BACKGROUND Recurrent bronchiectasis exacerbations are related to deterioration of lung function, progression of the disease, impairment of quality of life, and to an increased mortality. Improved detection of exacerbations has been accomplished in chronic obstructive pulmonary disease through the use of patient completed diaries. These tools may enhance exacerbation reporting and identification. The aim of this study was to develop a novel symptom diary for bronchiectasis symptom burden and detection of exacerbations, named the BEST diary. METHODS Prospective observational study of patients with bronchiectasis conducted at Ninewells Hospital, Dundee. We included patients with confirmed bronchiectasis by computed tomography, who were symptomatic and had at least 1 documented exacerbation of bronchiectasis in the previous 12 months to participate. Symptoms were recorded daily in a diary incorporating cough, sputum volume, sputum colour, dyspnoea, fatigue and systemic disturbance scored from 0 to 26. RESULTS Twenty-one patients were included in the study. We identified 29 reported (treated exacerbations) and 23 unreported (untreated) exacerbations over 6-month follow-up. The BEST diary score showed a good correlation with the established and validated questionnaires and measures of health status (COPD Assessment Test, r = 0.61, p = 0.0037, Leicester Cough Questionnaire, r = - 0.52,p = 0.0015, St Georges Respiratory Questionnaire, r = 0.61,p < 0.0001 and 6 min walk test, r = - 0.46,p = 0.037). The mean BEST score at baseline was 7.1 points (SD 2.2). The peak symptom score during exacerbation was a mean of 16.4 (3.1), and the change from baseline to exacerbation was a mean of 9.1 points (SD 2.5). Mean duration of exacerbations based on time for a return to baseline symptoms was 15.3 days (SD 5.7). A minimum clinically important difference of 4 points is proposed. CONCLUSIONS The BEST symptom diary has shown concurrent validity with current health questionnaires and is responsive at onset and recovery from exacerbation. The BEST diary may be useful to detect and characterise exacerbations in bronchiectasis clinical trials.

中文翻译：

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支气管扩张加重和症状工具（BEST）的开发和初步验证。

背景技术支气管扩张反复发作与肺功能恶化，疾病进展，生活质量受损以及死亡率增加有关。在慢性阻塞性肺疾病中，通过使用患者完整的日记可以改善对急性发作的检测。这些工具可以增强病情报告和识别。这项研究的目的是开发一种用于支气管扩张症状负担和加重病情检测的新型症状日记，称为BEST日记。方法在邓迪尼尼韦尔医院对支气管扩张患者进行前瞻性观察研究。我们纳入了通过计算机断层扫描确诊的支气管扩张患者，这些患者是有症状的，并且在过去的12个月中至少有1例记录了支气管扩张加剧的患者。每天在日记中记录症状，记录咳嗽，痰量，痰色，呼吸困难，疲劳和全身性不适，评分为0至26。结果本研究包括21名患者。在6个月的随访中，我们确定了29例报告的（加重病情加重）和23例未报告的（未加重病情加重）。BEST日记得分与已建立和验证的问卷和健康状况测量值具有良好的相关性（COPD评估测试，r = 0.61，p = 0.0037，莱斯特咳嗽问卷，r =-0.52，p = 0.0015，St Georges呼吸问卷， r = 0.61，p <0.0001和6分钟步行测试，r =-0.46，p = 0.037）。基线的平均BEST得分为7.1分（标准差2.2）。加重期间的最高症状评分平均为16.4（3.1），从基线到加重的变化平均为9。1分（SD 2.5）。根据恢复基线症状的时间，病情加重的平均持续时间为15.3天（SD 5.7）。建议在临床上的最小差异为4分。结论最佳症状日记已经显示出与当前健康状况调查表并发的有效性，并且对发作和发作后的恢复有反应。BEST日记可能对检测和表征支气管扩张临床试验中的病情加重有用。