Changes in dyspnea, health status, and lung function in chronic airway disease.

Mahler, Donald A.; Tomlinson, Donald; Olmstead, Elaine M.; Tosteson, Anna N.A.; O’Connor, Gerald T.

doi:10.1164/ajrccm.151.1.7812573

Cited by 102 publications

(59 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The observed effect size (half a standard deviation) corresponds, at the group level, to a strong association of reported deterioration and FEV1 level. This is stronger than the rather weak associations reported between lung function and quality of life scales, especially generic scales [7,[24][25][26][27] in other studies, conducted mostly in rather homogeneous groups of patients. Few respiratory epidemiological surveys have included health-related quality-of-life data [28,29].…”

Section: Discussioncontrasting

confidence: 65%

Validity of subjective assessment of changes in respiratory health status: a 30 year epidemiological study of workers in Paris

Kauffmann¹,

Annesi²,

Chwalow³

1997

Eur Respir J

View full text Add to dashboard Cite

The validity of scales used for subjective assessment of health, particularly transitional indices, is under discussion. The aim of the present study was to assess the concurrent and predictive validity of a simple estimate of long-term subjective assessment of respiratory health changes.A longitudinal study of 915 workers was conducted over 30 yrs, with both retrospective self-assessment of respiratory health changes and objective measurements of spirometric values 12 yrs apart. An assessment of the reason for death during the subsequent 20 yrs was performed.Subjective assessment of respiratory deterioration over 12 yrs was significantly related to both cross-sectional lung function values and longitudinal lung function changes (forced expiratory volume in one second (FEV1) decline), an association which remained after adjustment for FEV1 level. It was also related to the same risk factors as decline in FEV1 (smoking, occupational exposure). Self-evaluation of respiratory deterioration was significantly predictive of death from all causes, with the highest (but nonsignificant) rate ratio for respiratory causes. Asthmatics exhibited greater long-term variability (objective and subjective) than nonasthmatics. Independent of dyspnoea, self-assessment of respiratory health deterioration was significantly related to FEV1.Subjective assessment of long-term changes in respiratory health provides valid information. Eur Respir J 1997; 10: 2508-2514 The acceptance of self-perception of health status is relatively recent [1][2][3][4]. The validity of perceived health measures (which are the basis of items included in health-related quality of life scales) is a matter of discussion as objective measures of the same or highly related phenomenon are rarely available or relevant [5][6][7]. Responsiveness, i.e. the ability to detect changes between repeated measurements, is an important quality [2,6]. Transitional indices [6, 8-10] (i.e. those designed to directly assess perceived changes over time) are rarely used. Such indices are retrospectively assessed at the end of the period under study. The duration for which change is assessed is often short (less than 1 yr), and the interpretation of such transitional indices can be hampered by potential recall bias. Valid long-term assessment of respiratory health changes may be of interest for both epidemiological research and clinical practice. No study has assessed long-term perceived respiratory changes.The general aim of the present study was to assess the concurrent and predictive validity of a simple estimate of long-term subjective assessment of respiratory health changes using objective criteria recorded in the same longitudinal survey conducted in a working population. The specific aims were to assess whether retrospective subjective assessment of changes at 12 yrs was related to known risk factors of forced expiratory volume in one second (FEV1) decline, 12 yr FEV1 decline itself, a history of asthma, and 20 yr mortality data. MethodsThe subjects in the study we...

show abstract

Section: Discussioncontrasting

confidence: 65%

Validity of subjective assessment of changes in respiratory health status: a 30 year epidemiological study of workers in Paris

Kauffmann¹,

Annesi²,

Chwalow³

1997

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Although significant arterial hypoxaemia was excluded from the former study, the prebronchodilator FEV1 was almost identical to that of our group. In a more recent study, MAHLER et al [12] found an 82% 2 year survival in a group of 110 COPD patients. This group, however, had an FEV1 of 1.28 L, which was somewhat less severe than in the present study.…”

Section: Discussionmentioning

confidence: 93%

Variables related to increased mortality following out-patient pulmonary rehabilitation

Gerardi¹,

Lovett²,

et al. 1996

View full text Add to dashboard Cite

Although patients with advanced pulmonary disease have significant improvement in exercise ability and functional status following comprehensive outpatient pulmonary rehabilitation (OPR), their long-term prognosis once they have reached this stage of their diseases remains poor.To further evaluate predictors of increased mortality in these patients, we related patient characteristics and short-term outcome obtained during OPR assessment of 158 patients to subsequent survival. The time period from OPR to death or collection of survival data was 40.0±17.1 months. The following variables were tested individually and in stepwise fashion using a proportional hazards model: 1) age; 2) gender; 3) pulmonary diagnosis; 4) prebronchodilator forced expiratory volume in one second (FEV1); 5) arterial oxygen tension (Pa,O 2 ) and arterial carbon dioxide tension (Pa,CO 2 ); 6) body mass index (BMI); 7) pre-and post-OPR 12 min walking distance (12-MW); 8) pre-and post-OPR quality of life, using the Chronic Respiratory Disease Questionnaire (CRDQ); 9) number and type of nonpulmonary diagnoses; and 10) number of medications. Separate survival analyses were performed for all deaths (the total group), respiratory deaths only (nonrespiratory deaths excluded), and nonrespiratory deaths only (respiratory deaths excluded).Forty three patients (27%) died during the study period; and the 3 year survival was 80%. For all three survival analyses, the post-OPR 12-MW was the most significant variable related to prognosis: patients with low timed walking distance had increased mortality both from respiratory and nonrespiratory causes. Other variables related to increased mortality included: elevated Pa,CO 2 ; low pre-OPR 12-MW; reduced Pa,O 2 ; low FEV1; low BMI, increased number of medications, and increased CRDQ dyspnoea.These results indicate that the timed walking distance following out-patient pulmonary rehabilitation is an important predictor of survival in patients with advanced pulmonary disease.

show abstract

“…In 76 COPD patients monitored for 2 years, Mahler et al (5) found that, despite improvement in lung function, dyspnea scores assessed by the Transition Dyspnea Index (TDI) increased significantly. Other studies have also shown uncoupling between dyspnea perception and airway obstruction over time (6,7).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, longitudinal studies have shown that changes in the dyspnea sensation occur independently of alterations in airway obstruction assessed by FEV 1 (5,6). Oga et al (7) showed deterioration of health status over 5 years, with changes being only weakly correlated with changes in FEV 1 (7).…”

mentioning

confidence: 99%

Three-year follow-up study of respiratory and systemic manifestations of chronic obstructive pulmonary disease

Ferrari

Tanni

Faganello

et al. 2011

Braz J Med Biol Res

View full text Add to dashboard Cite

Changes in dyspnea, health status, and lung function in chronic airway disease.

Cited by 102 publications

References 26 publications

Validity of subjective assessment of changes in respiratory health status: a 30 year epidemiological study of workers in Paris

Validity of subjective assessment of changes in respiratory health status: a 30 year epidemiological study of workers in Paris

Variables related to increased mortality following out-patient pulmonary rehabilitation

Three-year follow-up study of respiratory and systemic manifestations of chronic obstructive pulmonary disease

Contact Info

Product

Resources

About