Powell Heather, Smart Joanne, Wood Lisa G, Grissell Terry, Shafren Darren R, Hensley Michael J, Gibson Peter G
Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, New Lambton, New South Wales, Australia.
PLoS One. 2008 Mar 19;3(3):e1802. doi: 10.1371/journal.pone.0001802.
The common cold questionnaire (CCQ) is used to discriminate those with and without a viral infection. Its usefulness in people with acute asthma is unknown. Our aim was to assess the ability of the CCQ to detect viral infection and to monitor recovery during a viral induced asthma exacerbation and confirmed by virological testing.
METHODOLOGY/PRINCIPAL FINDINGS: We studied subjects (> or =7 yrs) admitted to hospital with acute asthma and diagnosed as positive (n = 63), or negative to viral infection (n = 27) according to molecular and virological testing from respiratory samples. CCQ, asthma history and asthma control questionnaires were completed and repeated 4-6 weeks later. Sensitivity, specificity, and response to change of the CCQ were assessed by receiver operator curve (ROC) analysis and effect size calculation respectively. The CCQ did not discriminate between viral and non-viral infection for subjects with asthma (sensitivity = 76.2%; specificity = 29.6%). ROC analysis could not differentiate between positive or negative virus in subjects with asthma. The CCQ had a large response to change following recovery (effect size = 1.01). 39% of subjects recovering from viral exacerbation remained positive to virological testing at follow-up despite improvement in clinical symptoms. The CCQ reflected clinical improvement in these subjects, thus providing additional information to complement virological testing.
CONCLUSIONS/SIGNIFICANCE: The CCQ is a useful instrument for monitoring response to viral infection in people with asthma. Reliable differentiation between viral and non-viral asthma exacerbations was not achieved with the CCQ and requires specific virological testing. When combined with virological testing, the CCQ should be a useful outcome measure for evaluating therapies in viral-induced asthma.
普通感冒问卷（CCQ）用于区分是否存在病毒感染。其在急性哮喘患者中的效用尚不清楚。我们的目的是评估CCQ在病毒诱发哮喘加重期间检测病毒感染以及监测恢复情况的能力，并通过病毒学检测加以证实。
方法/主要发现：我们研究了因急性哮喘入院且根据呼吸道样本的分子和病毒学检测诊断为病毒感染阳性（n = 63）或阴性（n = 27）的受试者（年龄≥7岁）。完成CCQ、哮喘病史和哮喘控制问卷，并在4 - 6周后重复填写。分别通过受试者工作特征曲线（ROC）分析和效应量计算评估CCQ的敏感性、特异性和对变化的反应。CCQ无法区分哮喘患者的病毒感染和非病毒感染（敏感性 = 76.2%；特异性 = 29.6%）。ROC分析无法区分哮喘患者的病毒阳性或阴性情况。恢复后CCQ对变化有较大反应（效应量 = 1.01）。39%从病毒加重中恢复的受试者在随访时病毒学检测仍为阳性，尽管临床症状有所改善。CCQ反映了这些受试者的临床改善情况，从而提供了补充病毒学检测的额外信息。
结论/意义：CCQ是监测哮喘患者对病毒感染反应的有用工具。CCQ无法可靠地区分病毒和非病毒诱发的哮喘加重，需要进行特定的病毒学检测。与病毒学检测相结合时，CCQ应该是评估病毒诱发哮喘治疗效果的有用指标。
