Development of Self‐Administered Versions of Modified Baseline and Transition Dyspnea Indexes in COPD

Abstract

In this study we developed self-administered versions of modified baseline and transition dyspnea indexes and compared the scores obtained by this method with the mean value obtained by two trained interviewers. Twenty-five patients (14 males/11 females) with chronic obstructive disease who had a chief complaint of "breathlessness" were tested. Age was 66+/-11 years; forced expiratory volume in one second was 48+/-23% predicted. The baseline total scores were 5.0+/-1.8 for the interviewers and 5.4+/-2.0 for the self-administered method. For the baseline dyspnea scores the correlations were 0.83 (p<0.0001) between self-administration and the mean value of two interviewers and 0.75 (p<0.0001) between the two interviewers. The transition total scores, obtained an average of 102 days (range, 7-377 days) later, were - 0.1+/-3.0 for the interviewers and - 0.4+/-3.0 for the self-administered method. For the transition dyspnea scores the correlations were 0.94 (p<0.0001) between self-administration and the mean value of two interviewers and 0.83 (p<0.0001) between the two interviewers. The self-administered dyspnea scores had similar correlations with measures of lung function as did the interview dyspnea scores. We conclude that self-administered versions of the modified baseline and transition dyspnea indexes provide comparable scores as those obtained by trained and experienced interviewers. The advantages of the self-administered versions include standardized methodology and computerized scoring.

Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

“…For example, disease severity in COPD patients based on spirometric classification is related to health status, utilization of health-care resources, development of exacerbations, and mortality. 3,26,27 Although cross-sectional studies 8,16,28,29 show modest correlations between measures of lung function and dyspnea ratings, previous investigators 27, 30 -32 have not shown significant differences in MRC dyspnea scores with different stages of COPD. Our results are the first to demonstrate that patient-reported dyspnea ratings on three different instruments are significantly related to the stage of disease severity based on percent predicted FEV 1 in patients with COPD.…”

“…For the BDI (visits 1 and 2), the patient selected grades for each of the three components, which were summed to obtain a total score (0 to 12). 8,16 Lower scores represent more breathlessness. Using the TDI (visits 3 and 4), patients reported changes in breathlessness from baseline for each component by adjusting the length of a bar along a bidirectional visual analog scale.…”

“…Using the TDI (visits 3 and 4), patients reported changes in breathlessness from baseline for each component by adjusting the length of a bar along a bidirectional visual analog scale. 8,16 The three scores were summed and divided by 2 to obtain a total score (Ϫ9 to ϩ9). A negative score indicates deterioration, whereas a positive score indicates improvement.…”

“…Test-retest reliability is an essential criterion of any measurement scale or instrument. 13,14 The primary purpose of the present study was to investigate the test-retest reliability of the following three patient-reported measures of dyspnea: the mMRC scale 15 ; the self-administered computerized (SAC) versions of the BDI and TDI 8,16 ; and the University of California San Diego (UCSD) Shortness of Breath Questionnaire (SOBQ). 17 A secondary objective was to examine dyspnea scores based on the stage of COPD.…”

Dual Bronchodilation By Once Daily Fixed Dose Combined Indacaterol And Glycopyrronium, New Era For Treatment In Moderate To Severe COPD

“…In this multicentre, blinded, double-dummy, three-period crossover study, 247 patients were randomized to once-daily QVA149 110/50 µg, placebo or tiotropium 18 µg. Superiority of QVA149 versus placebo (primary objective) and tiotropium (secondary objective) was assessed for improvement in dyspnoea via the Self Administered Computerized (SAC) version of the Baseline and Transition Dyspnoea Index (BDI/TDI) after 6 weeks 4 .…”