Evidence map›Paper›PMID 34981344›Full record

Trial reportJournal of general internal medicine2022

Reliability, Validity, and Responsiveness of the DEG, a Three-Item Dyspnea Measure.

Duc M Ha, Lubin R Deng, Allison V Lange, Jeffrey J Swigris, David B Bekelman

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05001009 (Improving Implementation of Outpatient Goals of Care Conversations for Veterans With Serious Illness), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05001009 naenrolling by invitationnot on this map

Improving Implementation of Outpatient Goals of Care Conversations for Veterans With Serious Illness

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2022 to 2025Enrolled72ConditionsSeriously Ill Patients, Cancer, Heart Failure, Interstitial Lung DiseaseArmsClinician Implementation Strategy Stage 1: low intensity clinician training, Clinician Implementation Strategy Stage 2: high intensity clinician training, Low patient engagement, High patient engagement
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Survivorship Challenges and Supportive Care in Lung Cancer.Seminars in respiratory and critical care medicine · 2025
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Duc M HaMedical Service, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 N Wheeling Street, Aurora, CO, 80045, USA. duc.ha@va.gov.ORCID 0000-0002-3003-9438
Lubin R DengDenver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
Allison V LangeDivision of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Jeffrey J SwigrisInterstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.
David B BekelmanMedical Service, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 N Wheeling Street, Aurora, CO, 80045, USA.

Funding

Colorado Clinical and Translational Sciences InstituteUL1TR001082 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2013 to 2017
$48.0M
MULTIDISCIPLINARY RESPIRATORY DISEASES RESEARCH TRAININGT32HL007085 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI ELLEN L BURNHAM, LISA A MAIER · 1985 to 2026
$21.6M
Telerehabilitation for Veteran Lung Cancer Survivors Following Curative Intent TherapyIK2RX003661 · VA · VA EASTERN COLORADO HEALTH CARE SYSTEM · PI Duc M. Ha · 2022 to 2026
–
NCATS NIH HHS UL1 TR001082NHLBI NIH HHS T32 HL007085RRD VA IK2 RX003661
6 · The paper itself

Abstract

backgroundDyspnea is a common and debilitating symptom that affects many different patient populations. Dyspnea measures should assess multiple domains.

objectiveTo evaluate the reliability, validity, and responsiveness of an ultra-brief, multi-dimensional dyspnea measure.

designWe adapted the DEG from the PEG, a valid 3-item pain measure, to assess average dyspnea intensity (D), interference with enjoyment of life (E), and dyspnea burden with general activity (G).

participantsWe used data from a multi-site randomized clinical trial among outpatients with heart failure. MAIN MEASURES: We evaluated reliability (Cronbach's alpha), concurrent validity with the Memorial-Symptom-Assessment-Scale (MSAS) shortness-of-breath distress-orbothersome item and 7-item Generalized-Anxiety-Disorder (GAD-7) scale, knowngroups validity with New-York-Heart-Association-Functional-Classification (NYHA) 1-2 or 3-4 and presence or absence of comorbid chronic obstructive pulmonary disease (COPD), responsiveness with the MSAS item as an anchor, and calculated a minimal clinically important difference (MCID) using distribution methods. KEY

resultsAmong 312 participants, the DEG was reliable (Cronbach's alpha 0.92). The mean (standard deviation) DEG score was 5.26 (2.36) (range 0-10) points. DEG scores correlated strongly with the MSAS shortness of breath distress-or-bothersome item (r=0.66) and moderately with GAD-7 categories (ρ=0.36). DEG scores were statistically significantly lower among patients with NYHA 1-2 compared to 3-4 [mean difference (standard error): 1.22 (0.27) points, p<0.01], and those without compared to with comorbid COPD [0.87 (0.27) points, p<0.01]. The DEG was highly sensitive to change, with MCID of 0.59-1.34 points, or 11-25% change.

conclusionsThe novel, ultra-brief DEG measure is reliable, valid, and highly responsive. Future studies should evaluate the DEG's sensitivity to interventions, use anchor-based methods to triangulate MCID estimates, and determine its prognostic usefulness among patients with chronic cardiopulmonary and other diseases.

Indexed as

Pulmonary Disease, Chronic ObstructiveQuality of LifeDyspneaHumansPsychometricsReproducibility of ResultsSurveys and Questionnairescardiopulmonary diseasechronic obstructive pulmonary diseasedyspneaheart failurePatient-reported outcome measurepsychometrics

Identifiers

PMID34981344
PMCPMC9360273

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.