| Learning Objective #1: Identify the process of designing a symptom scale--a literature review to actual development | |||
| Learning Objective #2: Allow participants to understand the basic process of validating a new scale through the process of testing, refinement, and basic statistical analysis |
PURPOSE: The purpose of this presentation is to describe the development of population-specific outcome measures for patients diagnosed with asthma and/or COPD, as well as the testing used to validate those tools for the setting in which they are used.
METHOD: Many of the low-income and underserved patients in this asthma/COPD clinic have low reading levels and difficulty understanding the language of standardized surveys measuring symptoms of respiratory disorders. Since, most patients enrolled have neither pure asthma nor pure COPD, disease-specific scales were believed to be inappropriate for this population. A literature review identified the major symptoms described by patients with asthma and COPD. Clinic records were reviewed to identify commonly used terms by enrolled patients. Two tools were developed to measure respiratory symptoms: a shortness of breath visual analog scale (VAS) and a six-item shortness of breath questionnaire. Each tool has been used for over a year. Comparative data was collected using a quality of life VAS, the modified dyspnea index (MDI) and physiologic measures (peak flow and spirometry readings). Data sopports significant reliability alpha = .82, and validity. Scales correlate well with more difficult tools such as the MDI. The degree to which the responses to the VAS and symptom scale correlated with other respiratory measures will be reported and any differences between groups described.
DISCUSSION: This presentation will describe a successful attempt to create a clinic-specific outcome measurement for dyspnea, describing the process of refinement to achieve a more reliable instrument. This is a work in progress and adaptation of the scales will continue. Initial reliability testing has shown that these symptom scales are a valuable resource to those who treat patients with dyspnea. This presentation will provide information about selecting and monitoring specific outcome measures as well as tool development.
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