PMID- 34981344
OWN - NLM
STAT- MEDLINE
DCOM- 20220810
LR  - 20230802
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 37
IP  - 10
DP  - 2022 Aug
TI  - Reliability, Validity, and Responsiveness of the DEG, a Three-Item Dyspnea 
      Measure.
PG  - 2541-2547
LID - 10.1007/s11606-021-07307-1 [doi]
AB  - BACKGROUND: Dyspnea is a common and debilitating symptom that affects many 
      different patient populations. Dyspnea measures should assess multiple domains. 
      OBJECTIVE: To evaluate the reliability, validity, and responsiveness of an 
      ultra-brief, multi-dimensional dyspnea measure. DESIGN: We adapted the DEG from 
      the PEG, a valid 3-item pain measure, to assess average dyspnea intensity (D), 
      interference with enjoyment of life (E), and dyspnea burden with general activity 
      (G). PARTICIPANTS: We used data from a multi-site randomized clinical trial among 
      outpatients with heart failure. MAIN MEASURES: We evaluated reliability 
      (Cronbach's alpha), concurrent validity with the 
      Memorial-Symptom-Assessment-Scale (MSAS) shortness-of-breath 
      distress-orbothersome item and 7-item Generalized-Anxiety-Disorder (GAD-7) scale, 
      knowngroups validity with New-York-Heart-Association-Functional-Classification 
      (NYHA) 1-2 or 3-4 and presence or absence of comorbid chronic obstructive 
      pulmonary disease (COPD), responsiveness with the MSAS item as an anchor, and 
      calculated a minimal clinically important difference (MCID) using distribution 
      methods. KEY RESULTS: Among 312 participants, the DEG was reliable (Cronbach's 
      alpha 0.92). The mean (standard deviation) DEG score was 5.26 (2.36) (range 0-10) 
      points. DEG scores correlated strongly with the MSAS shortness of breath 
      distress-or-bothersome item (r=0.66) and moderately with GAD-7 categories 
      (rho=0.36). DEG scores were statistically significantly lower among patients with 
      NYHA 1-2 compared to 3-4 [mean difference (standard error): 1.22 (0.27) points, 
      p<0.01], and those without compared to with comorbid COPD [0.87 (0.27) points, 
      p<0.01]. The DEG was highly sensitive to change, with MCID of 0.59-1.34 points, 
      or 11-25% change. CONCLUSIONS: The novel, ultra-brief DEG measure is reliable, 
      valid, and highly responsive. Future studies should evaluate the DEG's 
      sensitivity to interventions, use anchor-based methods to triangulate MCID 
      estimates, and determine its prognostic usefulness among patients with chronic 
      cardiopulmonary and other diseases.
CI  - (c) 2021. This is a U.S. government work and not under copyright protection in the 
      U.S.; foreign copyright protection may apply.
FAU - Ha, Duc M
AU  - Ha DM
AUID- ORCID: 0000-0002-3003-9438
AD  - Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 N 
      Wheeling Street, Aurora, CO, 80045, USA. duc.ha@va.gov.
AD  - Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA. 
      duc.ha@va.gov.
AD  - Division of Pulmonary Sciences and Critical Care Medicine, Department of 
      Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 
      duc.ha@va.gov.
FAU - Deng, Lubin R
AU  - Deng LR
AD  - Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs 
      Medical Center, Aurora, CO, USA.
FAU - Lange, Allison V
AU  - Lange AV
AD  - Division of Pulmonary Sciences and Critical Care Medicine, Department of 
      Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
FAU - Swigris, Jeffrey J
AU  - Swigris JJ
AD  - Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.
FAU - Bekelman, David B
AU  - Bekelman DB
AD  - Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 N 
      Wheeling Street, Aurora, CO, 80045, USA.
AD  - Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs 
      Medical Center, Aurora, CO, USA.
AD  - Division of General Internal Medicine, Department of Medicine, University of 
      Colorado Anschutz Medical Campus, Aurora, CO, USA.
LA  - eng
GR  - IK2 RX003661/RX/RRD VA/United States
GR  - T32 HL007085/HL/NHLBI NIH HHS/United States
GR  - UL1 TR001082/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20220103
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
SB  - IM
MH  - Dyspnea/diagnosis/epidemiology/etiology
MH  - Humans
MH  - Psychometrics
MH  - *Pulmonary Disease, Chronic Obstructive/complications/diagnosis/epidemiology
MH  - *Quality of Life
MH  - Reproducibility of Results
MH  - Surveys and Questionnaires
PMC - PMC9360273
OTO - NOTNLM
OT  - Patient-reported outcome measure
OT  - cardiopulmonary disease
OT  - chronic obstructive pulmonary disease
OT  - dyspnea
OT  - heart failure
OT  - psychometrics
COIS- The authors declare no competing interests.
EDAT- 2022/01/05 06:00
MHDA- 2022/08/11 06:00
PMCR- 2023/08/01
CRDT- 2022/01/04 06:16
PHST- 2021/08/08 00:00 [received]
PHST- 2021/11/23 00:00 [accepted]
PHST- 2022/01/05 06:00 [pubmed]
PHST- 2022/08/11 06:00 [medline]
PHST- 2022/01/04 06:16 [entrez]
PHST- 2023/08/01 00:00 [pmc-release]
AID - 10.1007/s11606-021-07307-1 [pii]
AID - 7307 [pii]
AID - 10.1007/s11606-021-07307-1 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2022 Aug;37(10):2541-2547. doi: 10.1007/s11606-021-07307-1. 
      Epub 2022 Jan 3.