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Minimal Clinically Important Differences and Feasibility of Dyspnea-12 and the Multidimensional Dyspnea Profile in Cardiorespiratory Disease

Ekström, Magnus P. LU orcid ; Bornefalk, Hans ; Sköld, C. Magnus ; Janson, Christer ; Blomberg, Anders ; Bornefalk-Hermansson, Anna ; Igelström, Helena ; Sandberg, Jacob LU orcid and Sundh, Josefin (2020) In Journal of Pain and Symptom Management 60(5). p.1-975
Abstract

Context: Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). Objectives: The objective of the study is to determine the minimal clinically important differences (MCIDs) of all D12 and MDP summary and subdomain scores as well as the instruments' feasibility in patients with cardiorespiratory disease. Methods: Prospective multicenter cohort study of outpatients with diagnosed cardiorespiratory disease and breathlessness in daily life. D12 and MDP were assessed at baseline, after 30–90 minutes and two weeks. MCIDs were calculated using anchor-based and distributional methods for... (More)

Context: Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). Objectives: The objective of the study is to determine the minimal clinically important differences (MCIDs) of all D12 and MDP summary and subdomain scores as well as the instruments' feasibility in patients with cardiorespiratory disease. Methods: Prospective multicenter cohort study of outpatients with diagnosed cardiorespiratory disease and breathlessness in daily life. D12 and MDP were assessed at baseline, after 30–90 minutes and two weeks. MCIDs were calculated using anchor-based and distributional methods for summary and subdomain scores. Feasibility was assessed as rate of missing data, help required, self-reported difficulty, and completion time. Results: A total 182 outpatients (53.3% women) were included; main diagnoses were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%), and idiopathic pulmonary fibrosis (19%). Anchor-based MCIDs were for D12 total score 2.83 (95% CI 1.99–3.66); D12 physical 1.81 (1.29–2.34); D12 affective 1.07 (0.64–1.49); MDP A1 unpleasantness 0.82 (0.56–1.08); MDP perception 4.63 (3.21–6.05), and MDP emotional score 2.37 (1.10–3.64). The estimates were consistent with small-to-moderate effect sizes using distributional analysis, and MCIDs were similar between COPD and non-COPD patients. The instruments were generally feasible and quick to use. Conclusion: D12 and MDP are responsive to change and feasible for use for assessing multidimensional breathlessness in outpatients with cardiorespiratory disease. MCIDs were determined for use as endpoints in clinical trials.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
breathlessness, Dyspnea, heart disease, measurement, multidimensional, respiratory disease
in
Journal of Pain and Symptom Management
volume
60
issue
5
pages
1 - 975
publisher
Elsevier
external identifiers
  • scopus:85087777350
  • pmid:32512047
ISSN
0885-3924
DOI
10.1016/j.jpainsymman.2020.05.028
language
English
LU publication?
yes
id
4c5d445d-4458-4335-b29a-b8496b08b05f
date added to LUP
2020-07-24 08:45:45
date last changed
2024-06-26 19:30:26
@article{4c5d445d-4458-4335-b29a-b8496b08b05f,
  abstract     = {{<p>Context: Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). Objectives: The objective of the study is to determine the minimal clinically important differences (MCIDs) of all D12 and MDP summary and subdomain scores as well as the instruments' feasibility in patients with cardiorespiratory disease. Methods: Prospective multicenter cohort study of outpatients with diagnosed cardiorespiratory disease and breathlessness in daily life. D12 and MDP were assessed at baseline, after 30–90 minutes and two weeks. MCIDs were calculated using anchor-based and distributional methods for summary and subdomain scores. Feasibility was assessed as rate of missing data, help required, self-reported difficulty, and completion time. Results: A total 182 outpatients (53.3% women) were included; main diagnoses were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%), and idiopathic pulmonary fibrosis (19%). Anchor-based MCIDs were for D12 total score 2.83 (95% CI 1.99–3.66); D12 physical 1.81 (1.29–2.34); D12 affective 1.07 (0.64–1.49); MDP A1 unpleasantness 0.82 (0.56–1.08); MDP perception 4.63 (3.21–6.05), and MDP emotional score 2.37 (1.10–3.64). The estimates were consistent with small-to-moderate effect sizes using distributional analysis, and MCIDs were similar between COPD and non-COPD patients. The instruments were generally feasible and quick to use. Conclusion: D12 and MDP are responsive to change and feasible for use for assessing multidimensional breathlessness in outpatients with cardiorespiratory disease. MCIDs were determined for use as endpoints in clinical trials.</p>}},
  author       = {{Ekström, Magnus P. and Bornefalk, Hans and Sköld, C. Magnus and Janson, Christer and Blomberg, Anders and Bornefalk-Hermansson, Anna and Igelström, Helena and Sandberg, Jacob and Sundh, Josefin}},
  issn         = {{0885-3924}},
  keywords     = {{breathlessness; Dyspnea; heart disease; measurement; multidimensional; respiratory disease}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{5}},
  pages        = {{1--975}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pain and Symptom Management}},
  title        = {{Minimal Clinically Important Differences and Feasibility of Dyspnea-12 and the Multidimensional Dyspnea Profile in Cardiorespiratory Disease}},
  url          = {{http://dx.doi.org/10.1016/j.jpainsymman.2020.05.028}},
  doi          = {{10.1016/j.jpainsymman.2020.05.028}},
  volume       = {{60}},
  year         = {{2020}},
}