Minimal Clinically Important Difference in Barthel Index Dyspnea in Patients with COPD.
activities of daily life
breathlessness
chronic respiratory failure
dyspnea
exercise training
health related quality of life
rehabilitation
Journal
International journal of chronic obstructive pulmonary disease
ISSN: 1178-2005
Titre abrégé: Int J Chron Obstruct Pulmon Dis
Pays: New Zealand
ID NLM: 101273481
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
06
2020
accepted:
07
09
2020
entrez:
29
10
2020
pubmed:
30
10
2020
medline:
29
6
2021
Statut:
epublish
Résumé
The Barthel Index dyspnea (BId) is responsive to physiological changes and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, the minimum clinically important difference (MCID) has not been established yet. To identify the MCID of BId in patients with COPD stratified according to the presence of chronic respiratory failure (CRF) or not. Using the Medical Research Council (MRC) score as an anchor, receiver operating characteristic curves and quantile regression were retrospectively evaluated before and after pulmonary rehabilitation in 2327 patients with COPD (1151 of them with CRF). The median post-rehabilitation changes in BId for all patients were -10 (interquartile range = -17 to -3, p<0.001), correlating significantly with changes in MRC (r = 0.57, 95% CI = 0.53 to 0.59, p<0.001). Comparing different methods of assessment, the MCID ranged from -6.5 to -9 points for patients without and -7.5 to -12 points for patients with CRF. The most conservative estimate of the MCID is -9 points in patients with COPD, without and -12 in those with CRF. This estimate may be useful in the clinical interpretation of data, particularly in response to intervention studies.
Sections du résumé
Background
The Barthel Index dyspnea (BId) is responsive to physiological changes and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, the minimum clinically important difference (MCID) has not been established yet.
Aim
To identify the MCID of BId in patients with COPD stratified according to the presence of chronic respiratory failure (CRF) or not.
Materials and Methods
Using the Medical Research Council (MRC) score as an anchor, receiver operating characteristic curves and quantile regression were retrospectively evaluated before and after pulmonary rehabilitation in 2327 patients with COPD (1151 of them with CRF).
Results
The median post-rehabilitation changes in BId for all patients were -10 (interquartile range = -17 to -3, p<0.001), correlating significantly with changes in MRC (r = 0.57, 95% CI = 0.53 to 0.59, p<0.001). Comparing different methods of assessment, the MCID ranged from -6.5 to -9 points for patients without and -7.5 to -12 points for patients with CRF.
Conclusion
The most conservative estimate of the MCID is -9 points in patients with COPD, without and -12 in those with CRF. This estimate may be useful in the clinical interpretation of data, particularly in response to intervention studies.
Identifiants
pubmed: 33116476
doi: 10.2147/COPD.S266243
pii: 266243
pmc: PMC7585803
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2591-2599Informations de copyright
© 2020 Vitacca et al.
Déclaration de conflit d'intérêts
All authors report no conflict to disclose.
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