A complete tool validation requires the evaluation of its reproducibility. 5 However, some other psychometrics properties must be investigated as they are for questionnaires. A good inter-rater reproducibility was observed between the physicians and patients. Such validated tools are necessary to facilitate management. It allows clinicians to report sputum color by providing an accurate representation of the 3 major grades of color. 10įor this purpose, Murray et al 5 developed and validated a quantitative method (Sputum Color Chart) to standardize the evaluation. 9 However, the color can be difficult to evaluate, and when reported by patients, it is not reliable. 8 It has been proposed to take into account the sputum color to determine the clinical impact of COPD (the current consequences of the disease for the patient). Hence, the color of sputum could play an important role in clinical practice in lung diseases with productive cough even if that role is still debated. 7 Usually, the prescription is ordered empirically, based on clinical evidence of purulence. Sputum production and purulence were proposed as criteria for defining an exacerbation and justifying the use of antimicrobial agents. The decision to prescribe an antimicrobial agent in patients with an exacerbation is often difficult. 5 The purulence of sputum has also been associated with the bacterial load during exacerbations in subjects with COPD. Bacterial colonization has been demonstrated to be low (5%), moderate (43.5%), and very important (86.4%) in mucoid, mucopurulent, and purulent sputum, respectively ( P <. Sputum color is related to the degree of infection. Additionally, it is related to the mortality rate in patients with COPD. Sputum production is also associated with inflammatory processes in the airways 2 and with the progression of obstruction 3 in smokers. Indeed, sputum production is typical in cystic fibrosis or COPD for physiopathological reasons, and patients with bronchiectasis frequently present with a longstanding productive cough. Sputum is a common symptom in various pulmonary diseases.
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February 2023
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