Portuguese-language version of the COPD Assessment Test: validation for use in Brazil

OBJECTIVE: To validate a Portuguese-language version of the COPD assessment test (CAT) for use in Brazil and to assess the reproducibility of this version. METHODS: This was multicenter study involving patients with stable COPD at two teaching hospitals in the city of Fortaleza, Brazil. Two independent observers (twice in one day) administered the Portuguese-language version of the CAT to 50 patients with COPD. One of those observers again administered the scale to the same patients one week later. At baseline, the patients were submitted to pulmonary function testing and the six-minute walk test (6MWT), as well as completing the previously validated Portuguese-language versions of the Saint George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (MMRC) dyspnea scale, and hospital anxiety and depression scale (HADS). RESULTS: Inter-rater and intra-rater reliability was excellent (intraclass correlation coefficient [ICC] = 0.96; 95% CI: 0.93-0.97; p < 0.001; and ICC = 0.98; 95% CI: 0.96-0.98; p < 0.001, respectively). Bland Altman plots showed good test-retest reliability. The CAT total score correlated significantly with spirometry results, 6MWT distance, SGRQ scores, MMRC dyspnea scale scores, and HADS-depression scores. CONCLUSIONS: The Portuguese-language version of the CAT is a valid, reproducible, and reliable instrument for evaluating patients with COPD in Brazil

The effectiveness of the epworth sleepiness scale as an auxiliary resource in the diagnosis of obstructive sleep apnea syndrome

Objective: To analyze the effectiveness of the Epworth Sleepiness Scale (ESS) as an auxiliary resource in the diagnosis of the Obstructive Sleep Apnea Syndrome (OSAS). Methods: Observational study, with a retrospective phase and a prospective one, comprising 475 patients who sought the Sleep Study Center in Fortaleza (Centro de Estudo do Sono de Fortaleza - CESF). Data was collected from medical records, which comprises ESS, amidst some questionnaires prepared by CESF professionals and answered by the patients. The study compared the results raised by the ESS to the polysomnography data. Data analysis was performed on SPSS, using Pearson chi-square test, considering as statistically significant p-value 30 kg/m2 were the most affected by OSAS, with 38.9%, 41% and 45.1%, respectively. A significant relationship was found between ESS score and OSAS (p = 0,001), showing that 25.9% (n = 123) of patients, who had values higher than 10 in the ESS, were diagnosed with OSAS. Conclusions: Data on this study shows that ESS fits as an auxiliary resource in the diagnosis of OSAS and it may be applied by any health professional while taking the clinical history. However, clinical signs are not sufficient to diagnose it, so that polysomnography is still required

A efetividade da escala de sonolência de Epworth como recurso auxiliar no diagnóstico da síndrome da apnéia obstrutiva do sono

Objective: To analyze the effectiveness of the Epworth Sleepiness Scale (ESS) as an auxiliary resource in the diagnosis of the Obstructive Sleep Apnea Syndrome (OSAS). Methods: Observational study, with a retrospective phase and a prospective one, comprising 475 patients who sought the Sleep Study Center in Fortaleza (Centro de Estudo do Sono de Fortaleza - CESF). Data was collected from medical records, which comprises ESS, amidst some questionnaires prepared by CESF professionals and answered by the patients. The study compared the results raised by the ESS to the polysomnography data. Data analysis was performed on SPSS, using Pearson chi-square test, considering as statistically significant p-value 30 kg/m2 were the most affected by OSAS, with 38.9%, 41% and 45.1%, respectively. A significant relationship was found between ESS score and OSAS (p = 0,001), showing that 25.9% (n = 123) of patients, who had values higher than 10 in the ESS, were diagnosed with OSAS. Conclusions: Data on this study shows that ESS fits as an auxiliary resource in the diagnosis of OSAS and it may be applied by any health professional while taking the clinical history. However, clinical signs are not sufficient to diagnose it, so that polysomnography is still required.Objetivo: Analizar la efectividad de la Escala de Somnolencia de Epworth (ESE) como recurso auxiliar en el diagnóstico Del Síndrome de la Apnea Obstructiva del Sueño (SAOS). Métodos: Estudio observacional con una etapa retrospectiva y outra prospectiva con 475 pacientes que acudieron al Centro de Estudio del Sueño de Fortaleza (CESF). Los datos fueron recopilados a partir de las historias clínicas que se constituyen de cuestionarios incluyendo la ESE, creados por los profesionales del CESF y contestados por los pacientes. El estudio comparó los resultados obtenidos en la ESE con los datos de la polisomnografía. El análisis de los datos fue realizado a través del SPSS con el uso Del Chi-cuadrado de Pearson, considerando como estadísticamente significativos los valores de p 30 kg/m2 fueron los más comprometidos por el SAOS con respectivamente 38,9%, 41% y 45,1%. Fue evidenciada relación significativa entre la puntuación de la ESSE y el SAOS (p = 0,001), señalando que el 25,9% (n = 123) de los pacientes que obtuvieron valores superiores a 10 en la ESSE presentaron el diagnóstico de SAOS. Conclusiones: Los datos de esta investigación señalan que la ESE sirve como recurso auxiliar en el diagnóstico de la SAOS pudiendo ser utilizada por cualquier profesional sanitario durante las anamnesis clínicas. Sin embargo, la clinica del paciente no es suficiente para diagnosticarla, siendo necesaria la prueba de la polisomnografía.Objetivo: Analisar a efetividade da Escala de Sonolência de Epworth (ESE) como recurso auxiliar no diagnóstico da Síndrome da Apnéia Obstrutiva do Sono (SAOS). Métodos: Estudo observacional, sendo uma etapa retrospectiva e outra prospectiva com 475 pacientes que procuraram o Centro de Estudo do Sono de Fortaleza (CESF). Os dados foram coletados a partir de prontuários, que constam de questionários, incluindo a ESE, elaborados pelos profissionais do CESF e respondidos pelos pacientes. O estudo comparou os resultados obtidos na ESE com os dados da polissonografia. A análise dos dados foi realizada através do SPSS, utilizando o teste de Qui-quadrado de Pearson, considerando como estatisticamente significantes valores de p 30 kg/m2 foram os mais acometidos pela SAOS com respectivamente 38,9%, 41% e 45,1%. Foi evidenciada uma relação significativa entre a pontuação da ESE e a SAOS (p = 0,001), mostrando que 25,9% (n = 123) dos pacientes, que obtiveram valores maiores que 10 na ESE, estavam com diagnóstico de SAOS. Conclusões: Os dados desta pesquisa mostram que a ESE serve como recurso auxiliar para o diagnóstico da SAOS, podendo ser aplicada por qualquer profissional de saúde durante as anamneses clínicas. Porém, a clínica do paciente não é suficiente para diagnosticá-la, sendo necessário o exame de polissonografia