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      Comparing recalled versus experienced symptoms of breathlessness ratings: An ecological assessment study using mobile phone technology

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          Abstract

          Background and objective

          Recall of breathlessness is important for clinical care but might differ from the experienced (momentary) symptoms. This study aimed to characterize the relationship between momentary breathlessness ratings and the recall of the experience. It is hypothesized that recall is influenced by the peak (worst) and end (most recent) ratings of momentary breathlessness (peak‐end rule).

          Methods

          This study used mobile ecological momentary assessment (mEMA) for assessing breathlessness in daily life through an application installed on participants' mobile phones. Breathlessness ratings (0–10 numerical rating scale) were recorded throughout the day and recalled each night and at the end of the week. Analyses were performed using regular and mixed linear regression.

          Results

          Eighty‐four people participated. Their mean age was 64.4 years, 60% were female and 98% had modified Medical Research Council (mMRC) ≥ 1. The mean number of momentary ratings of breathlessness provided was 7.7 ratings/participant/day. Recalled breathlessness was associated with the mean, peak and end values of the day. The mean was most closely associated with the daily recall. Associations were strong for weekly values: peak breathlessness (beta = 0.95, r 2 = 0.57); mean (beta = 0.91, r 2 = 0.53); and end (beta = 0.67, r 2 = 0.48); p < 0.001 for all. Multivariate analysis showed that peak breathlessness had the strongest influence on the breathlessness recalled at the end of the week.

          Conclusion

          Over 1 week, recalled breathlessness is most strongly influenced by the peak breathlessness; over 1 day, it is mean breathlessness that participants most readily recalled.

          Abstract

          Recall of breathlessness is essential for clinical care but might differ from the momentary symptoms. This study reports that the peak momentary breathlessness most strongly influences recalled breathlessness over the past 7 days. Recall for 1 day was influenced the most by the mean breathlessness value for that day.

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          Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review.

          Marianne Jensen Hjermstad, Peter M. Fayers, Dagny Haugen … (2011)
          The use of unidimensional pain scales such as the Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), or Visual Analogue Scale (VAS) is recommended for assessment of pain intensity (PI). A literature review of studies specifically comparing the NRS, VRS, and/or VAS for unidimensional self-report of PI was performed as part of the work of the European Palliative Care Research Collaborative on pain assessment. To investigate the use and performance of unidimensional pain scales, with specific emphasis on the NRSs. A systematic search was performed, including citations through April 2010. All abstracts were evaluated by two persons according to specified criteria. Fifty-four of 239 papers were included. Postoperative PI was most frequently studied; six studies were in cancer. Eight versions of the NRS (NRS-6 to NRS-101) were used in 37 studies; a total of 41 NRSs were tested. Twenty-four different descriptors (15 for the NRSs) were used to anchor the extremes. When compared with the VAS and VRS, NRSs had better compliance in 15 of 19 studies reporting this, and were the recommended tool in 11 studies on the basis of higher compliance rates, better responsiveness and ease of use, and good applicability relative to VAS/VRS. Twenty-nine studies gave no preference. Many studies showed wide distributions of NRS scores within each category of the VRSs. Overall, NRS and VAS scores corresponded, with a few exceptions of systematically higher VAS scores. NRSs are applicable for unidimensional assessment of PI in most settings. Whether the variability in anchors and response options directly influences the numerical scores needs to be empirically tested. This will aid in the work toward a consensus-based, standardized measure. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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            An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea.

            Mark B Parshall, Richard Schwartzstein, Lewis Adams … (2012)
            Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases. Since the ATS published a consensus statement on dyspnea in 1999, there has been enormous growth in knowledge about the neurophysiology of dyspnea and increasing interest in dyspnea as a patient-reported outcome. The purpose of this document is to update the 1999 ATS Consensus Statement on dyspnea. An interdisciplinary committee of experts representing ATS assemblies on Nursing, Clinical Problems, Sleep and Respiratory Neurobiology, Pulmonary Rehabilitation, and Behavioral Science determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant expertise. The final content of this statement was agreed upon by all members. Progress has been made in clarifying mechanisms underlying several qualitatively and mechanistically distinct breathing sensations. Brain imaging studies have consistently shown dyspnea stimuli to be correlated with activation of cortico-limbic areas involved with interoception and nociception. Endogenous and exogenous opioids may modulate perception of dyspnea. Instruments for measuring dyspnea are often poorly characterized; a framework is proposed for more consistent identification of measurement domains. Progress in treatment of dyspnea has not matched progress in elucidating underlying mechanisms. There is a critical need for interdisciplinary translational research to connect dyspnea mechanisms with clinical treatment and to validate dyspnea measures as patient-reported outcomes for clinical trials.
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              WHEN MORE PAIN IS PREFERRED TO LESS:. Adding a Better End

              Daniel Kahneman, Barbara L. Fredrickson, Charles Schreiber … (1993)
              Article 0 comments Cited 240 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Jacob Sandberg:
                ORCID: https://orcid.org/0000-0003-1863-2033
                jacob.sandberg@gmail.com
                Journal
                Journal ID (nlm-ta): Respirology
                Journal ID (iso-abbrev): Respirology
                Journal ID (doi): 10.1111/(ISSN)1440-1843
                Journal ID (publisher-id): RESP
                Title: Respirology (Carlton, Vic.)
                Publisher: John Wiley & Sons, Ltd (Chichester, UK )
                ISSN (Print): 1323-7799
                ISSN (Electronic): 1440-1843
                Publication date (Electronic): 13 June 2022
                Publication date (Print): October 2022
                Volume: 27
                Issue: 10 ( doiID: 10.1111/resp.v27.10 )
                Pages: 874-881
                Affiliations
                [ 1 ] Department of Clinical Sciences, Division of Respiratory Medicine & Allergology Lund University Lund Sweden
                [ 2 ] Department of Respiratory Medicine, School of Medical Sciences Örebro University Örebro Sweden
                [ 3 ] Department of Health Blekinge Institute of Technology Karlskrona Sweden
                [ 4 ] Wolfson Palliative Care Research Centre, Hull York Medical School University of Hull Hull UK
                [ 5 ] IMPACCT, Faculty of Science, Medicine and Health University of Wollongong Wollongong New South Wales Australia
                [ 6 ] Department of Psychology University of Arizona Tucson Arizona USA
                Author notes
                [*] [* ] Correspondence

                Jacob Sandberg

                Email: jacob.sandberg@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-1863-2033
                https://orcid.org/0000-0001-9870-8477
                https://orcid.org/0000-0003-1988-1250
                https://orcid.org/0000-0001-6204-9158
                https://orcid.org/0000-0002-7227-5113
                Article
                Publisher ID: RESP14313
                DOI: 10.1111/resp.14313
                PMC ID: 9546302
                PubMed ID: 35697350
                SO-VID: 0d0f2e1d-78f6-42ba-918c-59e34865e35f
                Copyright © © 2022 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 January 2022
                Date accepted : 31 May 2022
                Page count
                Figures: 4, Tables: 3, Pages: 8, Words: 5874
                Funding
                Funded by: Hjrt‐Lungfonden
                Funded by: Region Blekinge
                Funded by: Svenska Sllskapet for Medicinsk Forskning
                Funded by: Vetenskapsradet
                Award ID: 2019‐02081
                Categories
                Subject: Original Article
                Subject: ORIGINAL ARTICLES
                Subject: Lung Function
                Custom metadata
                source-schema-version-number 2.0
                cover-date October 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                ScienceOpen disciplines: Respiratory medicine
                Keywords: breathlessness,dyspnoea symptoms,mema,mobile ecological momentary assessment,peak‐end rule,recall of symptoms
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: breathlessness, dyspnoea symptoms, mema, mobile ecological momentary assessment, peak‐end rule, recall of symptoms

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