title: Assessing validity by comparing transition and static measures of dyspnea in patients with acute decompensated heart failure.
abstract: This study assessed the convergent validity of 2 dyspnea measures, the transition measure and the change measure, by comparing them with each other in patients admitted to the hospital with acute decompensated heart failure. Static measures of dyspnea were obtained at baseline (pre-static measure) and at time 1 hour and 4 hour (post-static measures). The change measure was calculated as the difference between the pre-static and post-static measures. Transition measures were obtained at time 1 hour and 4 hour. Visual analog scales and Likert scales were used. Both physicians and patients measured the dyspnea independently. A total of 112 patients had complete data sets at time 0 and 1 hour and 86 patients had complete data sets at all 3 time points. Correlations were calculated between the transition measures and static measures (pre-static, post-static, and change measure). Bland-Altman plots were generated and the mean difference and limits of agreement between the transition measures and the change measures were calculated. In general, short-term dyspnea assessment using transition measures and serial static measures can not be used to validate each other in this population of patients being admitted with acute decompensated heart failure.
authors.affiliation: Department of Emergency Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA. howard.smithline@bhs.org
authors.forename: Howard A
authors.initials: HA
authors.lastname: Smithline
authors.forename: Selin
authors.initials: S
authors.lastname: Caglar
authors.forename: Fidela S J
authors.initials: FS
authors.lastname: Blank
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D004418:Dyspnea, Paroxysmal / Q000175:diagnosis / Q000209:etiology; D004632:Emergency Medical Services; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D019370:Observation; D010147:Pain Measurement; D010820:Physicians; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors; D014894:Weights and Measures / Q000295:instrumentation*