Standardized Indices of Breathlessness

描述(申请人提供)：对于呼吸系统疾病患者，呼吸困难(呼吸困难)是最常见的就医原因。目前衡量呼吸困难对日常生活活动影响的方法依赖于卫生保健提供者进行的面对面访谈。两个常见的衡量标准是代表单个时间点呼吸困难严重程度的基线呼吸困难指数和代表与治疗前基线水平相比呼吸困难变化的过渡性呼吸困难指数。尽管这些措施被广泛接受，但面谈技术在三个方面受到了批评：(1)气促严重程度的选择是由面试者而不是患者做出的，因此可能会增加测量误差(2)该方法不能在不同的医疗中心一致应用，因为不是在所有测试地点雇用相同的面试者(3)由于培训和雇用卫生保健提供者进行面谈和将数据输入计算机的成本，该过程代价高昂。需要一种成本更低、标准化的方法来测量呼吸困难，这种方法可以在世界各地一致应用。在这个项目的第一阶段，开发了基线呼吸困难指数和过渡性呼吸困难指数的计算机化版本，并通过与访谈版本的比较来测试其同时效度，通过与肺功能测试的比较来测试其结构效度。第二阶段的目的是进一步确定标准化方法的心理测量学和临床特性：基线和过渡性呼吸困难指数的重测可靠性、反应性和过渡性呼吸困难指数最小重要的临床差异。使用新的标准化计算机方法的受试者将是126名被诊断为慢性肺部疾病的患者。建议的商业应用。计算机软件有很好的商业前景，它允许患者评估他们与日常生活活动相关的呼吸困难水平。一旦该软件包被实施和测试，获取该程序的站点许可证将被出售给世界各地的诊所、医院和制药公司。该项目开发的计算机评估工具将量化患者报告的肺部疾病结果。总体目标是加深我们对这些疾病的了解，并确定更好的临床结果衡量标准。

DESCRIPTION (provided by applicant): For patients with respiratory disease the symptom of breathlessness (dyspnea) is the most frequent reason for seeking medical attention. Current methods for measuring the impact of breathlessness on activities of daily living rely on face-to-face interviews conducted by health care providers. Two common measures are the Baseline Dyspnea Index representing the severity of dyspnea at a single point in time, and the Transition Dyspnea Index representing changes in dyspnea compared with the baseline level before treatment. Despite widespread acceptance of these measures, the interview technique has been criticized on three counts: (1) selection of severity of breathlessness is made by the interviewer, not the patient, and thereby can increase measurement error (2) the method cannot be applied consistently in different medical centers because the same interviewers are not employed at all test sites (3) the process is expensive due to the cost of training and employing health care providers to conduct interviews and enter data into the computer. There is a need for a less expensive, standardized approach to the measurement of dyspnea that could be applied consistently throughout the world. In Phase I of this project computerized versions of the Baseline Dyspnea Index and the Transitional Dyspnea Index were developed and tested for concurrent validity by comparison with interview versions, and for construct validity by comparison with pulmonary function tests. The aims of Phase II are to determine further psychometric and clinical properties of the standardized methods: test- retest reliability of both the Baseline and Transition Dyspnea Indices, responsiveness and the minimally important clinical difference of the Transition Dyspnea Index. Subjects employing the new, standardized computer methods will be 126 patients diagnosed with chronic lung disease. PROPOSED COMMERCIAL APPLICATIONS. There are excellent commercial prospects for computer software that allows the patient to rate their level of dyspnea associated with activities of daily living. Once the software package is implemented and tested, site licenses for acquiring the program will be sold to clinics, hospitals, and pharmaceutical companies worldwide. The computer assessment instruments developed in this project will quantify the patient-reported outcomes of lung disease. The overall goal is to further our understanding about these diseases and to identify better clinical outcome measures.