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 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two standardized respiratory questionnaires were administered to 946 white male participants in a long-term study of respiratory symptoms in Washington County, Md. One half of the men were given the 1960 respiratory questionnaire developed by the British Medical Research Council (MRC) at the start of the interview and a new questionnaire developed by the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) at the end. The order was reversed for the other half of the subjects. No important differences were found in the responses. To obtain a minimal basic history for evaluation of chronic obstructive pulmonary disease, either the MRC questionnaire or the corresponding questions from the ATS-DLD questionnaire may be used. More detailed information on a wider variety of historical items may be obtained by using the ATS-DLD questionnaire.
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PMID:Standardized respiratory questionnaires: comparison of the old with the new. 42 Apr 37

The American Thoracic Society respiratory symptom questionnaire (ATS-Q) is widely used and has provided valuable information in epidemiologic studies. To determine the influence of psychological status on respiratory symptoms, we compared subjects' ATS-Q responses to their Ilfeld Psychiatric Symptom Index (PSI) scores. To minimize the potential confounding effect of respiratory disease on the association between respiratory and psychological status, from a population-based survey of 3,628 subjects, we studied only the 600 "healthy" subjects, defined by the following characteristics: between 14 and 55 yr of age; never-smokers; no diagnoses of respiratory, heart, kidney, thyroid disease, or anemia; and normal spirometry (defined as an FEV1 and FVC greater than 80% of predicted). Associations were found between respiratory symptoms (cough, phlegm, wheeze, dyspnea) and PSI subscales (anxiety, anger, depression, and cognitive disturbance). Adjusted odds ratios for respiratory symptoms ranged from 1.13 to 2.15 for every 10% increase in PSI score. Psychological status is an important determinant of respiratory symptoms and therefore must be taken into consideration when interpreting results of epidemiologic studies using questionnaire information.
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PMID:The influence of psychological status on respiratory symptom reporting. 272 53

The relationship between 6 chronic respiratory symptoms and the performance of an excessively variable FEV1 (test failure) was examined among 8,522 white adults in 6 U.S. cities. A total of 747 (8.9%) performed an excessively variable FEV1 according to the American Thoracic Society criterion. After adjusting for smoking, age, and city of residence in 6 separate logistic regression models, the odds ratios for FEV1 failure among men were 2.32, 1.39, 1.40, 1.82, 2.61, 1.92 for moderate breathlessness, chronic cough, phlegm, wheeze, asthma, and recurrent chest illness, respectively. Among women, FEV1 failure was significantly associated with moderate breathlessness, chronic phlegm, wheeze, and asthma with odds ratios of 1.55, 1.45, 1.62, and 1.95, respectively. When all symptoms were evaluated simultaneously in a single logistic regression model, only breathlessness and asthma remained associated with FEV1 failure; odds ratio = 1.97 for asthma and 2.03 for breathlessness among men and 1.53 for both asthma and breathlessness among women. The 11-yr mortality experience of subjects with test failure, as defined by 2 different criteria, was compared to that of the quartile of the cohort with the highest cross-sectional test results. After adjusting for age, gender, and smoking, the relative risks of mortality were 1.62 and 1.98 for subjects with an FEV1 failure as defined by the ATS and 6-Cities criteria, respectively, and 1.99 and 1.90 for the groups with FVC failure as defined by the 2 criteria. Thus test failure is almost as strong a predictor of mortality as poor FEV1.
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PMID:The association between health status and the performance of excessively variable spirometry tests in a population-based study in six U.S. cities. 368 41

A study group of 1,299 adult Israelis aged 30 to 65 years was chosen from persons referred for evaluation of possible pulmonary diseases in two outpatient chest clinics. They were interviewed using the ATS-NHLI (American Thoracic Society-National Heart and Lung Institute) health questionnaire and underwent the pulmonary function test (PFT), which included the following parameters: forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), FEV1/FVC, peak expiratory flow (PEF), FEF50 and FEF25 (forced expiratory flow at 50 and 25% of FVC, respectively). The effect of the country of origin of the subjects on the distribution of respiratory symptoms, pulmonary diseases and PFT was analyzed. The lowest PFT values and an excess of reported respiratory symptoms and chronic obstructive airways diseases--especially asthma--among subjects and their parents were found among immigrants from Iraq-Iran. In immigrants from Morocco, reported respiratory symptoms, pulmonary diseases and impaired PFT were relatively uncommon. The different distribution of reported respiratory symptoms, pulmonary diseases and impaired PFT by country of origin could not be explained by environmental factors, such as smoking habits and socioeconomic background. The high prevalence of reported asthma among immigrants from Iraq-Iran is most probably due to a genetic factor.
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PMID:Pulmonary functions and respiratory symptoms and diseases among adult Israelis. Variations by country of origin. 379 34

In industries where there are occupational exposures to dusts, fumes, and gases, employers should monitor periodically their employees' respiratory health, using both spirometric pulmonary function tests and respiratory symptoms questionnaires. To incorporate the recent American Thoracic Society recommendations of standardization in these areas into an industrial pulmonary function evaluation program, a three-day standardized pulmonary function evaluation course was developed by a respiratory epidemiologist with extensive spirometry experience and was offered to many of Alcoa's domestic plant medical departments. The course included spirometric pulmonary function testing and use of the ATS-DLD-78A respiratory symptoms questionnaire. The major points covered in the course, the quality control follow-up of the course, and the need for such a standardized pulmonary function evaluation program in a large company are described in this report.
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PMID:Development of a standardized pulmonary function evaluation program in industry. 648 1

We evaluated the prevalence of asthma and its predictors in studies of several male working groups: 619 cedar sawmill, 724 grain elevator, 399 pulpmill, 798 aluminum smelter, and 1,127 unexposed workers. These workers had taken part in health studies for assessment of chronic respiratory effects of various workplace exposures between 1979 and 1982. The American Thoracic Society Adult Questionnaire (ATS-DLD-78) was used for these studies. Allergy skin tests were also performed. The participation rates were > 80%. The overall prevalance of physician-diagnosed asthma was 4.6%, and current asthma 3%. The prevalence of asthma after employment in the current industry, as a surrogate for work-related asthma, was 3.9 times higher in cedar sawmill workers, 2.2 times higher in pulpmill and aluminum smelter workers, and 1.7 times higher in grain elevator workers compared with unexposed workers. Atopy and a positive parental history of asthma, but not smoking, were important risk factors for asthma before the onset of first employment. Also, for asthma after employment in the current industry, atopy and a positive parental history of asthma were important risk factors. Smoking was associated with a significant reduction in the risk for asthma after employment in the current industry. Within specific work groups, the prevalence of atopy was significantly higher among pulpmill workers with asthma after employment in current industry than those without asthma. Conversely, cedar sawmill workers who had asthma after employment in the current industry were nonatopic and nonsmokers.
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PMID:Prevalence and predictors of asthma in working groups in British Columbia. 748 94

Nonspecific bronchial hyperresponsiveness (BHR) is a hallmark of clinical asthma, but can be present in nonasthmatics as well. The diagnosis of asthma is based on clinical grounds, and no laboratory procedure can definitely establish its presence. This poses a problem in studies of asthma. If epidemiological studies are to provide valid information, the tools used must have a relative degree of predictive or diagnostic ability. This report determined whether the American Thoracic Society-Division of Lung Disease (ATS-DLD) respiratory questionnaire has the ability to predict different degrees of non-specific BHR. In the years 1983-1990, when the ATS-DLD questionnaire was used in our Natural History of Asthma study, 192 subjects completed the ATS-DLD questionnaire and underwent a standardized methacholine challenge. A recursive partitioning analysis of the ATS-DLD questionnaire was able to predict which questions would likely be answered if the subject had nonspecific bronchial reactivity to inhaled methacholine of 100 and 200 breath units. Positive responses for questions concerning treatment for asthma, wheezing, or shortness of breath, and emergency treatment for asthma predicted the presence of increased bronchial reactivity.
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PMID:The usefulness of questionnaire-derived information to predict the degree of nonspecific bronchial hyperresponsiveness. 755 71

The first widely used questionnaire in respiratory epidemiology was the questionnaire from the Medical Research Council (MRC) of Great Britain. In the first version, from 1960, there were only a few questions about wheezing, but in later editions, more questions about asthma and asthma-like symptoms were added. The MRC questionnaire initiated the development of other questionnaires such as the European Community for Coal and Steel (ECSC) questionnaire of respiratory symptoms and the questionnaire from the American Thoracic Society and the Division of Lung Diseases (ATS-DLD-78). In Tucson, Ariz, a questionnaire was developed in the 1970s that was focused on the subject's own report of asthma. In Great Britain, a questionnaire was developed in the 1980s with the intention of finding the most valid symptom-based items for identifying asthma, "the IUATLD (1984) questionnaire." When judging the validity of a questionnaire, it is essential to understand sensitivity and specificity. Sensitivity is the fraction of the truly diseased subjects found to be diseased using the questionnaire. Specificity is the fraction of the truly healthy subjects found to be healthy using the questionnaire. Regarding questionnaires dealing with asthma, the situation is confusing because of the absence of any gold standard for asthma. The most usual mode of validation has been to test the questionnaire against the results of a clinical physiologic investigation, often a nonspecific bronchial challenge test. Another approach has been to compare the answers from the questionnaire with the clinical diagnoses of asthma. When validated in relation to bronchial challenge tests, the questions about self-reported asthma have a mean sensitivity of 36 percent (range, 7 to 80 percent) and a mean specificity of 94 percent (range, 74 to 100 percent). The questions about "physician-diagnosed asthma" have even higher specificity, 99 percent. When validated in relation to a clinical diagnosis of asthma, the mean sensitivity for the question about self-reported asthma was 68 percent in the reviewed studies (range, 48 to 100 percent). The specificity was 94 percent (range, 78 to 100 percent). One problem in using the presence of bronchial hyperreactivity (BHR) as a gold standard for asthma is that many people with BHR report no respiratory complaints. In other words, the presence of BHR is a measure with high sensitivity but low specificity for asthma. The effect of using a methacholine challenge test as a standard for the disease will thus be an underestimation of the sensitivity of the questionnaire.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Asthma and asthma-like symptoms in adults assessed by questionnaires. A literature review. 792 33

Studies of respiratory questionnaire efficacy have emphasized reliability of responses; few have validated symptom response with objective measures of pulmonary function. To determine whether respiratory symptoms are associated with diminished pulmonary function, symptoms reported on the American Thoracic Society (ATS-DLD-78A) questionnaire were correlated cross-sectionally with measured spirometric volumes in 816 asbestos-exposed workers. Cough, phlegm, wheeze, and dyspnea were inversely related to pulmonary function. Cough, phlegm, and chronic bronchitis were associated with a 2 to 8% reduction (p < 0.001) in predicted values for forced vital capacity (FVC) and forced expiratory volume (FEV1); wheeze and dyspnea were clinically more significant, with an 11 to 17% reduction (p < 0.001). Wheeze, dyspnea, and roentgenographic fibrosis were all significant independent predictors of risk for restrictive impairment. These results support the validity of the ATS questionnaire as an epidemiologic tool and emphasize the importance of clinical history in assessing respiratory status.
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PMID:Correlation between respiratory symptoms and pulmonary function in asbestos-exposed workers. 831 11

During spring 1984, second and fifth grade schoolchildren living in three Haifa Bay areas on the eastern Mediterranean coast, with different levels of air pollution, were studied. The parents of these children filled out ATS-NHLI (American Thoracic Society and the National Heart and Lung Institute) health questionnaires and the children performed PFT (Pulmonary Function Tests). A trend of higher prevalence of most reported respiratory symptoms was found for schoolchildren growing up in the medium and high polluted areas as compared with the low pollution area. Logistic models fitted for the respiratory conditions that differed significantly among the three residential areas also included background variables that could be responsible for these differences. Relative risks for respiratory conditions calculated from these models were in the range of 1.38 and 1.81 for children from the polluted area as compared to 1.00 for the low polluted area. All the measured values of PFT were within the normal range, with no consistent reduction in PFT for any residential area. During spring 1989, seventh graders (second graders in 1984) were reexamined and a new cohort of fifth grade children was studied, using the same techniques as in 1984. A very significant rise in the prevalence of most reported respiratory symptoms and diseases was observed among both fifth and seventh grade schoolchildren in 1989 compared to 1984, especially in the low and medium polluted areas and less in the polluted area. Changes over time in PFT in the older cohort were similar in the three areas. PFT of fifth graders in 1984 and in 1989 were very similar. The most significant factor in logistic models fitted for the prevalence of respiratory conditions among the studied schoolchildren in 1989, was the subjective attitude of their parents towards the deleterious effects of air pollution on their children's health, and the subjective estimate of their children's exposure to pollution rather than measured exposure. A huge campaign carried out during the survey against the main polluters in the Haifa Bay area caused both public concern and apparently reporting bias.
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PMID:Reporting bias related to an environmental hazard. 985 6


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