The following is a summary of “Association of Bronchial Disease on CT Imaging and Clinical Definitions of Chronic Bronchitis in a Single-Center COPD Phenotyping Study,” published in the July 2024 issue of Pulmonology by Fat et al.

Chronic Bronchitis (CB) is a distinct phenotype within the spectrum of chronic obstructive pulmonary disease (COPD). While various clinical definitions are employed for diagnosing CB, the correlation between these definitions and radiologic assessments of bronchial disease (BD) remains underexplored. This study aimed to evaluate the relationship between three clinical definitions of CB and radiographic findings of BD in patients with spirometry-defined COPD.

A cross-sectional analysis was conducted using data from a COPD phenotyping study, which was a prospective observational cohort. The study included participants with spirometry-defined COPD and available chest CT imaging. The clinical definitions of CB—Medical Research Council (CBMRC), St. George’s Respiratory Questionnaire (CBSGRQ), and COPD Assessment Test (CBCAT)—were compared with CT findings of BD. Statistical analyses included Cohen’s Kappa for agreement, as well as univariate and multivariate logistic regressions.

Of the 112 participants initially assessed, 83 met the inclusion criteria. The demographic profile of the cohort included an average age of 70.1±7.0 years, predominantly male (59.0%), with a mean smoking history of 45.8±30.8 pack-years; 21.7% were actively smoking, and the mean FEV1 was 61.5±21.1%. CB was identified in 22.9% of patients using the CBMRC definition, 36.6% using CBSGRQ, and 28.0% using CBCAT. BD was more frequently observed in patients classified as having CB compared to patients who don’t have CB. However, no statistically significant relationship was found between BD and any of the CB definitions. Among the definitions, CBSGRQ showed better agreement with radiographically assessed BD.

Radiologic identification of BD was associated with the clinical diagnoses of CB, although the agreement between imaging findings and clinical definitions was not statistically significant. This suggests that radiologic findings of BD and clinical criteria for CB may not correspond to the same COPD phenotype. Further research is needed to standardize imaging and clinical methods to achieve more objective identification of COPD phenotypes, ultimately improving diagnostic accuracy and patient management.

Source: sciencedirect.com/science/article/pii/S0954611124002087