• Victor Kim, James Crapo, Huaqing Zhao, Paul W Jones, Edwin K Silverman, Alejandro Comellas, Barry J Make, Gerard J Criner, and COPDGene Investigators.
• 1 Department of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
• Ann Am Thorac Soc. 2015 Mar 1;12(3):332-9.

RationalePrevious studies on chronic bronchitis (CB) have used varying definitions.ObjectivesWe sought to compare an alternative CB definition, using the St. George's Respiratory Questionnaire (SGRQ), a commonly used assessment tool, with the classic definition and to investigate if it had independent or additive value.MethodsWe analyzed data from 4,513 subjects from Global Initiative for Chronic Obstructive Lung Disease groups 1 to 4 in the COPDGene cohort. We compared the classic definition of CB with the SGRQ definition, defined by their answers to the questions about both cough and phlegm. We compared the Classic CB+ versus CB- groups, and the SGRQ CB+ and CB- groups. We also analyzed the cohort split into four groups: Classic CB+/SGRQ CB+, Classic CB+/SGRQ CB-, Classic CB-/SGRQ CB+, Classic CB-/SGRQ CB-.Measurements And Main ResultsA total of 26.1% subjects were Classic CB+, whereas 39.9% were SGRQ CB+. When the SGRQ definition was compared with the Classic CB definition, using this as the gold standard, the SGRQ CB definition had a sensitivity and specificity of 0.87 and 0.77, respectively. The SGRQ CB+ and Classic CB+ groups were strikingly similar, with more respiratory symptoms and exacerbations, worse lung function, and greater airway wall thickness. In addition, the Classic CB+/SGRQ CB+, Classic CB+/SGRQ CB-, and Classic CB-/SGRQ CB+ groups shared similar characteristics as well.ConclusionsThe SGRQ CB definition identifies more subjects with chronic cough and sputum who share a similar phenotype identified by the Classic CB definition. The addition of the SGRQ CB definition to the classic one can be used to identify more patients with chronic obstructive pulmonary disease at risk for poor outcomes.

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