Assessment of dyspnea in sarcoidosis using the Baseline Dyspnea Index (BDI) and the Transition Dyspnea Index (TDI)

Ogugua Ndili Obi; Marc A Judson; Surinder S Birring; Lisa A Maier; Athol U Wells; Elyse E Lower; Robert P Baughman

doi:10.1016/j.rmed.2021.106436

Assessment of dyspnea in sarcoidosis using the Baseline Dyspnea Index (BDI) and the Transition Dyspnea Index (TDI)

Respir Med. 2022 Jan:191:106436. doi: 10.1016/j.rmed.2021.106436. Epub 2021 May 4.

Authors

Ogugua Ndili Obi¹, Marc A Judson², Surinder S Birring³, Lisa A Maier⁴, Athol U Wells⁵, Elyse E Lower⁶, Robert P Baughman⁶

Affiliations

¹ Division of Pulmonary Critical Care and Sleep Medicine, 3E-149E Brody Medical Sciences Building, 600 Moye Blvd, Mail Stop 628, Brody School of Medicine, East Carolina University, Greenville, NC, 27834-4354, USA. Electronic address: obio@ecu.edu.
² Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, New York, 12208, USA.
³ Kings College Hospital, London.
⁴ Division of Environmental and Occupational Health Sciences, National Jewish Health, University of Colorado Denver, USA; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, USA; Department of Medicine, School of Medicine, University of Colorado Denver, USA; Department of Environmental/Occupational Health, Colorado School of Public Health, University of Colorado Denver, USA.
⁵ Interstitial Lung Disease Unit, Royal Brompton Hospital, London, SW3 6NP, UK.
⁶ Department of Medicine, University of Cincinnati, Cincinnati, Ohio.

PMID: 33992496
DOI: 10.1016/j.rmed.2021.106436

Abstract

Introduction: The Borg and Modified Medical Research Council (mMRC) dyspnea scales have been used to evaluate dyspnea in sarcoidosis. The Baseline Dyspnea Index (BDI) and Transitional Dyspnea Index (TDI) are useful for the assessment of dyspnea in COPD. It is not known if the BDI-TDI accurately assesses dyspnea in sarcoidosis patients.

Methods: Data was analyzed from the Registry for Advanced Sarcoidosis (ReAS), a multi-national database enrolling patients with advanced sarcoidosis and a comparison group of sarcoidosis patients with non-advanced disease. At baseline, patients completed a BDI questionnaire along with spirometry, 6-min walk distance (6MWD), mMRC, Borg score, fatigue assessment score (FAS) and HRQoL assessments using Kings Sarcoidosis Questionnaire (KSQ) and St Georges Respiratory Questionnaire (SGRQ). At 12-months, patients with advanced disease completed a TDI questionnaire along with the other measures. Correlations between BDI and baseline variables, and between TDI and changes in baseline variables were evaluated.

Results: There was significant correlation (p < 0.001 for all) between BDI and baseline 6MWD (rho = 0.336), FVC% (rho = 0.387), FEV1% (rho = 0.285), DLCO% (rho = 0.355), mMRC (rho = -0.721), Borg score (rho = -0.389), FAS (rho = -0.669), SGRQ (rho = -0.785), and KSQ (rho = 0.318 to 0.724). At follow-up, TDI correlated with BDI, but not with changes in pulmonary function or other dyspnea measures.

Conclusion: BDI scores correlated with pulmonary function, 6MWD, and other dyspnea measures. TDI scores did not correlate with changes in pulmonary function or other dyspnea measures. BDI may be a useful independent measure of dyspnea in sarcoidosis patients. The role of TDI needs further evaluation in longitudinal studies associated with changes in clinical parameters.

Keywords: Baseline dyspnea index; Dyspnea; Health related quality of life; Sarcoidosis; Transitional dyspnea index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Dyspnea / diagnosis
Dyspnea / etiology
Humans
Pulmonary Disease, Chronic Obstructive* / complications
Pulmonary Disease, Chronic Obstructive* / diagnosis
Quality of Life
Sarcoidosis* / complications
Sarcoidosis* / diagnosis
Surveys and Questionnaires