The validity and precision of the Leicester Cough Questionnaire in COPD patients with chronic cough

Farida F Berkhof, Lisenka N Boom, Nynke E ten Hertog, Steven M Uil, Huib A M Kerstjens, Jan W K van den Berg, Farida F Berkhof, Lisenka N Boom, Nynke E ten Hertog, Steven M Uil, Huib A M Kerstjens, Jan W K van den Berg

Abstract

Background: A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated for a population of general patients presenting with chronic cough. We examined the psychometric performance of the LCQ in patients with COPD and chronic productive cough.

Methods: Concurrent validity, internal consistency, reproducibility and responsiveness were determined. The St. George's Respiratory Questionnaire (SGRQ) and the Short Form-36 (SF-36) were used as external criteria. Questionnaires were completed at the start of the study. After 2 and 12 weeks the LCQ was repeated, together with a global rating of change.

Results: In total 54 patients were included. Concurrent validity analysis showed significant correlations between corresponding domains of the LCQ and the SGRQ (r(s) -0.31 to -0.60). Corresponding domains of the LCQ and the SF-36 showed weaker correlations (r(s) 0.04 to 0.41). Internal consistency was adequate for two of the three domains (Cronbach's α 0.74 - 0.86). Test-retest reliability in stable patients was high (intraclass correlation coefficients 0.79 - 0.93). The mean difference after two weeks was 0.73 (± 1.75). Responsiveness analysis indicated that the LCQ was able to detect changes after 12 weeks.

Conclusion: The LCQ is a valid, reliable, responsive instrument to measure health status in COPD patients with chronic productive cough.

Trial registration: ClinicalTrials.gov: NCT01071161.

© 2012 Berkhof et al; licensee BioMed Central Ltd.

Figures

Figure 1
Figure 1
Bland-Altman plot of LCQ total score repeated over 2 weeks in stable patients representing agreement. The mean difference over 2 weeks is represented by the solid line. The dashed lines are the limits of agreement, which represent 2 times the standard deviation of the mean difference.
Figure 2
Figure 2
Receiver Operating Curve for responsiveness of the LCQ total score in COPD patients with chronic cough (n = 49). The Area Under the Curve is 0.85 (95%CI: 0.73; 0.97).

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