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Assessing exertional dyspnea in patients with idiopathic pulmonary fibrosis

  • Author(s): Swigris, JJ
  • Streiner, DL
  • Brown, KK
  • Belkin, A
  • Green, KE
  • Wamboldt, FS
  • Schwarz, M
  • Zisman, DA
  • Hunninghake, G
  • Chapman, J
  • Olman, M
  • Lubell, S
  • Morrison, LD
  • Steele, MP
  • Haram, T
  • Roman, J
  • Perez, R
  • Perez, T
  • Ryu, JH
  • Utz, JP
  • Limper, AH
  • Daniels, CE
  • Meiras, K
  • Walsh, S
  • Brown, KK
  • Schwarz, M
  • Bair, C
  • Kervitsky, D
  • Lasky, JA
  • Ditta, S
  • De Andrade, J
  • Thannickal, VJ
  • Stewart, M
  • Zisman, DA
  • Lynch, J
  • Calahan, E
  • Lopez, P
  • King, TE
  • Collard, HR
  • Golden, JA
  • Wolters, PJ
  • Jeffrey, R
  • Noth, I
  • Hogarth, DK
  • Sandbo, N
  • Strek, ME
  • White, SR
  • Brown, C
  • Garic, I
  • Maleckar, S
  • Martinez, FJ
  • Flaherty, KR
  • Han, M
  • Moore, B
  • Toews, GB
  • Dahlgren, D
  • Raghu, G
  • Hayes, J
  • Snyder, M
  • Loyd, JE
  • Lancaster, L
  • Lawson, W
  • Greer, R
  • Mason, W
  • Kaner, RJ
  • Monroy, V
  • Wang, M
  • Lynch, DA
  • Colby, T
  • Anstrom, KJ
  • Becker, RC
  • Eisenstein, EL
  • MacIntyre, NR
  • Morrison, LD
  • Rochon, J
  • Steele, MP
  • Sundy, JS
  • Davidson-Ray, L
  • Dignacco, P
  • Edwards, R
  • Anderson, R
  • Beci, R
  • Calvert, S
  • Cain, K
  • Gentry-Bumpass, T
  • Hill, D
  • Ingham, M
  • Kagan, E
  • Kaur, J
  • Matti, C
  • McClelland, J
  • Meredith, A
  • Nguyen, T
  • Pesarchick, J
  • Roberts, RS
  • Tate, W
  • Thomas, T
  • Walker, J
  • Whelan, D
  • Winsor, J
  • et al.

Published Web Location

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951298/
No data is associated with this publication.
Abstract

Background: Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. Methods: We examined response data for the 21 physical activity items (the first 21 of 24) from the University of California San Diego Shortness of Breath Questionnaire (UCSD) collected at baseline in a recently conducted IPF trial. We used Rasch analysis and hypothesis testing with conventional statistical methodology to achieve three objectives: 1) to examine the items to identify the one characteristic that distinguishes one from another; 2) to asses these items for their ability to measure dyspnea severity in IPF; 3) to use the items to develop a dyspnea ruler. Results: The sample comprised 178 subjects. The 21 items fit the Rasch model. There was very strong correlation between Rasch item severity and their metabolic equivalents (METS) values (r = -0.86, p < 0.0001). With the sample stratified on scores from the 21 items, there were significant between group differences in FVC%, DLCO% and distance walked during the six-minute walk test. The dyspnea ruler can be used to put dyspnea levels in a more easily understood clinical context. Conclusions: The first 21 items from the UCSD compose a unidimensional dyspnea-with-activity scale and are both sensibly ordered and distinguished from each other by their METS values. These 21 items can be used confidently to formulate clinically-relevant inferences about IPF patients and should be considered for use as a meaningful endpoint in IPF research. © 2013 Elsevier Ltd. All rights reserved.

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