Standardized Indices of Breathlessness

描述（由申请人提供）：对于呼吸系统疾病患者，呼吸困难（呼吸困难）症状是就医的最常见原因。目前用于测量呼吸困难对日常生活活动的影响的方法依赖于由卫生保健提供者进行的面对面访谈。两种常见的测量方法是基线呼吸困难指数和过渡期呼吸困难指数，基线呼吸困难指数代表单个时间点呼吸困难的严重程度，过渡期呼吸困难指数代表与治疗前基线水平相比呼吸困难的变化。尽管这些措施被广泛接受，但面谈技术在三个方面受到批评：（1）呼吸困难严重程度的选择由访谈者而不是患者做出，并且由此可能增加测量误差（2）该方法不能一致地应用于不同的医学中心，因为在所有的测试点处不使用相同的访问者（3）由于培训和雇用卫生保健提供者进行访谈和将数据输入计算机的成本，该过程是昂贵的。需要一种更便宜、标准化的方法来测量呼吸困难，这种方法可以在全世界一致地应用。在该项目的第I阶段，开发了基线呼吸困难指数和过渡期呼吸困难指数的计算机化版本，并通过与访谈版本进行比较来测试并行有效性，并通过与肺功能测试进行比较来测试结构有效性。II期的目的是确定标准化方法的进一步心理测量和临床特性：基线和过渡期呼吸困难指数的重测信度、反应性和过渡期呼吸困难指数的最小重要临床差异。采用新的标准化计算机方法的受试者将是126名被诊断患有慢性肺病的患者。建议的商业应用。计算机软件有很好的商业前景，可以让病人评价他们与日常生活活动相关的呼吸困难程度。一旦软件包被实施和测试，获得该程序的网站许可证将出售给世界各地的诊所，医院和制药公司。本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局。总体目标是进一步了解这些疾病，并确定更好的临床结局指标。

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.