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Evaluation of the Individual Activity Descriptors of the mMRC Breathlessness Scale: A Mixed Method Study
- Source :
- Yorke, J 2022, ' Evaluation of the Individual Activity Descriptors of the mMRC Breathlessness Scale: A Mixed Method Study ', The International Journal of Chronic Obstructive Pulmonary Disease, vol. 2022:17, 17, pp. 2289-2299 . https://doi.org/10.2147/COPD.S372318
- Publication Year :
- 2022
- Publisher :
- Dove Press, 2022.
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Abstract
- Janelle Yorke,1,2 Naimat Khan,1,3 Adam Garrow,1 Sarah Tyson,1 Dave Singh,1,3 Jorgen Vestbo,1,4 Paul W Jones5 1Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; 2Christie Patient Centred Research, The Christie NHS Foundation Trust, Whittington, Manchester, UK; 3Medicines Evaluation Unit, Wythenshawe, Manchester, UK; 4Department of Respiratory Medicine, Wythenshawe Hospital, Manchester, UK; 5St Georgeâs Hospital, University of London, London, UKCorrespondence: Janelle Yorke, Tel +44920 264411, Email janelle.yorke@nhs.netPurpose: The modified-Medical Research Council (mMRC) breathlessness scale consists of five grades that contain of a description of different activities. It has wide utility in the assessment of disability due to breathlessness but was originally developed before the advent of modern psychometric methodology and, for example contains more than one activity per grade. We conducted an evaluation of the mMRC structure.Patients and Methods: Cognitive debriefing was conducted with COPD patients to elicit their understanding of each mMRC activity. In a cross-sectional study, patients completed the mMRC scale (grades 0â 4) and an MRC-Expanded (MRC-Ex) version consisting of 10-items, each containing one mMRC activity. Each activity was then given a 4-point response scale (0 ânot at allâ to 4 âall of the timeâ) and all 10 items were given to 203 patients to complete Rasch analysis and assess the pattern of MRC item severity and its hierarchical structure.Results: Cognitive debriefing with 36 patients suggested ambiguity with the term âstrenuous exerciseâ and perceived severity differences between mMRC activities. 203 patients completed the mMRC-Ex. Strenuous exercise was located third on the ascending severity scale. Rasch identified the mildest term was âwalking up a slight hillâ (logit â 2.76) and âtoo breathless to leave the houseâ was the most severe (logit 3.42).Conclusion: This analysis showed that items that were combined into a single mMRC grade may be widely separated in terms of perceived severity when assessed individually. This suggests that mMRC grades as a measure of individual disability related to breathlessness contain significant ambiguity due to the combination of activities of different degrees of perceived severity into a single grade.Keywords: psychometrics, Rasch analysis, patient reported outcomes, qualitative, scale development
Details
- Language :
- English
- ISSN :
- 11782005
- Database :
- OpenAIRE
- Journal :
- International Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi.dedup.....da6547c09ee3e28db47cfb255fdd229f