title: Validity and responsiveness of the self-administered computerized versions of the baseline and transition dyspnea indexes.
abstract: BACKGROUND
  Numerous instruments have been developed to examine the impact of activities on breathlessness. The primary purpose of this study was to examine the validity and responsiveness of the self-administered computerized (SAC) versions of the multidimensional baseline dyspnea index (BDI) and the transition dyspnea index (TDI).
  
  
  METHODS
  Sixty-five patients with COPD who complained of exertional breathlessness were evaluated at an initial visit and after receiving standard therapy at two academic medical centers. Dyspnea scores from the SAC versions were compared with those obtained with the Medical Research Council (MRC) scale and with the original interview versions of the BDI and TDI.
  
  
  RESULTS
  At the initial visit, all three dyspnea instruments showed similar correlations among themselves and with lung function. At the follow-up visit (mean [+/- SD] time after initial visit, 48 +/- 16 days), breathlessness scores were improved on all three instruments. Correlations were consistently higher for both versions of the TDI, and changes in lung function compared with corresponding values for DeltaMRC scale. Although 55% of patients reported no change in breathlessness on the MRC scale following treatment, the mean SAC and interview TDI scores were increased by 1.0 +/- 2.4 and 1.4 +/- 2.5, respectively, in these same patients.
  
  
  CONCLUSIONS
  Both versions of the BDI and the MRC scale showed concurrent validity at the initial visit. The SAC TDI demonstrated responsiveness to standard therapy that was comparable with the findings of the interview TDI, but was better than that recorded with the MRC scale. The advantages of the SAC TDI include a patient-reported score on a continuous scale using computer technology.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Pulmonary and Critical Care Medicine, 3-D, 1 Medical Center Dr, Lebanon, NH 03756-0001, USA. donald.a.mahler@hitchcock.org
authors.forename: Donald A
authors.initials: DA
authors.lastname: Mahler
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Waterman
authors.forename: Joseph
authors.initials: J
authors.lastname: Ward
authors.forename: Corliss
authors.initials: C
authors.lastname: McCusker
authors.forename: Richard
authors.initials: R
authors.lastname: ZuWallack
authors.forename: John C
authors.initials: JC
authors.lastname: Baird
mesh_terms: D000368:Aged; D003201:Computers; D004417:Dyspnea / Q000175:diagnosis; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires