Comorbidity Components

Full blood count (Haemoglobin) – Anemia is indicated if haemoglobin values are <120 g/L for women or <140 g/L for men.

Hospital Anxiety and Depression Scale (HADS) – The HADS is a 14 item self-administered screening tool for possible or probable anxiety and depression in non-psychiatric hospital clinics (Zigmond et al. 1983). A score of > 8 in either domain indicates possible anxiety or depression. Permissions are required from GL Assessment Ltd. More information the HADS questionnaire and access can be found here

Kessler Psychological Distress Scale (K10) – The K10 is a 10-item self-administered questionnaire that is useful as a general indicator of psychological distress. The K10 is available for use on the BeyondBlue website. Additional information on administration and interpretation are available on the ABS website.

Chest radiography, echocardiogram (ECG), NT-proBNP – For more information see Comorbidities – Cardiovascular Disease & Metabolic Disease

Absolute Cardiovascular Disease Risk Calculator – Developed by the National Vascular Disease Prevention Alliance. This calculator provides a “risk score” based on the presence of known risk factors for cardiovascular disease.

Nijmegen Questionnaire – The Nijmegen Questionnaire is a 16-item assessment for dysfunctional breathing, on a 4-point scale. An overall score >23 indicates significant hyperventilation. For more information see Dysfunctional Breathing

Breathing Pattern Assessment Tool (BPAT) – A semi-quantitative screening tool that collates data obtained from a respiratory physiotherapy assessment, including chest/abdominal wall movement, noise of inspiratory/expiratory flow, channel of inspiration/expiration, signs of air hunger, respiratory rate and rhythm. Utility has been demonstrated in a severe asthma population, with a BPAT score ≥4 providing 0.92 sensitivity and 0.75 specificity for dysfunctional breathing in this pouplation (Todd et al. 2018). For more information see Dysfunctional Breathing

Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ) – The LHQ is a 14 item, 7-point ordinal scale, self-administered screening tool, which assesses across three domains: obstruction, pain/thermal and throat tickle. A cut-off for normal function can be considered at 17, with lower scores indicating increased laryngeal dysfunction (Vertigan et al. 2014). For more information, see Comorbidities – Vocal Cord Dysfunction

Download the LHQ and accompanying Questionnaire worksheet here.

Vocal Cord Dysfunction Questionnaire (VCDQ) – The VCDQ is a 12-item questionnaire on a 5-point Likert scale. The minimal clinically important difference = 4 points. Higher scores have a higher probability of VCD, but has not been tested as a diagnostic questionnaire. For permissions, contact Dr. Stephen Fowler (Fowler et al. 2015). The VCDQ can be downloaded here, for clinical and research use.

Pittsburgh Vocal Cord Dysfunction Index (PVCDI) – The PVCDI assesses symptoms of throat tightness, dysphonia, absence of wheeze and triggering by odours as key features that differentiate VCD from asthma. It consists of a 4-item binary scale. A score ≥4 indicates a diagnosis of VCD, with sensitivity 83% and specificity 95% for VCD diagnosis. False negatives are seen in 23% of patients with VCD (Traister et al. 2014). For permissions, contact Dr. Andrei Petrov (petrovaa@upmc.edu)

Dyspnoea Severity Index – Assesses upper airway symptoms and treatment follow-up. Consists of a 10-item 5-point Likert scale (Gartner-Schmidt et al. 2014).  Score > 10 suggestive of abnormal upper airway dyspnoea. Good reliability and discriminant validity reported, but has not been reported as a diagnostic tool and not specific for VCD. For access email: gartnerschmidtjl@upmc.edu

Dyspnoea-12 – The Dyspnoea-12 is a 12-item assessment tool that provides an overall score of dyspnoea magnitude (scored 0-36, higher score indicate more severe dyspnoea) as well as two sub-scores: i) physical component and ii) affective component. It has been validated in a range of conditions including asthma, it is simple and quick to use. It has a minimal clinically important difference of 3 points (calculated for COPD and lung cancer) (Yorke et al. 2010). More information is available here

Download the Dypspnoea-12 questionnaire here.

Vocal Hygiene Information Sheet – This document provides advice on how to reduce irritation that triggers coughing. It includes specific guidance on hydration, breathing, talking and tips for everyday living. For more information and to download an information sheet: http://www.severeasthma.org.au/vocal-hygiene/

Voice Handicap Index – To measure voice related quality of life (Jacobson et al. 1997). Consists of a 30-item, 5-point ordinal scale. Scores <10 are normal. For more information see Comorbidities – Vocal Cord Dysfunction

Blood C-reactive Protein – A high-sensitivity CRP (Hs-CRP) measurement of >3 mg/mL is indicative of low grade systemic inflammation.

pH Monitoring – 24-hour ambulatory oesophageal pH monitoring is considered the gold standard for GORD diagnosis. More information is available on the Health Direct website

Gastro-esophageal Reflux Disease Questionnaire (GERD-Q) – The GERD-Q is a 6-item assessment tool for the assessment of GORD. Increasing scores indicate higher risk, with 3-7 = 50%, 8-10 = 79% and 11-18 = 89% likelihood of GORD (Jones et al. 2009). Permissions required from AstraZeneca.

Reflux Disease Questionnaires (RDQ) – The RDQ is a 12-item self-administered questionnaire developed to facilitate the diagnosis of GORD in primary care (Shaw et al. 2001). The primary publication can be downloaded here.

Sino-Nasal Questionnaire (SNQ) – The SNQ allows for detection of undifferentiated snonasal disease, including both allergic rhinitis and chronic sinusitis. A score >1 indicates sinonasal disease. For permissions, contact Prof. Anne Dixon (Anne.dixon@uvmhealth.org).

Score for Allergic Rhinitis Questionnaire (SFAR) – The SFAR allows for assessment of allergic rhinitis provides a score from 0 – 16, where ≥7 is indicative of allergic rhinitis (Annesi-Maesano et al. 2002). The SFAR assessment questionnaire is available in the primary publication

Sino-Nasal Outcome Test (SNOT–22) – The SNOT-22 is a 22-item assessment tool for sino-nasal disease, assessed based on a 0-5 scale (Hopkins et al. 2009). A score >40 indicates likely sinonasal disease. The SNOT-22 questionnaire can be accessed here

Rhinitis Control Assessment Test (RCAT) – The RCAT is a 6-item, self-administered assessment tool for allergic rhinitis, on a 5-point scale. A score <12 indicates poor rhinitis control (Schatz et al. 2010).

Berlin Questionnaire – The Berlin questionnaire is a survey for the detection of sleep apnoea, based on snoring severity, daytime function and high blood pressure. A score of 2-3 indicates high risk (Netzer et al. 1999). For permissions, contact Prof. Nikolaus Netzer (Nikolaus.Netzer@uibk.ac.at)..

STOP-Bang Questionnaire – The STOP-Bang questionnaire is a concise screening tool for OSA (Chung et al. 2008). Results are based on observed snoring, tiredness, observed interruptions in breathing during sleep, high blood pressure, high BMI, age (>50), neck size and gender. Answering yes to 5-8 of the questions indicates a high risk of OSA. An online calculator is available here

Epworth Sleepiness Scale (ESS) – The ESS is a self-administered 8-item questionnaire that to assess daytime sleepiness, on a 4-point scale (0-3). A score >16 indicates a high level of sleepiness (Rosenthal et al. 2008). An online calculator is available here

Pittsburgh Sleep Quality Index (PSQI) – The PSQI assesses sleep quality and sleep habits. Assessment is based on sleep duration, sleep latency and difficulty, sleep medications and daytime function (Buysse et al. 1989). The PSQI and scoring information can be accessed here

Leicester Cough Questionnaire (LCQ) – The LCQ is a 19-item, 7-point ordinal scale self-administered quality of life measure for chronic cough. Scores of 20-21 are normal, with 17-19 in the mild range (Birring et al. 2003).

Vocal Hygiene Information Sheet – This document provides advice on how to reduce irritation that triggers coughing. It includes specific guidance on hydration, breathing, talking and tips for everyday living.

For access and to download the information sheet: www.severeasthma.org.au/vocal-hygiene/

Chronic Cough Information Sheet – This document provides information for people who experience chronic cough and excessive throat clearing. It includes important facts about coughing and insight into how speech pathology can help with control of cough.

For access and to download the information sheet: www.severeasthma.org.au/chronic-cough/