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Original Research: SIGNS AND SYMPTOMS OF CHEST DISEASES |

Dyspnea-12 Is a Valid and Reliable Measure of Breathlessness in Patients With Interstitial Lung Disease

Janelle Yorke, PhD; Jeffrey Swigris, DO, MS; Anne-Marie Russell, MSc; Shakeeb H. Moosavi, PhD; Georges Ng Man Kwong, MD; Mark Longshaw, MD; Paul W. Jones, PhD
Author and Funding Information

From the Faculty of Health and Social Care (Dr Yorke), School of Nursing, University of Salford, Greater Manchester, England; Interstitial Lung Disease Program (Dr Swigris), National Jewish Health, Denver, CO; University of Huddersfield (Ms Russell), West Yorkshire, England; Faculty of Medicine (Dr Moosavi), Imperial College London, London, England; Pennine Acute Trust (Drs Ng Man Kwong and Longshaw), Crumpsall, England; and St. Georges University of London (Dr Jones), London, England.

Correspondence to: Janelle Yorke, PhD, School of Nursing & Midwifery, Faculty of Health and Social Care, Mary Seacole Building, Room 1.43, University of Salford, Greater Manchester, M66PU, England; e-mail: j.yorke@salford.ac.uk


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Funding/Support: This study was funded by Action Medical Research, England. Dr Swigris is supported in part by a Career Development Award from the National Institutes of Health (K23 HL092227).


© 2011 American College of Chest Physicians


Chest. 2011;139(1):159-164. doi:10.1378/chest.10-0693
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Objective:  In this study, we aimed to determine the validity and reliability of the Dyspnea-12 questionnaire (D-12) for the assessment of breathlessness in patients with interstitial lung disease (ILD).

Methods:  A total of 101 patients with ILD completed the D-12 (scale range, 0-36, with a high score indicating worse dyspnea), Medical Research Council (MRC) dyspnea scale, St. George Respiratory Questionnaire (SGRQ), and Hospital Anxiety and Depression Scale (HADS) at baseline, and 84 patients completed the D-12 and a global health transition score at follow-up 2 weeks later. D-12 psychometric properties, including floor and ceiling effects, internal consistency, test-retest reliability, and construct validity were examined.

Results:  The D-12 showed good internal consistency (Cronbach α, 0.93) and repeatability (intraclass correlation coefficient, 0.94). Its scores were significantly associated with MRC grade (r = 0.59; P < .001), SGRQ (symptoms, r = 0.57; activities, r = 0.78; impacts, r = 0.75; total, r = 0.79; P < .001). Factor analysis confirmed the previously determined structure of the D-12 in this patient group.

Conclusion:  In patients with ILD, the D-12, a patient-reported measure of dyspnea severity that requires no reference to activity, is a reliable and valid instrument. It is short, simple to complete, and easy to score.

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