Fifteen‐Count Breathlessness Score in adults with COPD

Abstract

Most subjects completed the 15CBS using one breath, limiting discrimination between subjects with differing degrees of breathlessness. Although data from this study confirmed that the 15CBS is a reliable procedure within people with COPD, further modification is required to increase the validity and discriminative ability of this instrument.

Thirty‐count breathlessness score: Reliability, sensitivity, specificity and validity

“…The 6MWT did not demonstrate a significant association with the 15CBS in the study by Williams et al 3 . or the 30CBS in the current study supporting previous authors contentions that the 6MWT measures exercise capacity in a different way to other impairment and dyspnoea tools 12,13 .…”

“…By extending the counting time from 15 to 30, the reliability of this counting test has remained essentially unchanged but the ceiling effect has been reduced. While a similar degree of agreement existed between previous assessors of the 15CBS (ICC 0.72, 95% CI: 0.50–0.86) and the 30CBS (COPD group: ICC 0.70, 95% CI: 0.59–0.80, Control group ICC 0.86, 95% CI: 0.77–0.92), Williams et al 3 . reported higher intra‐assessor reliability for the 15CBS (mean ICC 0.98) than that calculated for the 30CBS in the current study (mean ICC 0.73).…”

“…This difference may have resulted from the variance introduced by an additional assessor in the current study, but is more likely a reflection of the number of breaths required to complete the two respective counting tasks. The majority of people with COPD completing the 15CBS required only one breath (mean 1.46 ± 0.7 (range 1–3 breaths)) in both Williams et al 3 . and in the current study (mean 1.40 ± 0.66 (range 1–5 breaths)).…”

“…Scores for the 30CBS were higher in people with COPD compared with a group of subjects asymptomatic for COPD (2.88 Ϯ 1.55 (1-11) vs 1.78 Ϯ 0.86 (1)(2)(3)(4)(5)). While a significant association was calculated between the number of breaths required to complete the 30CBS and the presence of COPD, the 30CBS did not display sufficient sensitivity to accurately discriminate between those with and without COPD (FEV1/FVC < 70%).…”

“…Only one self‐report measure of breathlessness (VAS at rest P = 0.001) demonstrated a significant association with the 30CBS. Previous studies have reported significant associations between counting or speaking tests and indices of airflow obstruction 1–4 . Given the significant relationships between the 30CBS and the majority of measures of pulmonary impairment, it appears that the factors impacting upon pulmonary flows and volumes (age, height, degree of obstruction and hyperinflation) reflect the ventilatory requirements of the 30CBS.…”

Thirty‐count breathlessness score: Reliability, sensitivity, specificity and validity

“…The 6MWT did not demonstrate a significant association with the 15CBS in the study by Williams et al 3 . or the 30CBS in the current study supporting previous authors contentions that the 6MWT measures exercise capacity in a different way to other impairment and dyspnoea tools 12,13 .…”

“…By extending the counting time from 15 to 30, the reliability of this counting test has remained essentially unchanged but the ceiling effect has been reduced. While a similar degree of agreement existed between previous assessors of the 15CBS (ICC 0.72, 95% CI: 0.50–0.86) and the 30CBS (COPD group: ICC 0.70, 95% CI: 0.59–0.80, Control group ICC 0.86, 95% CI: 0.77–0.92), Williams et al 3 . reported higher intra‐assessor reliability for the 15CBS (mean ICC 0.98) than that calculated for the 30CBS in the current study (mean ICC 0.73).…”

“…This difference may have resulted from the variance introduced by an additional assessor in the current study, but is more likely a reflection of the number of breaths required to complete the two respective counting tasks. The majority of people with COPD completing the 15CBS required only one breath (mean 1.46 ± 0.7 (range 1–3 breaths)) in both Williams et al 3 . and in the current study (mean 1.40 ± 0.66 (range 1–5 breaths)).…”

“…Scores for the 30CBS were higher in people with COPD compared with a group of subjects asymptomatic for COPD (2.88 Ϯ 1.55 (1-11) vs 1.78 Ϯ 0.86 (1)(2)(3)(4)(5)). While a significant association was calculated between the number of breaths required to complete the 30CBS and the presence of COPD, the 30CBS did not display sufficient sensitivity to accurately discriminate between those with and without COPD (FEV1/FVC < 70%).…”

“…Only one self‐report measure of breathlessness (VAS at rest P = 0.001) demonstrated a significant association with the 30CBS. Previous studies have reported significant associations between counting or speaking tests and indices of airflow obstruction 1–4 . Given the significant relationships between the 30CBS and the majority of measures of pulmonary impairment, it appears that the factors impacting upon pulmonary flows and volumes (age, height, degree of obstruction and hyperinflation) reflect the ventilatory requirements of the 30CBS.…”

Thirty‐count breathlessness score: Reliability, sensitivity, specificity and validity

“…The 6MWT did not demonstrate a significant association with the 15CBS in the study by Williams et al 3 . or the 30CBS in the current study supporting previous authors contentions that the 6MWT measures exercise capacity in a different way to other impairment and dyspnoea tools 12,13 .…”

“…By extending the counting time from 15 to 30, the reliability of this counting test has remained essentially unchanged but the ceiling effect has been reduced. While a similar degree of agreement existed between previous assessors of the 15CBS (ICC 0.72, 95% CI: 0.50–0.86) and the 30CBS (COPD group: ICC 0.70, 95% CI: 0.59–0.80, Control group ICC 0.86, 95% CI: 0.77–0.92), Williams et al 3 . reported higher intra‐assessor reliability for the 15CBS (mean ICC 0.98) than that calculated for the 30CBS in the current study (mean ICC 0.73).…”

“…This difference may have resulted from the variance introduced by an additional assessor in the current study, but is more likely a reflection of the number of breaths required to complete the two respective counting tasks. The majority of people with COPD completing the 15CBS required only one breath (mean 1.46 ± 0.7 (range 1–3 breaths)) in both Williams et al 3 . and in the current study (mean 1.40 ± 0.66 (range 1–5 breaths)).…”

“…Scores for the 30CBS were higher in people with COPD compared with a group of subjects asymptomatic for COPD (2.88 Ϯ 1.55 (1-11) vs 1.78 Ϯ 0.86 (1)(2)(3)(4)(5)). While a significant association was calculated between the number of breaths required to complete the 30CBS and the presence of COPD, the 30CBS did not display sufficient sensitivity to accurately discriminate between those with and without COPD (FEV1/FVC < 70%).…”

“…Only one self‐report measure of breathlessness (VAS at rest P = 0.001) demonstrated a significant association with the 30CBS. Previous studies have reported significant associations between counting or speaking tests and indices of airflow obstruction 1–4 . Given the significant relationships between the 30CBS and the majority of measures of pulmonary impairment, it appears that the factors impacting upon pulmonary flows and volumes (age, height, degree of obstruction and hyperinflation) reflect the ventilatory requirements of the 30CBS.…”

Thirty‐count breathlessness score: Reliability, sensitivity, specificity and validity

“…The 6MWT did not demonstrate a significant association with the 15CBS in the study by Williams et al 3 . or the 30CBS in the current study supporting previous authors contentions that the 6MWT measures exercise capacity in a different way to other impairment and dyspnoea tools 12,13 .…”

“…By extending the counting time from 15 to 30, the reliability of this counting test has remained essentially unchanged but the ceiling effect has been reduced. While a similar degree of agreement existed between previous assessors of the 15CBS (ICC 0.72, 95% CI: 0.50–0.86) and the 30CBS (COPD group: ICC 0.70, 95% CI: 0.59–0.80, Control group ICC 0.86, 95% CI: 0.77–0.92), Williams et al 3 . reported higher intra‐assessor reliability for the 15CBS (mean ICC 0.98) than that calculated for the 30CBS in the current study (mean ICC 0.73).…”

“…This difference may have resulted from the variance introduced by an additional assessor in the current study, but is more likely a reflection of the number of breaths required to complete the two respective counting tasks. The majority of people with COPD completing the 15CBS required only one breath (mean 1.46 ± 0.7 (range 1–3 breaths)) in both Williams et al 3 . and in the current study (mean 1.40 ± 0.66 (range 1–5 breaths)).…”

“…Scores for the 30CBS were higher in people with COPD compared with a group of subjects asymptomatic for COPD (2.88 Ϯ 1.55 (1-11) vs 1.78 Ϯ 0.86 (1)(2)(3)(4)(5)). While a significant association was calculated between the number of breaths required to complete the 30CBS and the presence of COPD, the 30CBS did not display sufficient sensitivity to accurately discriminate between those with and without COPD (FEV1/FVC < 70%).…”

“…Only one self‐report measure of breathlessness (VAS at rest P = 0.001) demonstrated a significant association with the 30CBS. Previous studies have reported significant associations between counting or speaking tests and indices of airflow obstruction 1–4 . Given the significant relationships between the 30CBS and the majority of measures of pulmonary impairment, it appears that the factors impacting upon pulmonary flows and volumes (age, height, degree of obstruction and hyperinflation) reflect the ventilatory requirements of the 30CBS.…”