forced expiratory volume in one second (FEV(1)) and health status also improved significantly in salmeterol/fluticasone group compared with ipratropium/albuterol. Salmeterol/fluticasone treatment subjects who had a decrease of circulating C-reactive protein level had a significant improvement in FEV(1) and St George's Respiratory Questionnaire total scores compared with those who did not (185 vs. 83 ml and -5.71 vs. -1.79 units, respectively, both P < 0.01). CONCLUSION Salmeterol/fluticasone treatment reduced circulating C-reactive protein concentration in clinically stable moderate-to-severe chronic obstructive pulmonary disease patients after 6-month treatment.

Salmeterol/fluticasone treatment reduces circulating C-reactive protein level in patients with stable chronic obstructive pulmonary disease.

OBJECTIVE To study the value of St George's respiratory questionnaire (SGRQ) in evaluating the life quality of Chinese patients with COPD. METHODS The SGRQ score and spirometry were collected from 30 patients with COPD. The validity was documented by performing correlation analysis, and Pearson's correlation coefficients were calculated. Nineteen patients were reassessed after three months' treatment with inhaled glucocorticoids. Paired t test was performed to evaluate the sensitivity of SGRQ to changes of disease severity. RESULTS The correlation coefficients between the total score and the symptoms section score, the activity section score, and the impacts section score of SGRQ were 0.61, 0.79 and 0.97, respectively. The symptoms section score, the activity section score, the impacts section score, and the total score were significantly correlated with FEV(1)% pred, and with similar coefficients (-0.4 - -0.5, P < 0.05). The result of paired t test showed that the changes of SGRQ between the two assessments were significant (P < 0.001) and consistent with changes of clinical symptoms and spirometry. SGRQ was more sensitive than spirometry in evaluating the changes of disease severity. CONCLUSION SGRQ was a valid, sensitive and feasible method in measuring the quality of life in Chinese patients with COPD. Large-scale application in China needs to be carried out.

[Application of St George's respiratory questionnaire in evaluating the life quality of Chinese patients with chronic obstructive pulmonary disease].

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[Application of St George's respiratory questionnaire in evaluating the life quality of Chinese patients with chronic obstructive pulmonary disease].