Adaptação cultural e análise das propriedades de medida do Bronchiectasis Exacerbation and Symptoms Tool (BEST) para uso em pacientes com bronquiectasia não-fibrocística no Brasil

Abstract

Introduction: The Bronchiectasis Exacerbation and Symptoms Tool (BEST) was developed to accurately detect exacerbations and daily changes in bronchiectasis symptoms. Objectives: To culturally adapt the BEST and test its measurement properties for use in patients with bronchiectasis in Brazil. Methods: A measurement properties analysis study. The original BEST was culturally adapted to Brazilian Portuguese. The final Brazilian Portuguese version of the BEST was administered twice via telephone (test-retest), with a 7 to 14-day interval. The measurement properties analyzed included internal consistency, measurement error, reliability, construct validity, and floor and ceiling effects. Results: The BEST questionnaire demonstrated satisfactory measurement properties, with adequate internal consistency (Cronbach’s α = 0.80) and good precision (Standard Error of Measurement [SEM] = 9.96% and Minimal Detectable Change [MDC] = 7.18), showing reliable reproducibility between applications. Reliability was moderate (Intraclass Correlation Coefficient [ICC] = 0.66), reflecting an acceptable ability to distinguish individual outcomes. Although no significant correlation was observed with the Exacerbations, Forced expiratory volume in 1 second, Age, Colonization, Extension and Dyspnea (E-FACED) and Bronchiectasis Severity Index (BSI) scales, the BEST differentiated severity levels of bronchiectasis on the E-FACED scale (p = 0.03), supporting its construct validity. No floor or ceiling effects were observed, indicating adequate sensitivity across various disease gravities. Conclusion: The BEST is a valid and precise instrument for evaluating bronchiectasis symptoms, potentially aiding in clinical follow-up of patients.