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

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          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.

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          Most cited references 28

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            Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                copd
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                21 October 2020
                2020
                : 15
                : 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 michele.vitacca@icsmaugeri.it
                Article
                266243
                10.2147/COPD.S266243
                7585803
                33116476
                © 2020 Vitacca et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                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
                Original Research

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