, how intense it is or how distressed one is by it) and consistently given, the symptom dimension being measured is potentially ambiguous [16]. In addition, the internal consistency reliability of single items is indeterminate (e.g., Cronbach’s coefficient alpha cannot be estimated for
a single item) [17,18]. Although test–retest reliability of single items can be assessed, this can be challenging in the ED if what is being measured changes in response to acute treatment. We are Inhibitors,research,lifescience,medical aware of only one study of dyspnea in an ED that assessed the test–retest reliability of recall ratings of dyspnea prior to a visit [19]. The median correlation for numeric ratings of seven dyspnea descriptors was .95, and the largest within-subjects difference for any descriptor was less than 1 point on a 0-to-10 numeric scale. However, that assessment was conducted with just a small subset Inhibitors,research,lifescience,medical (~10%) of the study sample, and conventional correlation coefficients are suboptimal for assessing test–retest reliability [18,20-22]. Results of that study [19] also suggested several potentially distinguishable
dimensions of sensory quality in ED patients with chronic obstructive pulmonary disease (COPD), three of which (Smothering/Air hunger, Work/Effort, and Tightness) were confirmed in a subsequent study of hospital patients admitted for heart failure [23]. Only a few other studies have attempted to Inhibitors,research,lifescience,medical assess sensory qualities of dyspnea during ED visits [24,25]. The results of these studies suggest that multiple sensory quality Inhibitors,research,lifescience,medical dimensions of dyspnea may be common to patients of various diagnoses who come to an ED because of dyspnea. Although the clinical relevance of multiple dimensions of dyspnea in the acute care setting is not clearly established, in a study of ED patients with asthma, it was found that perceptions of increased work and effort in breathing persisted even after the sensation of tightness was relieved with albuterol [24]. The purpose of the present study was to assess the reliability of recall ratings of dyspnea in ED patients
with acute or chronic pulmonary or cardiac disease. Inhibitors,research,lifescience,medical Specifically, we administered the Multidimensional Dyspnea Profile (MDP) [26-28] to obtain serial real-time and recall ratings during an ED visit and in an outpatient follow-up visit 4 to 6weeks later. Results pertaining to the real-time ratings and overall psychometric performance of the MDP are being published separately [28]. Entinostat Methods Design, setting, and participants The study had a Vismodegib Sigma prospective, longitudinal correlational design with repeated measures. The study was conducted in three urban EDs in the southwestern United States: at an academic health center, a Department of Veterans Affairs (VA) medical center, and a private, not-for-profit community hospital. The study was approved by the Human Research Review Committee of the University of New Mexico Health Sciences Center and the Raymond G. Murphy VA Medical Center Research and Development Committee, Albuquerque, NM.