Assessment of dyspnea in asthma: validation of The Dyspnea-12

J Asthma. 2011 Aug;48(6):602-8. doi: 10.3109/02770903.2011.585412. Epub 2011 Jun 2.


Background: Dyspnea is a prominent symptom in asthma. The Dyspnea-12 (D-12), an instrument that quantifies breathlessness using 12 descriptors that tap the physical and affective aspects, has shown promise for the measurement of dyspnea in cardiorespiratory disease.

Objective: We report the results of a study designed to test the validity and reliability of the D-12 in a population of patients with asthma.

Methods: This cross-sectional study included 102 patients with asthma. Subjects completed the D-12, Hospital Anxiety and Depression scale, St. George's Respiratory Questionnaire (SGRQ), and Medical Research Council scale. Confirmatory factor analysis confirmed the two-component structure of the D-12 (i.e., seven items that tap the physical aspects of breathlessness and five items that tap the affective aspects).

Results: The D-12 subscales had excellent internal reliability (Cronbach's alpha for the "physical" score was 0.94 and the affective score was 0.95). The D-12 physical component was more strongly correlated with SGRQ Symptoms (r = 0.648), SGRQ Activities (r = 0.635) and Medical Research Council grade (r = 0.636), while the affective component was more strongly correlated with SGRQ Impacts (r = 0.765) and Hospital Anxiety and Depression scale scores (anxiety r = 0.641 and depression r = 0.602).

Conclusion: This study supports validity of the D-12 for use in the assessment of dyspnea of patients with asthma. It assesses one of the most pertinent symptoms of asthma from two viewpoints-physical and affective.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Asthma / complications*
  • Asthma / diagnosis
  • Asthma / drug therapy
  • Asthma / physiopathology*
  • Cross-Sectional Studies
  • Data Interpretation, Statistical
  • Dyspnea / diagnosis*
  • Dyspnea / etiology
  • Exercise Test
  • Female
  • Forced Expiratory Volume / physiology
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Reproducibility of Results
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • Vital Capacity / physiology
  • Walking / physiology