PURPOSE:Dyspnea may signal serious disease with increased morbidity and mortality. The study aim was to determine the reliability of assessing dyspnea through a simple questionnaire among a rural adult population.
METHODS:Participants were from Health Effects of Arsenic Longitudinal Study in Araihazar, Bangladesh (1). Dyspnea assessment used a simple questionnaire among 129 participants at two time points: at baseline and after greater than two-weeks to 9-months by trained physicians. All subjects were asked about the presence or absence of dyspnea in the last 6 months. At the time of second interview a physician (blinded-to-questionnaire) conducted a clinical heart/lung examination and obtained a pulse oximeter reading.
RESULTS:The mean age was 43.4 ± 9.1 years (range 22 –60) with an average retest interval of 168 ± 80 days (range 19 –276). The overall reliability was 93.8%. If the initial response was ‘yes’ for the presence of dyspnea, reliability was 90.6%. For an initial response of ‘no’ for presence of dyspnea, reliability was 96.1%. The pulmonary examination was abnormal in 37.5% of those with dyspnea and 6.8% of those without dyspnea (p < 0.01). The pulse oximeter reading was low in 14.3% of those with dyspnea and 1.4% of those with no dyspnea (p < 0.01).
CONCLUSION:The reliability of a simple question on dyspnea is high in a rural developing country when obtained by physicians. Although validity wasn't tested, the presence of a significant increase in an abnormal chest examination or low pulse oximeter saturation suggests more significant underlying cardiopulmonary disease for those reporting ‘yes’ to the dyspnea question.
CLINICAL IMPLICATIONS:From a public health perspective, reproducible dyspnea as determined by questionnaire in this study might serve as a very inexpensive screen in poor undeveloped countries to target subjects who might benefit from a more comprehensive health examination.1. Ahasan H, Chen Y, Parvez F, et. al. Health Effects of Arsenic longitudinal study. J Expo Sci Environ Epidemiol 2006;16:161–205.
DISCLOSURE:Gene Pesola, No Financial Disclosure Information; No Product/Research Disclosure Information