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How to evaluate exertional breathlessness using normative reference equations in research

Ekström, Magnus LU orcid ; Lewthwaite, Hayley and Jensen, Dennis (2024) In Current Opinion in Supportive and Palliative Care 18(4). p.191-198
Abstract

Purpose of review Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research. Recent findings Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for... (More)

Purpose of review Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research. Recent findings Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual's exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating > upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups. Summary Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dyspnea, exercise capacity, exercise testing, measurement, prevalence, reference values
in
Current Opinion in Supportive and Palliative Care
volume
18
issue
4
pages
8 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:39494536
  • scopus:85204141941
ISSN
1751-4258
DOI
10.1097/SPC.0000000000000721
language
English
LU publication?
yes
id
eb00565e-809c-47a7-aad9-5cd2c88243a9
date added to LUP
2024-11-27 12:16:55
date last changed
2025-07-10 07:03:52
@article{eb00565e-809c-47a7-aad9-5cd2c88243a9,
  abstract     = {{<p>Purpose of review Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research. Recent findings Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual's exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating &gt; upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups. Summary Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research.</p>}},
  author       = {{Ekström, Magnus and Lewthwaite, Hayley and Jensen, Dennis}},
  issn         = {{1751-4258}},
  keywords     = {{dyspnea; exercise capacity; exercise testing; measurement; prevalence; reference values}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{191--198}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Current Opinion in Supportive and Palliative Care}},
  title        = {{How to evaluate exertional breathlessness using normative reference equations in research}},
  url          = {{http://dx.doi.org/10.1097/SPC.0000000000000721}},
  doi          = {{10.1097/SPC.0000000000000721}},
  volume       = {{18}},
  year         = {{2024}},
}