TY - JOUR
T1 - The minimal important difference in borg dyspnea score in pulmonary arterial hypertension
AU - Khair, Rubina M.
AU - Nwaneri, Chisom
AU - Damico, Rachel L.
AU - Kolb, Todd
AU - Hassoun, Paul M.
AU - Mathai, Stephen C.
N1 - Publisher Copyright:
Copyright © 2016 by the American Thoracic Society.
PY - 2016/6
Y1 - 2016/6
N2 - Rationale: Despite therapeutic advances, pulmonary arterial hypertension remains a disease without a cure. Focusing on symptoms, such as dyspnea, is an important part of assessing response to therapy. Objectives: To determine the minimal important differences for the Borg dyspnea score and the Borg fatigue score in adult patients undergoing initial therapy for pulmonary arterial hypertension. Methods: We studied 129 patients enrolled between 2003 and 2013 in the Pulmonary Arterial Hypertension Program registry at Johns Hopkins University Hospital in Baltimore, Maryland. We analyzed baseline demographics, clinical characteristics, 6-minute-walk test distance, and Borg dyspnea and fatigue scores at baseline and at follow up 3months after initiation of pulmonary arterial hypertension therapy. Theminimal important differences for the Borg dyspnea and fatigue scores were determined using distributional and anchor-based methods, using 6-minute-walk test distance as the anchor. Measurements and Main Results: Most subjects were in New York Heart Association functional class II or III and had moderate to severe pulmonary arterial hypertension. The baseline Borg dyspnea score was 3.4 ±1.9 units; the baseline Borg fatigue score was 2.8 ±2.2 units. After therapy, the average change in the dyspnea score was -0.16 ±1.9 units and the average change in the fatigue score was -0.21 ±2.4 units. Using distributional methods, the minimum important difference for Borg dyspnea score ranged from 0.7 to 1.24 units and for Borg fatigue score ranged from 0.73 to 1.39 units. Using anchor-based methods, the minimum important difference for the Borg dyspnea scales was 0.36; this could not be calculated for the Borg fatigue score. Conclusions: Using distributional and anchor-based methods, we estimate the minimum important difference for Borg dyspnea scale in pulmonary arterial hypertension is approximately 0.9 units. Using distributional methods only, we estimate the minimum important difference for the Borg fatigue scale is around 1 unit. Further studies are needed to determine the clinical utility of these scores in patients with pulmonary arterial hypertension.
AB - Rationale: Despite therapeutic advances, pulmonary arterial hypertension remains a disease without a cure. Focusing on symptoms, such as dyspnea, is an important part of assessing response to therapy. Objectives: To determine the minimal important differences for the Borg dyspnea score and the Borg fatigue score in adult patients undergoing initial therapy for pulmonary arterial hypertension. Methods: We studied 129 patients enrolled between 2003 and 2013 in the Pulmonary Arterial Hypertension Program registry at Johns Hopkins University Hospital in Baltimore, Maryland. We analyzed baseline demographics, clinical characteristics, 6-minute-walk test distance, and Borg dyspnea and fatigue scores at baseline and at follow up 3months after initiation of pulmonary arterial hypertension therapy. Theminimal important differences for the Borg dyspnea and fatigue scores were determined using distributional and anchor-based methods, using 6-minute-walk test distance as the anchor. Measurements and Main Results: Most subjects were in New York Heart Association functional class II or III and had moderate to severe pulmonary arterial hypertension. The baseline Borg dyspnea score was 3.4 ±1.9 units; the baseline Borg fatigue score was 2.8 ±2.2 units. After therapy, the average change in the dyspnea score was -0.16 ±1.9 units and the average change in the fatigue score was -0.21 ±2.4 units. Using distributional methods, the minimum important difference for Borg dyspnea score ranged from 0.7 to 1.24 units and for Borg fatigue score ranged from 0.73 to 1.39 units. Using anchor-based methods, the minimum important difference for the Borg dyspnea scales was 0.36; this could not be calculated for the Borg fatigue score. Conclusions: Using distributional and anchor-based methods, we estimate the minimum important difference for Borg dyspnea scale in pulmonary arterial hypertension is approximately 0.9 units. Using distributional methods only, we estimate the minimum important difference for the Borg fatigue scale is around 1 unit. Further studies are needed to determine the clinical utility of these scores in patients with pulmonary arterial hypertension.
KW - Dyspnea
KW - Outcomes
KW - Pulmonary hypertension
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U2 - 10.1513/AnnalsATS.201512-824OC
DO - 10.1513/AnnalsATS.201512-824OC
M3 - Article
C2 - 26974862
AN - SCOPUS:84989284810
SN - 2325-6621
VL - 13
SP - 842
EP - 849
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 6
ER -