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The Language of Breathlessness Differentiates Between Patients With COPD and Age-Matched Adults

*From the Department of Respiratory Medicine (Mr. Cafarella), Repatriation General Hospital, Daw Park, Adelaide; School of Health Sciences (Drs. Williams and Olds), University of South Australia, City East Campus, Adelaide; Applied Statistics Unit (Mr. Petkov), University of South Australia, Whyalla Campus, Whyalla; and Respiratory Services (Dr. Firth), Repatriation General Hospital and Flinders Medical Centre, Repatriation General Hospital, Daw Park, Adelaide, SA, Australia.

Correspondence to: Marie Williams, BAppSc (Physio), PhD, Associate Professor, School of Health Sciences, University of South Australia, City East Campus, North Terrace 5000, Adelaide, SA, Australia; e-mail: marie.williams{at}unisa.edu.au

Abstract

Background:If descriptors of the sensation of breathlessness are able to differentiate between medical conditions, the language of breathlessness could potentially have a role in differential diagnosis. This study investigated whether the language used to describe the sensation of breathlessness accurately categorized older individuals with and without a prior diagnosis of COPD.

Methods:Using a parallel-group design, participants with and without a prior diagnosis of COPD volunteered words and phrases and endorsed up to three statements to describe their sensation of breathlessness. Cluster analysis (v-fold cross-validation) was applied, and subjects were clustered by their choice of words. Cluster membership was then compared to original group membership (COPD vs non-COPD), and predictive power was assessed.

Results:Groups were similar for age and gender (COPD, n = 94; 48 men; mean age, 70 ± 10 years [± SD]; vs non-COPD, n = 55; 21 men; mean age, 69 ± 13 years) but differed significantly in breathlessness-related impairment, intensity, and quality of life (p < 0.0001). Cluster membership corresponded accurately with original group classifications (volunteered, 85%; and up to three statements, 68% agreement). Classification based on a single best descriptor (volunteered [62%] or endorsed [55%]) was less accurate for group membership.

Conclusions:Language used to describe the sensation of breathlessness differentiated people with and without a prior diagnosis of COPD when descriptors were not limited to a single best word or statement.

Key Words: dyspnea • language • pulmonary disease, chronic obstructive

Abbreviations: CI, confidence interval • GHQ, General Health Questionnaire • MRC, Medical Research Council • SF-36, Short-Form Quality of Life Questionnaire • VAS, visual analogue scale

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