PMID- 28433323
OWN - NLM
STAT- MEDLINE
DCOM- 20170809
LR  - 20181202
IS  - 1527-3288 (Electronic)
IS  - 0147-9563 (Linking)
VI  - 46
IP  - 4
DP  - 2017 Jul-Aug
TI  - Is there a clinically meaningful difference in patient reported dyspnea in acute 
      heart failure? An analysis from URGENT Dyspnea.
PG  - 300-307
LID - S0147-9563(16)30358-2 [pii]
LID - 10.1016/j.hrtlng.2017.03.003 [doi]
AB  - BACKGROUND: Dyspnea is the most common presenting symptom in patients with acute 
      heart failure (AHF), but is difficult to quantify as a research measure. The 
      URGENT Dyspnea study compared 3 scales: (1) 10 cm VAS, (2) 5-point Likert, and 
      (3) a 7-point Likert (both VAS and 5-point Likert were recorded in the upright 
      and supine positions). However, the minimal clinically important difference 
      (MCID) to patients has not been well established. METHODS: We performed a 
      secondary analysis from URGENT Dyspnea, an observational, multi-center study of 
      AHF patients enrolled within 1 h of first physician assessment in the ED. Using 
      the anchor-based method to determine the MCID, a one-category change in the 
      7-point Likert was used as the criterion standard ('minimally improved or 
      worse'). The main outcome measures were the change in visual analog scale (VAS) 
      and 5-point Likert scale from baseline to 6-h assessment relative to a 1-category 
      change response in the 7-point Likert scale ('minimally worse', 'no change', or 
      'minimally better'). RESULTS: Of the 776 patients enrolled, 491 had a final 
      diagnosis of AHF with responses at both time points. A 10.5 mm (SD 1.6 mm) change 
      in VAS was the MCID for improvement in the upright position, and 14.5 mm (SD 
      2.0 mm) in the supine position. However, there was no MCID for worsening, as few 
      patients reported worse dyspnea. There was also no significant MCID for the 
      5-point Likert scale. CONCLUSION: A 10.5 mm change is the MCID for improvement in 
      dyspnea over 6 h in ED patients with AHF.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Pang, Peter S
AU  - Pang PS
AD  - Department of Emergency Medicine, Indiana University School of Medicine, USA; 
      Indianapolis EMS, USA. Electronic address: ppang@iu.edu.
FAU - Lane, Kathleen A
AU  - Lane KA
AD  - Department of Biostatistics, Indiana University School of Medicine, USA.
FAU - Tavares, Miguel
AU  - Tavares M
AD  - Department of Anesthesiology and Critical Care, Hospital Geral de Santo Antonio, 
      Porto, Portugal.
FAU - Storrow, Alan B
AU  - Storrow AB
AD  - Department of Emergency Medicine, Vanderbilt University, Nashville, VA, USA.
FAU - Shen, Changyu
AU  - Shen C
AD  - Department of Biostatistics, Indiana University School of Medicine, USA.
FAU - Peacock, W Frank
AU  - Peacock WF
AD  - Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.
FAU - Nowak, Richard
AU  - Nowak R
AD  - Department of Emergency Medicine, Henry Ford Health System, Wayne State 
      University, USA.
FAU - Mebazaa, Alexandre
AU  - Mebazaa A
AD  - Department of Anesthesia and Critical Care, Hopitaux Universitaires Saint Louis 
      Lariboisiere, France.
FAU - Laribi, Said
AU  - Laribi S
AD  - Tours University Hospital, Emergency Department, 37044, France; INSERM, U942, 
      BIOmarkers in CArdioNeuroVAScular diseases, France.
FAU - Hollander, Judd E
AU  - Hollander JE
AD  - Sidney Kimmel Medical College of Thomas Jefferson University, USA.
FAU - Gheorghiade, Mihai
AU  - Gheorghiade M
AD  - Division of Cardiology, Northwestern University Feinberg School of Medicine, USA.
FAU - Collins, Sean P
AU  - Collins SP
AD  - Department of Emergency Medicine, Vanderbilt University, Nashville, VA, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20170419
PL  - United States
TA  - Heart Lung
JT  - Heart & lung : the journal of critical care
JID - 0330057
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Dyspnea/*diagnosis/etiology
MH  - Emergency Service, Hospital
MH  - Female
MH  - Heart Failure/*complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Acute heart failure
OT  - Dyspnea
OT  - Emergency department
OT  - MCID
OT  - Shortness of breath
EDAT- 2017/04/24 06:00
MHDA- 2017/08/10 06:00
CRDT- 2017/04/24 06:00
PHST- 2016/11/23 00:00 [received]
PHST- 2017/03/10 00:00 [revised]
PHST- 2017/03/13 00:00 [accepted]
PHST- 2017/04/24 06:00 [pubmed]
PHST- 2017/08/10 06:00 [medline]
PHST- 2017/04/24 06:00 [entrez]
AID - S0147-9563(16)30358-2 [pii]
AID - 10.1016/j.hrtlng.2017.03.003 [doi]
PST - ppublish
SO  - Heart Lung. 2017 Jul-Aug;46(4):300-307. doi: 10.1016/j.hrtlng.2017.03.003. Epub 
      2017 Apr 19.