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COMPREHENSIVE MEASUREMENT OF BREATHLESSNESS USING THE SELF-ADMINISTERED COMPUTERIZED VERSIONS OF THE BASELINE AND TRANSITION DYSPNEA INDEXES

Dartmouth-Hitchcock Medical Center, Lebanon, NH

PURPOSE: To examine and compare the component and total scores of the self-administered computerized (SAC) versions of the Baseline (BDI) and the Transition (TDI) Dyspnea Indexes with scores from the interviewer-administered (IA) original versions.

METHODS: Observational study of 56 patients with respiratory disease who had a chief complaint of dyspnea on exertion at an initial visit and at a follow-up ( 4 weeks) visit after treatment. Order of administration of the SAC and IA dyspnea instruments was random. Spirometry and inspiratory capacity (IC) were measured at each visit.

RESULTS: Age was 67 ± 11 years. There were 29 females and 27 males. Diagnoses were: COPD (n=40); asthma (n=7); ILD (n=7); and other (n=2). BDI total scores (mean/SD)were 5.4/2.2 (IA) and 6.4/2.0 (SAC); TDI total scores were + 2.1/3.1 (IA) and + 1.9/3.0 (SAC). Pearson’s correlation coefficients between IA and SAC versions were: 0.76 for functional impairment, 0.58 for magnitude of task, 0.64 for magnitude of effort, and 0.84 for total scores for the BDI; and 0.74 for change in functional impairment, 0.80 for change in magnitude of task; 0.82 for change in magnitude of effort, and 0.79 for the total scores of the TDI. Both IA TDI total score (r=0.85, 0.55, 0.53) and SAC TDI total score (r=0.77, 0.54, 0.53) were significantly related to the changes in total health score reported by the patient, forced vital capacity (% predicted), and IC (% predicted), respectively (p < 0.001).

CONCLUSION: Component and total scores of the IA and the SAC versions of the BDI/TDI were similar in patients with symptomatic respiratory disease. The TDI total scores from the IA and SAC versions had similar correlations with changes in overall health and with changes in lung function.

CLINICAL IMPLICATIONS: The SAC versions of the BDI/TDI are recommended to measure dyspnea rather than the original IA method becasue the SAC instruments use standardized methodology, are patient-reported, and provide a continuous measure of any change in dyspnea.

DISCLOSURE: Donald Mahler, None.