title: Responsiveness of the cough and sputum assessment questionnaire in exacerbations of COPD and chronic bronchitis.
abstract: BACKGROUND
  To assess the responsiveness of the Cough and Sputum Assessment Questionnaire (CASA-Q) in COPD and chronic bronchitis patients recovering from an acute exacerbation. The 20-item questionnaire with a 7-day recall assesses the frequency and severity of cough and sputum and their impact on everyday life in clinical (trial) settings. The four domains (cough/sputum symptom and impact) use scales from 0 to 100, with lower scores indicating higher symptom/impact levels.
  
  
  METHODS
  Outpatients were enrolled within 48h of symptom onset of their exacerbation. Treatment was initiated at the discretion of the investigator, and patients observed for 6 weeks. During study visits, 59 eligible patients completed the CASA-Q at enrolment, week 1, 2 and 6. Responsiveness was assessed by calculating standardized effect sizes.
  
  
  RESULTS
  Of the 19 male and 40 female patients with a mean (standard deviation, SD) age of 61.1 (10.5) years, all were classified by their physician to have improved or recovered after six weeks. The mean (SD) CASA-Q sores for the cough symptom, cough impact, sputum symptom and sputum impact domains increased from 32.6 (21.0), 40.7 (22.4), 37.4 (20.1), 47.1 (24.2) at enrolment to 54.0 (19.8), 63.7 (21.3), 55.1 (19.0), 65.5 (20.5) at week 6, respectively. Standardized effect sizes for patients improved or recovered from their exacerbation at week 6 were above 1.0 for the cough domains and at least 0.77 for the sputum domains.
  
  
  CONCLUSIONS
  The CASA-Q was responsive to symptom changes in patients recovering from an exacerbation.
authors.affiliation: Boehringer Ingelheim GmbH, Binger Strasse 173, D-55216 Ingelheim, Germany. Brigitta.Monz@boehringer-ingelheim.com
authors.forename: Brigitta U
authors.initials: BU
authors.lastname: Monz
authors.forename: Paul
authors.initials: P
authors.lastname: Sachs
authors.forename: Jeffrey
authors.initials: J
authors.lastname: McDonald
authors.forename: Bruce
authors.initials: B
authors.lastname: Crawford
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nivens
authors.forename: Kay
authors.initials: K
authors.lastname: Tetzlaff
mesh_terms: D029481:Bronchitis, Chronic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D003371:Cough / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011788:Quality of Life; D012720:Severity of Illness Index; D013183:Sputum / Q000378:metabolism*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome