Purpose
The BDI rates severity of dyspnea at a single point in time.
Link to Instrument
Acronym
BDI
Primary Image
Baseline Dyspnea Index
Populations
Key Descriptions
- A 24-item interviewer administered rating of severity of dyspnea at a single state.
- There are 3 categories and 24 items in the instrument:
1) Functional impairment - Functional loss is evaluated during occupational activities/daily living
2) Magnitude of task - assesses what daily living tasks can provoke dyspnea
3) Magnitude of effort - evaluates how much effort needs to be sustained by the individual to evoke dyspnea - Each category has 5 levels of symptom severity (0-4).
- Patient’s condition is rated from 0 (severe) to 4 (unimpaired) for each category.
- Ratings on each of the 3 categories are added to get a score ranging from 0-12.
- Each category has 3 circumstances in which dyspnea can’t be measured:
1) Amount uncertain
2) Unknown
3) Impaired for reasons other than shortness of breath - Lower score indicates greater severity of dyspnea.
Number of Items
24
Equipment Required
- Computerized version needs a computer otherwise no equipment are needed.
Time to Administer
5 minutes
5 minutes or less
Required Training
No TrainingInstrument Reviewers
Initially reviewed by Kavita Joshi, PT, MS in 10/2013.
ICF Domain
ParticipationConsiderations
BDI has been used on large populations and for different cardiorespiratory conditions. BDI also has a self administered computerized version. Its optimal use depends on the clinical experience of the raters. Ratings by non physician personnel may be more accurate than those by the physicians, since they may be less likely to be affected by the expectations of a physician’s response to therapy. Few instructions are provided with the instrument.
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Pulmonary Diseases
back to PopulationsTest/Retest Reliability
COPD:
(Mahler, Ward, Waterman et al, 2009; n = 101; mean age = 66 (9) years)
- Excellent test retest reliability (ICC = 0.90)
Obstructive Lung Disease:
(Eakin, Sassi-Dambron, Ries et al, 1995; n = 143; mean age = 67.7 (8.6) years)
- Excellent test retest reliability (ICC = 0.76)
Interrater/Intrarater Reliability
Chronic Obstructive Pulmonary Disease:
(Meek, Lareau, 2003)
- Adequate interrater reliability (ICC = 0.65 - 0.72)
Obstructive Lung Disease:
(Eakin, Sassi-Dambron, Ries et al, 1995)
- Excellent interrater reliability (ICC = 0.88)
Internal Consistency
Obstructive Lung Disease:
(Eakin, Sassi-Dambron, Ries et al, 1995)
- Excellent internal consistency (Cronbach’s alpha = 0.80); 6 measures of dyspnea were reviewed
Criterion Validity (Predictive/Concurrent)
COPD:
(Mahler, Waterman, Ward et al, 2007; n = 65; mean age = 67 (9) years)
- Adequate correlations between SAC BDI and MRC scale (r = -0.56)
- Excellent correlations between interview BDI and MRC scale (r = -0.73)
(Witek, Mahler, 2003; n = 997; mean age = 64 years)
- Adequate to excellent correlations with SGRQ scores (r = -0.35 to -0.64)
- Adequate correlations with DD score (r = -0.34)
- Adequate correlations with PGE at baseline (r = 0.39)
Construct Validity
COPD:
(Witek, Mahler et al, 2003)
- Adequate correlations with FEV1 (r = 0.31)
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BDI shows validity with 12MW test: (Mahler, Weinberg, Wells et al, 1984; n = 38; mean age = 62 (10) years) BDI shows validity with 6 MW test: but the type wasn’t discussed.
Obstructive Lung Disease:
-
(Eakin, Sassi-Dambron, Ries et al, 1995)
-
Adequate correlation with SOBQ (r = -0.70)
-
Bibliography
Eakin, E. G., Sassi-Dambron, D. E., et al. (1995). "Reliability and validity of dyspnea measures in patients with obstructive lung disease." Int J Behav Med 2(2): 118-134.
Mahler, D. A., Ward, J., et al. (2009). "Patient-reported dyspnea in COPD reliability and association with stage of disease." Chest 136(6): 1473-1479.
Mahler, D. A., Waterman, L. A., et al. (2007). "Validity and responsiveness of the self-administered computerized versions of the baseline and transition dyspnea indexes." Chest 132(4): 1283-1290.
Mahler, D. A., Weinberg, D. H., et al. (1984). "The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes." Chest 85(6): 751-758.
Meek, P. M. and Lareau, S. C. (2003). "Critical outcomes in pulmonary rehabilitation: assessment and evaluation of dyspnea and fatigue." J Rehabil Res Dev 40(5 Suppl 2): 13-24.
Witek, T. J., Jr. and Mahler, D. A. (2003). "Minimal important difference of the transition dyspnoea index in a multinational clinical trial." Eur Respir J 21(2): 267-272.