Validation of a New Dyspnea Measure

Eakin, Elizabeth G.; Resnikoff, Pamela M.; Prewitt, Lela M.; Ries, Andrew L.; Kaplan, Robert M.

doi:10.1378/chest.113.3.619

Cited by 364 publications

(109 citation statements)

References 19 publications

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“…The baseline dyspnoea scale has also often been used in previous studies related to COPD; it uses five grades (0-4) for each of the categories, functional impairment, magnitude of task, and magnitude of effort (0-12 for total score) [26]. The University of California San Diego Shortness of Breath Questionnaire has also sometimes been used [27]. This questionnaire comprises 24 items that assess dyspnoea over the preceding week.…”

Section: Discussionmentioning

confidence: 99%

A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis

Nishiyama¹,

Taniguchi²,

Kondoh³

et al. 2010

European Respiratory Journal

188

152

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The prognosis in idiopathic pulmonary fibrosis (IPF) is poor. No therapy has been shown to prolong survival. The objective of this study was to examine the prognostic significance of dyspnoea in daily living at baseline in IPF using a simple assessment tool.93 consecutive patients with IPF, who had undergone evaluation at diagnosis, were included. The level of dyspnoea was assessed using the modified Medical Research Council (MRC) scale. The relationship between data at baseline and survival was examined.A univariate Cox proportional-hazard model showed that forced vital capacity % predicted (hazard ratio (HR) 0.965, 95% CI 0.948-0.982; p,0.0001), diffusing capacity of the lung for carbon monoxide % predicted (HR 0.978, 95% CI 0.963-0.993; p50.0041), baseline arterial oxygen tension (HR 0.963, 95% CI 0.938-0.989; p50.0060) and modified MRC score (HR 2.402, 95% CI 1.495-3.858; p50.0003) were significantly predictive of survival. All variables of the 6-min walk test, including walk distance (HR 0.995, 95% CI 0.992-0.998; p50.0020), the lowest arterial oxygen saturation measured by pulse oximetry (Sp,O 2 ) (HR 0.944, 95% CI 0.918-0.972; p,0.0001) and the Borg scale (HR 1.285, 95% CI 1.091-1.514; p50.0027), were also significant. With stepwise, multivariate Cox proportional analysis, the modified MRC score (HR 2.181, 95% CI 1.333-3.568; p50.0019) and the lowest Sp,O 2 during the 6-min walk test (HR 0.952, 95% CI 0.924-0.981; p50.0014) were the most significant. Dyspnoea in daily living, assessed with the modified MRC scale at baseline, provides additional prognostic information for patients with IPF.

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Section: Discussionmentioning

confidence: 99%

A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis

Nishiyama¹,

Taniguchi²,

Kondoh³

et al. 2010

European Respiratory Journal

188

152

View full text Add to dashboard Cite

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“…To assess changes in shortness of breath, we usedthe SOBQ, a validated tool to assess dyspnea in patients with lung disease [21]. The patients are asked to rate their shortness of breath with activities of daily living.…”

Section: Methodsmentioning

confidence: 99%

Therapeutic Bronchoscopy Improves Spirometry, Quality of Life, and Survival in Central Airway Obstruction

et al. 2015

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Background: Central airway obstruction (CAO) occurs in patients with primary or metastatic lung malignancy and nonmalignant pulmonary disorders and results in significant adverse effects on respiratory function and quality of life. Objectives: The objective of this study was to assess the effect of therapeutic bronchoscopic interventions on spirometry, dyspnea, quality of life, and survival in patients with CAO. Methods: We prospectively studied patients who underwent therapeutic rigid bronchoscopy for CAO. Spirometry, San Diego Shortness of Breath questionnaire (SOBQ), and SF-36 questionnaire responses were obtained before the procedure and at follow-up 6-8 weeks after the procedure. Results: Fifty-three patients (24 malignant and 29 nonmalignant CAO), who underwent successful rigid bronchoscopic intervention, were enrolled. Airway stent placement and various debulking techniques including mechanical debridement and heat therapy were used. After bronchoscopy, there was a significant increase in forced vital capacity (2.2 ± 0.91 l before, 2.7 ± 0.80 l after, p = 0.009) and forced expiratory volume at 1 s (1.4 ± 0.60 l before, 1.8 ± 0.67 l after, p = 0.002). The SOBQ score improved from 55.8 ± 30.1 before the procedure to 37.9 ± 27.25 after the procedure (p = 0.002). In the SF-36, there was an improvement in almost all domains, with statistically significant improvement seen in several domains. Benefits were seen independent of the etiology of CAO, site of intervention or stent placement. The patients with malignant CAO, in whom airway patency could not be achieved, had a poor survival. Conclusions: Alleviation of CAO with therapeutic rigid bronchoscopy results in improvement in spirometry, shortness of breath, quality of life, and survival.

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“…In addition, compared with placebo, significantly more patients receiving roflumilast+tiotropium in the 6-month study29 achieved clinically meaningful differences in an instrument that assessed dyspnea associated with specific activities of daily living, the University of California, San Diego Shortness of Breath Questionnaire (SOBQ),30 further demonstrating the positive impact of roflumilast treatment on breathlessness. Numerical improvements in TDI focal scores were also observed with the addition of roflumilast to salmeterol in a separate 6-month study in patients with moderate to severe COPD; however, these differences were not significantly different from patients treated with salmeterol and placebo (treatment difference of 0.1 unit) 31.…”

Section: Discussionmentioning

confidence: 97%

Roflumilast and dyspnea in patients with moderate to very severe chronic obstructive pulmonary disease: a pooled analysis of four clinical trials

Rennard¹,

Sun²,

Tourkodimitris³

et al. 2014

COPD

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PurposeBreathlessness is a predominant symptom of chronic obstructive pulmonary disease (COPD), making it a valuable outcome in addition to lung function to assess treatment benefit. The phosphodiesterase-4 inhibitor roflumilast has been shown to provide small but significant improvements in dyspnea, as measured by the transition dyspnea index (TDI), in two 1-year studies in patients with severe to very severe COPD.Patients and methodsTo provide a more comprehensive assessment of the impact of roflumilast on dyspnea, post hoc analyses of four 1-year roflumilast studies (M2-111, M2-112, M2-124, and M2-125) in patients with moderate to very severe COPD were conducted.ResultsIn this pooled analysis (N=5,595), roflumilast significantly improved TDI focal scores versus placebo at week 52 (treatment difference, 0.327; P<0.0001). Roflumilast was associated with significantly greater TDI responders and significantly fewer TDI deteriorators (≥1-unit increase or decrease from baseline, respectively) versus placebo at week 52 (P<0.01, both); these significant differences were apparent by week 8 and maintained until study end (P<0.05, all). At study end, the postbronchodilator forced expiratory volume in 1 second improvement in TDI responders was significantly greater with roflumilast versus placebo (P<0.05). Similar to the overall population, improvements in TDI focal scores at week 52 were small but consistently significant over placebo in patients with chronic bronchitis, regardless of exacerbation history, concomitant treatment with short-acting muscarinic antagonists or long-acting β2-agonists, or pretreatment with inhaled corticosteroids.ConclusionThis analysis shows that patients treated with roflumilast to reduce exacerbation risk may also experience small but significant improvements in dyspnea, with accompanying improvements in lung function.

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Validation of a New Dyspnea Measure

Cited by 364 publications

References 19 publications

A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis

A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis

Therapeutic Bronchoscopy Improves Spirometry, Quality of Life, and Survival in Central Airway Obstruction

Roflumilast and dyspnea in patients with moderate to very severe chronic obstructive pulmonary disease: a pooled analysis of four clinical trials

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