Practical Dyspnea Assessment: Relationship Between the 0-10 Numerical Rating Scale and the Four-Level Categorical Verbal Descriptor Scale of Dyspnea Intensity.

Journal Article (Journal Article;Multicenter Study)

CONTEXT: Measurement of dyspnea is important for clinical care and research. OBJECTIVES: To characterize the relationship between the 0-10 Numerical Rating Scale (NRS) and four-level categorical Verbal Descriptor Scale (VDS) for dyspnea assessment. METHODS: This was a substudy of a double-blind randomized controlled trial comparing palliative oxygen to room air for relief of refractory breathlessness in patients with life-limiting illness. Dyspnea was assessed with both a 0-10 NRS and a four-level categorical VDS over the one-week trial. NRS and VDS responses were analyzed in cross section and longitudinally. Relationships between NRS and VDS responses were portrayed using descriptive statistics and visual representations. RESULTS: Two hundred twenty-six participants contributed responses. At baseline, mild and moderate levels of breathlessness were reported by 41.9% and 44.6% of participants, respectively. NRS scores demonstrated increasing mean and median levels for increasing VDS intensity, from a mean (SD) of 0.6 (±1.04) for VDS none category to 8.2 (1.4) for VDS severe category. The Spearman correlation coefficient was strong at 0.78 (P < 0.0001). Based on the distribution of NRS scores within VDS categories, we calculated test characteristics of two different cutpoint models. Both models yielded 75% correct translations from NRS to VDS; however, Model A was more sensitive for moderate or greater dyspnea, with fewer misses downcoded. CONCLUSION: There is strong correlation between VDS and NRS measures for dyspnea. Proposed practical cutpoints for the relationship between the dyspnea VDS and NRS are 0 for none, 1-4 for mild, 5-8 for moderate, and 9-10 for severe.

Full Text

Duke Authors

Cited Authors

  • Wysham, NG; Miriovsky, BJ; Currow, DC; Herndon, JE; Samsa, GP; Wilcock, A; Abernethy, AP

Published Date

  • October 2015

Published In

Volume / Issue

  • 50 / 4

Start / End Page

  • 480 - 487

PubMed ID

  • 26004401

Pubmed Central ID

  • PMC5008963

Electronic International Standard Serial Number (EISSN)

  • 1873-6513

Digital Object Identifier (DOI)

  • 10.1016/j.jpainsymman.2015.04.015


  • eng

Conference Location

  • United States