Leicester Cough Questionnaire

Introduction

Leicester Cough Questionnaire (LCQ) is an English-born self-reporting quality of life measure of chronic cough, developed by S.S. Birring[1]. It consists of 19 items with a 7 point likert response scale (range from 1 to 7), a format example is available here. Each item is developed to assess symptoms during cough and impact of cough on three main domains: physical, psychological and social. Scores are calculated as a mean of each domain and the total score is calculated by adding every domain score. It generally takes about 5 minutes to be completed and it is designed for adults. Since the first development in 2003 LCQ has been translated and validated in several languages (Dutch[2], French[3], Korean[4], Lithuanian[5], Mandarin Chinese[6], Polish[7], Portuguese[8], Spanish[9], Swedish[10], Thai[11]). LCQ has been used as an outcome measure for different respiratory diseases like COPD[3][10][12], Cystic Fibrosis[13], non-CF bronchiectasis[6][14].

Objective

This instrument has been developed to detect the effect of chronic cough on health status and consequently on quality of life of chronic respiratory disease patients. Patients are asked 19 questions reflecting on their cough over the previous two weeks including areas of; chest or stomach pain, sputum, embarrassment, anxiety, sleep disruption and energy.

Clinimetric properties of LCQ

The LCQ has been shown to be a valid and reliable health status measure for adults with chronic cough[1]. Concurrent validity measures how much a test correlates well with another measure that has previously been validated.

Concurrent Validity English Vers.[1] Dutch Vers.[2] Mandarin Vers.[6] Korean Vers.[4] French Vers.[3] Thai Vers.[11] Spanish Vers.[9] Swedish Vers.[10] Polish Vers.[7] Lithuanian Vers.[5]
Cough VAS -0.72 -0.58 -0.39 0.40
SGRQ - total -0.56 -0.60 -0.66 -0.55 -0.49
SF36 – total 0.46 0.41 0.55 0.33
Borg Cough Scale -0.41 -0.74
HADS - total -0.46 -0.36 u.v.
Cough symptom score -0.66
CASA-Q 0.58-0.81
CAT -0.69
EQ5D -0.59

SGRQ: Saint George respiratory Questionnaire; VAS: Visual Analogue Scale; SF-36: Short Form-36; HADS: Hospital Anxiety and Depression Scale; CASA-Q: Cough and Sputum Assessment Questionnaire; CAT: COPD Assessment Test; EQ5D: EuroQol five-dimensional Questionnaire; u.v.: unreported value by authors because non significant

All data are expressed as r-correlation coefficient between total scores of each instruments listed and are all statistically significant unless specified.

Repeatability or test–retest reliability reflects the agreement between the results of successive measurements of the same "test" or "instrument" that occurs under the same conditions of the previous measurement

Repeatability Intraclass Correlation Coefficient
English Version[1] 0.96
Dutch Version[2] 0.93
Mandarin Chinese Version[6] 0.89
Korean Version[4] 0.75
French Version[3] 0.85
Thai Version[11] 0.91
Spanish Version[9] 0.84
Swedish version[10] 0.96
Polish Version[7] 0.99
Lithuanian Version[5] 0.89
Internal consistency and Reliability Cronbach’s

alpha

coefficient

English Version[1] 0.92
Dutch Version[2] 0.93
Mandarin Chinese Version[6] 0.93
Korean Version[4] 0.94
French Version[3] 0.92
Thai Version[11] 0.92
Spanish Version[9] 0.91
Swedish version[10] 0.97
Polish Version[7] 0.89
Lithuanian Version[5] 0.93

References

  1. 1.0 1.1 1.2 1.3 1.4 Birring SS, Prudon B, Carr AJ, Singh SJ, Morgan MD, Pavord ID. Development of a symptom specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ). Thorax. 2003; 58(4): 339-343.
  2. 2.0 2.1 2.2 2.3 Huisman AN, Wu MZ, Uil SM, van den Berg JWK. Reliability and validity of a Dutch version of the Leicester Cough Questionnaire. Cough. 2007; 3(1): 3. doi: 10.1186/1745-9974-3-3
  3. 3.0 3.1 3.2 3.3 3.4 Reychler G, Schinckus M, Fremault A, Liistro G, Pieters T. Validation of the French version of the Leicester Cough Questionnaire in chronic obstructive pulmonary disease. Chronic respiratory disease. 2015; 12(4): 313-319.
  4. 4.0 4.1 4.2 4.3 Kwon JW, Moon JM, Kim SH, Song WJ, Kim MH, Kang MG, et al. Reliability and validity of a Korean version of the leicester cough questionnaire. Allergy, asthma & immunology research. 2015; 7(3): 230-233.
  5. 5.0 5.1 5.2 5.3 Merkytė I, Biekšienė K, Vagulienė N, Sakalauskas R. Reliability and Validity of a Lithuanian version of Leicester Cough Questionnaire. J Lung Pulm Respir Res. 2016; 3(5): 00099.
  6. 6.0 6.1 6.2 6.3 6.4 Gao YH, Guan WH, Xu G, Gao Y, Lin ZY, Tang Y, et al. Validation of the Mandarin Chinese version of the Leicester Cough Questionnaire in bronchiectasis. The International Journal of Tuberculosis and Lung Disease. 2014; 18(12): 1431-1437.
  7. 7.0 7.1 7.2 7.3 Dąbrowska M, Krakowiak K, Radlińska O, Rybka A, Grabczak EM, Maskey-Warzęchowska M, et al.Validation of the Polish Version of the Chronic Cough Quality of Life Questionnaire (Leicester Cough Questionnaire). Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University. 2016;25(4):649-653
  8. Felisbino MB, Marques Steidle LJ, Gonçalves-Tavares M, Pizzichini MMM,  Pizzichini E. Leicester Cough Questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil. Jornal Brasileiro de Pneumologia. 2014; 40(3): 213-221.
  9. 9.0 9.1 9.2 9.3 Muñoz G, Buxó M, de Gracia J, Olveira C, Martinez-Garcia MA, Giron R, et al. Validation of a Spanish version of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis. Chronic respiratory disease. 2016; 128–136. https://doi.org/10.1177/1479972316632005
  10. 10.0 10.1 10.2 10.3 10.4 Sönnerfors P, Faager G, Einarsson U. Translation of the Leicester Cough Questionnaire into Swedish, and validity and reliability in chronic obstructive pulmonary disease. Disability and rehabilitation. 2017; 40(22): 2662-2670
  11. 11.0 11.1 11.2 11.3 Pornsuriyasak P, Kawamatawong T, Rattanasiri S, Tantrakul V, Pongmesa T, Birring SS, et al. Validity and reliability of the Thai version of the leicester cough questionnaire in chronic cough. Asian Pacific journal of allergy and immunology. 2016; 34(3):212-216 DOI: 10.12932/AP0685.34.3.2016
  12. Berkhof FF,  Boom LN, ten Hertog NE, Uil SM, Kerstjens HA, van den Berg JW. The validity and precision of the Leicester Cough Questionnaire in COPD patients with chronic cough. Health and quality of life outcomes. 2012; 10(1): 4. DOI: 10.1186/1477-7525-10-4
  13. Ward N, Stiller K. Rowe H, Holland AE. The psychometric properties of the Leicester Cough Questionnaire and Respiratory Symptoms in CF tool in cystic fibrosis: A preliminary study. Journal of Cystic Fibrosis. 2017; 16(3): 425-432. DOI: https://doi.org/10.1016/j.jcf.2016.11.011
  14. Murray MP, Turnbull K, MacQuarrie S, Pentland JL, Hill AT. Validation of the Leicester Cough Questionnaire in non-cystic fibrosis bronchiectasis. European Respiratory Journal. 34(1): 125-131.