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Original Research: COPD |

The Language of Breathlessness Differentiates Between Patients With COPD and Age-Matched Adults

Marie Williams, BAppSc (Physio), PhD; Paul Cafarella, BA; Timothy Olds, BA, BSpSc, PhD; John Petkov, MSc; Peter Frith, MBBS, FRACP, FCCP
Author and Funding Information

*From the Department of Respiratory Medicine (Mr. Cafarella), Repatriation General Hospital, Daw Park, Adelaide; School of Health Sciences (Drs. Williams and Olds), University of South Australia, City East Campus, Adelaide; Applied Statistics Unit (Mr. Petkov), University of South Australia, Whyalla Campus, Whyalla; and Respiratory Services (Dr. Firth), Repatriation General Hospital and Flinders Medical Centre, Repatriation General Hospital, Daw Park, Adelaide, SA, Australia.

Correspondence to: Marie Williams, BAppSc (Physio), PhD, Associate Professor, School of Health Sciences, University of South Australia, City East Campus, North Terrace 5000, Adelaide, SA, Australia; e-mail: marie.williams@unisa.edu.au


For editorial comment see page 476

This work was performed at the University of South Australia and Repatriation General Hospital, Adelaide.

This work was supported by a Physiotherapy Research Foundation Cardiorespiratory Physiotherapy Australia research grant. The Physiotherapy Research Foundation had no involvement in study design, data collection, analysis, interpretation of data, writing of the report, or the decision to submit the article for publication.

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(3):489-496. doi:10.1378/chest.07-2916
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Background:  If descriptors of the sensation of breathlessness are able to differentiate between medical conditions, the language of breathlessness could potentially have a role in differential diagnosis. This study investigated whether the language used to describe the sensation of breathlessness accurately categorized older individuals with and without a prior diagnosis of COPD.

Methods:  Using a parallel-group design, participants with and without a prior diagnosis of COPD volunteered words and phrases and endorsed up to three statements to describe their sensation of breathlessness. Cluster analysis (v-fold cross-validation) was applied, and subjects were clustered by their choice of words. Cluster membership was then compared to original group membership (COPD vs non-COPD), and predictive power was assessed.

Results:  Groups were similar for age and gender (COPD, n = 94; 48 men; mean age, 70 ± 10 years [± SD]; vs non-COPD, n = 55; 21 men; mean age, 69 ± 13 years) but differed significantly in breathlessness-related impairment, intensity, and quality of life (p < 0.0001). Cluster membership corresponded accurately with original group classifications (volunteered, 85%; and up to three statements, 68% agreement). Classification based on a single best descriptor (volunteered [62%] or endorsed [55%]) was less accurate for group membership.

Conclusions:  Language used to describe the sensation of breathlessness differentiated people with and without a prior diagnosis of COPD when descriptors were not limited to a single best word or statement.

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