PMID- 22877809
OWN - NLM
STAT- MEDLINE
DCOM- 20121010
LR  - 20220317
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 164
IP  - 2
DP  - 2012 Aug
TI  - Minimally clinically important difference in chronic breathlessness: every little 
      helps.
PG  - 229-35
LID - 10.1016/j.ahj.2012.05.003 [doi]
AB  - OBJECTIVES: The aim of the study was to determine the minimally clinically 
      important difference (MCID) for breathlessness due to chronic heart failure 
      (CHF). BACKGROUND: The measurement of breathlessness is difficult because it is 
      subjective and multifactorial. Statistically significant changes in assessment 
      may not be clinically meaningful. This is the first determination of MCID in 
      chronic breathlessness in CHF using patient-rated data. METHODS: Measurements 
      were made as part of a randomized, controlled, crossover trial of morphine, 
      oxycodone, or placebo for breathlessness in CHF. Breathlessness intensity was 
      assessed at baseline and at the end of each intervention (day 4) using 11-point 
      numerical rating scales (NRS), modified Borg (mBorg) scales, and global 
      impression of change (GC) in breathlessness at day 4. From these data, the change 
      in NRS or mBorg associated with a 1-point change in GC was calculated. RESULTS: 
      Thirty-five patients completed all study interventions, resulting in 105 data 
      sets. We defined MCID as a 1-point change in GC. Regression analysis found that 
      the MCID, including 95% CIs, equaled change in average NRS breathlessness per 24 
      hours of 0.5 to 2.0 U (P < .001), change in worst NRS breathlessness per 24 hours 
      of 0.4 to 2.9 (P < .001), change in average mBorg score of 0.2 to 2.0 (P < .001), 
      and change in worst mBorg score as between 0.3 and 1.9 (P < .001). Corresponding 
      effect size calculations lay within the 95% CIs for the regression analysis for 
      each measure. CONCLUSIONS: A 1-point change in NRS or mBorg score is a reasonable 
      estimate of the MCID in average daily chronic breathlessness in CHF.
CI  - Copyright (c) 2012 Mosby, Inc. All rights reserved.
FAU - Oxberry, Stephen G
AU  - Oxberry SG
AD  - Kirkwood Hospice, Huddersfield, United Kingdom.
FAU - Bland, J Martin
AU  - Bland JM
FAU - Clark, Andrew L
AU  - Clark AL
FAU - Cleland, John G F
AU  - Cleland JG
FAU - Johnson, Miriam J
AU  - Johnson MJ
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Chronic Disease
MH  - Dyspnea/*diagnosis/*etiology
MH  - Heart Failure/*complications
MH  - Humans
EDAT- 2012/08/11 06:00
MHDA- 2012/10/12 06:00
CRDT- 2012/08/11 06:00
PHST- 2012/01/03 00:00 [received]
PHST- 2012/05/11 00:00 [accepted]
PHST- 2012/08/11 06:00 [entrez]
PHST- 2012/08/11 06:00 [pubmed]
PHST- 2012/10/12 06:00 [medline]
AID - S0002-8703(12)00319-5 [pii]
AID - 10.1016/j.ahj.2012.05.003 [doi]
PST - ppublish
SO  - Am Heart J. 2012 Aug;164(2):229-35. doi: 10.1016/j.ahj.2012.05.003.