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All clinical characteristics of participants (including FEV 1 ) explained between 26% of heterogeneity in the occurrence of cough to 49% for dyspnea.
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FEV ¹ explained 28% of the variation between individuals in the occurrence of dyspnea, 8% for phlegm, 3% for cough, and 2% for wheeze. This heterogeneity was highest for wheeze and dyspnea (IQR of probabilities: 0.13-0.78 and 0.19-0.81, respectively). There was substantial heterogeneity in the individual-specific probabilities for the occurrence of symptoms. Results: Four hundred forty-nine participants (53% male, mean age 67 years) contributed 968 visits in total, and 89% of patients reported at least one symptom during follow-up. We used mixedeffect logistic regression models (separately for each symptom) to assess overall heterogeneity in the occurrence of symptoms between individuals, and the proportion of variation in symptom burden explained by lung function vs all other clinical characteristics of participants. Participants reported whether they experienced chronic coughing, phlegm, wheezing, or dyspnea during visits at 18-month intervals. Methods: A sample of the general Canadian population ≥40 years with persistent airflow limitation was followed for up to 3 years. While heterogeneity in lung function decline and exacerbations have been previously studied, the extent of heterogeneity in symptoms and the factors associated with this heterogeneity are not well understood. MDP is a valid instrument for multidimensional measurement of breathlessness in Swedish outpatients across cardiorespiratory diseases.īackground: The burden of symptoms varies markedly between patients with COPD and is only weakly correlated with lung function impairment. There was no evidence of a learning effect. The MDP total, immediate perception and emotional response scores, and individual item scores showed expected factor structure and acceptable measurement properties: internal consistency (Cronbach’s alpha, range 0.80–0.93) test–retest reliability at 30–90 min and 2 weeks (ICC, range 0.67–0.91) and concurrent validity. In total, 182 outpatients with cardiorespiratory disease and breathlessness in daily life were included 53.3% were women main diagnoses were chronic obstructive pulmonary disease (24.7%), asthma (21.4%), heart failure (19.2%) and idiopathic pulmonary fibrosis (18.7%). Concurrent validity was evaluated using correlations with validated scales of breathlessness, anxiety, depression and health-related quality of life. Factor structure of MDP was analysed using confirmatory factor analysis internal consistency was analysed using Cronbach’s alpha and test–retest reliability was analysed using intraclass correlation coefficients (ICCs) for patients with unchanged breathlessness between assessments (baseline, after 30–90 min and 2 weeks). Outpatients with stable cardiorespiratory disease and breathlessness in daily life were recruited.
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This study aimed to validate the MDP in terms of the underlying factor structure, internal consistency, test–retest reliability and concurrent validity in Swedish outpatients with cardiorespiratory disease. An instrument for measuring different aspects of breathlessness was recently developed, the Multidimensional Dyspnea Profile (MDP). Breathlessness is a cardinal symptom in cardiorespiratory disease.