Contemporary Methods for Patients to Report the Severity of Dyspnea

Donald   A.   Mahler; John   C.   Baird

Abstract

Scales and questionnaires have been used for nearly 50 years in an effort to quantify the severity of dyspnea as experienced by patients with chronic respiratory disease. These instruments have been used for grading the severity of breathlessness (discriminative purpose), predicting outcomes such as survival, and assessing the efficacy of a treatment (evaluative purpose). Two distinct approaches have been used for patients to report the severity of breathlessness. Questionnaires are used in order to grade the impact of activities of daily living on dyspnea; and patients can use the 0 – 10 Category-Ratio scale or a visual analog scale to report the intensity of dsypnea at selected work loads or time periods during an exercise test. Recently, these standard methods have been modified to enhance the quality and utility of patientreported ratings of breathlessness. The Baseline and Transition Dyspnea Indexes have been converted into selfadministered computerized versions; the dyspnea component of the Chronic Respiratory Questionnaire has been converted from an interview-based format into a self-reported version containing individualized activities. In addition, a computerized method has been developed whereby the patient provides continuous ratings of breathlessness throughout exercise using a computer mouse to adjust the length of a bar located next to the 0 -10 Category-Ratio scale. These modifications of traditional instruments have greatly improved the measurement of the intensity of breathlessness in patients with chronic respiratory disease.

Keywords: Self-administered computerized versions, baseline dyspnea index, transition dyspnea index, continuous ratings of breathlessness during exercise

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