Minimal Clinically Important Difference in Barthel Index Dyspnea in Patients with COPD

Abstract

Background

The Barthel Index dyspnea (BId) is responsive to physiological changes and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, the minimum clinically important difference (MCID) has not been established yet.

Aim

To identify the MCID of BId in patients with COPD stratified according to the presence of chronic respiratory failure (CRF) or not.

Materials and Methods

Using the Medical Research Council (MRC) score as an anchor, receiver operating characteristic curves and quantile regression were retrospectively evaluated before and after pulmonary rehabilitation in 2327 patients with COPD (1151 of them with CRF).

Results

The median post-rehabilitation changes in BId for all patients were −10 (interquartile range = −17 to −3, p<0.001), correlating significantly with changes in MRC (r = 0.57, 95% CI = 0.53 to 0.59, p<0.001). Comparing different methods of assessment, the MCID ranged from −6.5 to −9 points for patients without and −7.5 to −12 points for patients with CRF.

Conclusion

The most conservative estimate of the MCID is −9 points in patients with COPD, without and −12 in those with CRF. This estimate may be useful in the clinical interpretation of data, particularly in response to intervention studies.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): copd

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 21 October 2020

Publication date Collection: 2020

Volume: 15

Pages: 2591-2599

Affiliations

[1 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Lumezzane , Brescia, Italy

[2 ]Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia , Pavia, Italy

[3 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Veruno , Novara, Italy

[4 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Cassano Delle Murge , Bari, Italy

[5 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Pavia , Pavia, Italy

[6 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Tradate , Varese, Italy

[7 ]University of Insubria, MACRO , Varese, Italy

[8 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Montescano , Pavia, Italy

[9 ]Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation Unit of the Institute of Telese , Benevento, Italy

[10 ]Istituti Clinici Scientifici Maugeri IRCCS, Health Directorate of the Institute of Lumezzane , Brescia, Italy

Author notes

Correspondence: Michele Vitacca Istituti Clinici Scientifici Maugeri IRCCS , Via Salvatore Maugeri, 4, Pavia27100, Italy Email [e-mail]

Article

Publisher ID: 266243

DOI: 10.2147/COPD.S266243

PMC ID: 7585803

PubMed ID: 33116476

Copyright statement: © 2020 Vitacca et al.

License:

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Page count

Figures: 4, Tables: 8, References: 30, Pages: 9

Funding

Funded by: Ricerca Corrente;

This work was supported by the “Ricerca Corrente” Funding scheme of the Ministry of Health, Italy.

Categories

Subject: Original Research