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Table 2 Symptoms discussed during concept elicitation interviews

From: Understanding and measuring symptoms and health status in asthma COPD overlap: content validity of the EXACT and SGRQ

Sign/symptom Patients with ACO, n (%) (N = 20) Patients with COPD, n (%) (N = 10)
Shortness of breath 20 (100) 10 (100)
“My airway is restricted it seems like when I’m, when I’m breathing in. And of course, when you breathe in and you can’t take enough air in” (M-65) “I’m just more or less just pulling in air. Well really I’m not even doing that but I’m just gasping for air” (F-78)
Difficulty breathing 14 (70) 9 (90)
“You’re just wanting that next breath. You want everybody away from you and it’s just really it’s are you going to die, are you going to suffocate right here. Suffocation is, is a, uh, common factor. Uh, because it, it feels like everything is right on your face. It’s, it’s like mask” (M-53) “I was having a hard time breathing. I had an elephant sitting on my chest and I just seemed like I couldn’t get hardly anything done and that’s when we decided I needed to have inhalers” (M-52)
Wheezing 19 (95) 7 (70)
“Um, kind of like, uh, you, you take a deep breath but it kind of makes a high pitched sound going in. Like your throat’s closing or something.” (M-47) “It’s just a rattling in my chest, it’s, that’s all it is.” (M-60)
Cough 20 (100) 9 (90)
“It’s like you’re trying to… pull something out of your lungs, you know? Trying to—you feel like something’s obstructing it and you’re really coughing deep to try to dislodge something” (F-48) “I would cough using my muscles, but sometimes it hurt when I cough (M-58)
Mucus/phlegm 19 (95) 7 (70)
“Well on a day like today my throat is not clear and I can, I can feel something here” (M-62) “nasty little stuff, yellow and green and, you know, and some of it’s coming out of my nose, out of my throat, out of my chest” (M-58)
Vocal Changes 12 (60) 5 (50)
“I can’t yell as good as I used to, you know, or, or call out to somebody. I used to have a voice that would carry for, forever. And, uh, I can’t do that anymore.” (M-65) “It feels like I can’t get my voice out some. That’s what it really feels like.” (F-53)
Congestion 8 (40) 3 (30)
“congestion in my lungs... feels really hard to breath, and it, it’s really uncomfortable” (M-44) “[congestion] I have that in my throat. I wake up in the mornings, you know, and just feel like I’m choking sometimes” (F-65)
Chest tightness 13 (65) 8 (80)
“It’s like somebody takes and just squeezes your lungs and they don’t expand so that you can get the air in” (F-55) “I get a little tight, feels like something pushing on me, you know, kinda like some people will probably tell you they’re about to have a heart attack, you know, that’s just the way you feel” (M-67)
Chest heaviness or pressure 9 (45) 5 (50)
“I have pressure in my chest, but where I’m coughing so much, making my chest so sore can’t hardly breathe.” (M-59) “Severe symptoms is the elephants that you can’t get off your chest. It’s really tight and pressurized and you have to use your inhaler like, every hour for a while until you get things opened up.” (M-52)
Chest pain 8 (40) 3 (30)
“it’s just a sharp pain that just shoots across my chest” (M-62) “It gets real tight, and it hurts” (F-53)
Tiredness, weakness or fatigue 12 (60) 8 (80)
“Sometimes you don’t feel like going to the bathroom, you know… you can go into bed... it’s just tiredness. I think it’s more tiredness than it’s lethargy” (M-53) “I’m getting run down. I’m tired during the day, you know, and I have to sit down and take it easy… I can’t do what I want to do” (M-58)
Dizziness or lightheadedness 10 (50) 5 (50)
“I have to sit down or whatever, you know, because I don’t wanna fall. But yeah, I have, uh, felt dizziness in the—like even doing my inhaler I might have to just wait a second in between now and then” (F-57) “You just feel like you’re going to fall over –..And you kind of walk sideways” (F-65)
  1. Quotes are followed by a patient identifier. Patient identification numbers are coded as Male (M) or Female (F) followed by age. For example, F-45 is a quote from a 45-year-old female