Table 2

List of potential treatable traits within the extrapulmonary domain to consider in patients with chronic airway disease

TraitTrait identification marker/diagnostic criteriaPossible treatmentsEvidence level I–IV#
DepressionQuestionnaires (e.g. HADS depression domain score ≥8, GADS score >5), psychologist/liaison psychiatrist assessmentCBT, pharmacotherapyI
AnxietyQuestionnaires (e.g. HADS anxiety domain score ≥8), psychologist/liaison psychiatrist assessmentPharmacotherapy (i.e., anxiolytics/antidepressants), breathing retraining, CBTI
Dysfunctional breathingNijmegen Questionnaire Total score ≥23, B-PAT (breathing pattern assessment tool) score >4, breath holding time, manual assessment of respiratory motion (MARM)Breathing retrainingI
Physical inactivity and sedentary behaviourActigraphy, International Physical Activity QuestionnairePulmonary rehabilitation, physical activity, breaking bouts of sedentary activityI
Overweight/obesityOverweight: BMI 25–29.9 kg·m−2
Obesity: BMI ≥30 kg·m−2
Caloric restriction, exercise, bariatric surgery, pharmacotherapyI–II
DeconditioningCardiopulmonary exercise testing, 6MWTStructured exercise programme, rehabilitationI+, II
RhinosinusitisHistory and examination, imaging (sinus CT), Sino-Nasal Outcome Test (SNOT-22)Topical corticosteroids, leukotriene receptor antagonists, antihistamines, surgery, intranasal saline lavageII
VCDQuestionnaires (e.g. Pittsburgh ≥4), laryngoscopy, dynamic neck CT, inspiratory flow–volume curveSpeech pathology intervention, laryngeal botulinum toxin, gabapentin/pregabalin, psychology/psychiatryII
Systemic inflammationLeukocyte count >9×109 cells·L−1or high-sensitivity CRP >3 mg·L−1StatinsII
AnaemiaMales: Hb <140 g·L−1
Females: Hb <120 g·L−1
Haematinic (iron/B12) supplementationI+, IV
Cardiovascular diseaseDoppler echocardiography, Electrocardiogram, brain natriuretic peptidePharmacotherapy (β-blockers, diuretics, angiotensin-converting enzyme inhibitors), surgeryII
GORDQuestionnaires, gastrointestinal endoscopy, pH monitoringAnti-reflux lifestyle measures, antacids, proton pump inhibitors, fundoplication surgeryII
OSAQuestionnaires (i.e., STOP-Bang Questionnaire), polysomnographyCPAP, mandibular advancement splint, positional therapy, weight lossIII-2

HADS: hospital anxiety and depression scale; GADS: Goldberg Anxiety and Depression Scale; CBT: cognitive behavioural therapy; BMI: body mass index; 6MWT: 6-min walk test; VCD: vocal cord dysfunction; CRP: C-reactive protein; Hb: haemoglobin; GORD: gastro-oesophageal reflux disease; OSA: obstructive sleep apnoea; CPAP: continuous positive airway pressure. #: NHMRC level of evidence currently available for the management/treatment of each trait; : currently research only; +: evidence from the general population. Content has been reproduced with permission from the Centre of Excellence in Treatable Traits, originally developed as part of the Centre of Excellence in Treatable Traits (