Show simple item record

dc.contributor.authorWade, Joshuaen
dc.contributor.authorMendonca, Silviaen
dc.contributor.authorBooth, Saraen
dc.contributor.authorEwing, Gailen
dc.contributor.authorGardener, Anitaen
dc.contributor.authorFarquhar, Moragen
dc.date.accessioned2018-01-19T12:01:07Z
dc.date.available2018-01-19T12:01:07Z
dc.date.issued2017-01en
dc.identifier.issn2052-4439
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/270831
dc.description.abstractIntroduction The Numerical Rating Scale (NRS) is frequently used to assess patient reported breathlessness in both a research and clinical context. A subgroup report average breathlessness as worse than worst breathlessness in the last 24 hours. The Peak/End rule describes how the most extreme and current breathlessness influence reported average. This study seeks to highlight the existence of a subpopulation who give ‘paradoxical averages using the NRS, to characterise this group and to investigate the explanatory relevance of the ‘Peak/End’ rule. Methods Data were collected within mixed method face-to-face interviews for three studies: the Living with Breathlessness Study and the two sub-protocols of the Breathlessness Intervention Service Phase III randomised controlled trial. Key variables from the three datasets were pooled (n=561) and cases where participants reported a paradoxical average (n=45) identified. These were compared to non-cases and interview transcripts interrogated. NRS rating of average breathlessness were assessed for fit to Peak/End rule Results Patients in the paradoxical average group had higher Chronic Respiratory Questionnaire physical domain scores on average p=0.042). Peak/End rule analysis showed high positive correlation (Spearman’s rho= 0.756, p<0.001) Conclusions The NRS requires further standardisation with reporting of question order and construction of scale used to enable informed interpretation. The application of the Peak/End rule demonstrates fallibility of NRS-Average as a construct as it is affected by current breathlessness. Measurement of breathlessness is important for both clinical management and research, but standardisation and transparency is required for meaningful results.
dc.format.mediumElectronic-eCollectionen
dc.languageengen
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleAre within-person Numerical Rating Scale (NRS) ratings of breathlessness 'on average' valid in advanced disease for patients and for patients' informal carers?en
dc.typeArticle
prism.issueIdentifier1en
prism.publicationDate2017en
prism.publicationNameBMJ open respiratory researchen
prism.startingPagee000235
prism.volume4en
dc.identifier.doi10.17863/CAM.17758
dcterms.dateAccepted2017-09-05en
rioxxterms.versionofrecord10.1136/bmjresp-2017-000235en
rioxxterms.versionVoR*
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/en
rioxxterms.licenseref.startdate2017-01en
dc.contributor.orcidEwing, Gail [0000-0001-9547-7247]
dc.contributor.orcidGardener, Anita [0000-0002-8064-3780]
dc.contributor.orcidFarquhar, Morag [0000-0001-7991-7679]
dc.identifier.eissn2052-4439
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMacmillan Cancer Support (unknown)
pubs.funder-project-idMarie Curie Cancer Care (MCCC-RP-12-A14129)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (PB-PG-0107-11134)
pubs.funder-project-idNational Institute for Health Research (NIHR) via Comprehensive Local Research Network (CLRN) (unknown)
cam.orpheus.successThu Jan 30 12:59:42 GMT 2020 - The item has an open VoR version.*
rioxxterms.freetoread.startdate2100-01-01


Files in this item

Thumbnail
Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record

Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International