TABLE 3

Importance on breathlessness, shortness of breath, or dyspnoea

StudyInstrumentReport formatResults
Gruenberger et al. [49]SF-6D utilityMeanSF-6D health utilities were 0.060 points lower in higher dyspnoea patients (modified Medical Research Council score ≥2) than in lower dyspnoea patients
Kim et al. [28]EQ-5D VASMean±semEQ-5D utility
Level 1 breathlessness (short of breath during strenuous activities): 0.870±0.020
Level 2 breathlessness (stopping to catch breath after a few minutes walking): 0.740±0.030
Level 3 breathlessness (breathless when dressing or washing): 0.540±0.060
EQ-5D utilityMean±semEQ-VAS
Level 1 breathlessness (short of breath during strenuous activities): 0.751±0.026
Level 2 breathlessness (stopping to catch breath after a few minutes walking): 0.656±0.035
Level 3 breathlessness (breathless when dressing or washing): 0.526±0.071
Punekar et al. [43]EQ-5D utilityMean (95% CI)All in primary care physician setting: 0.700 (0.680–0.710)
Breathlessness after exercising heavily in primary care physician setting: 0.880 (0.860–0.900)
Breathlessness when hurrying on level ground in primary care physician: 0.790 (0.770–0.810)
Too breathless to leave house in primary care physician: 0.170 (0.110–0.240)
All in respiratory specialist setting: 0.680 (0.660–0.690)
Breathlessness after exercising heavily in respiratory specialist setting: 0.880 (0.850–0.900)
Breathlessness when hurrying on level ground in respiratory specialist setting: 0.790 (0.770–0.810)
Too breathless to leave house in respiratory specialist setting: 0.290 (0.220–0.350)
Braido et al. [50]Uncategorised surveyChoice or proportion of choiceBreathlessness as most troublesome symptom: 64.6% (ranking first; chronic cough: 13.9%; sputum production: 11.0%; exacerbation: 8.3%)
Downey et al. [51]Uncategorised survey: End of life Priority Score (the highest priority aspect of the end-of-life period)Mean±sdIn a survey on end-of-life priority score measured by rank order (out of 5), breathing comfort was considered as priority: 1.27±1.83 (ranking third, only after time with family and friends, and pain under control)
Haughney et al. [52]Conjoint analysis/discrete choice analysisMeanBreathlessness was considered important for patients. Of all the attributes, it was after “impact on everyday life”, “need for medical care” and “number of future attacks”. It is more important than speed of recovery, productive cough, social impact, sleep disturbance and impact on mood.
Hernández et al. [53]Impact of shortness of breathChoice or proportion of choiceShortness of breath is an important outcome, because 6.0% of participants stated the impact on activities of daily living was extreme, 29.0% “very much”, 24.0% “a little” and 13.0% “not at all”
Miravitlles et al. [54]Ideal characteristics of a COPD therapyChoice or proportion of choice37.0% of the participants chose “increased shortness of breath” as the symptom that has a high impact on wellbeing (ranking second; increased coughing 42.0%, increased fatigue 37.0%, increased production of sputum 35.0%, increased frequency of chest pains 20.0% and fever 13.0%)
Pisa et al. [55]Direct choice: relative importance of COPD attributes (%, higher proportion indicating more importance)Choice or proportion of choiceDyspnoea was considered the most important COPD attribute
Relative importance of COPD attributes
Dyspnoea: 36.0%
Performance capability (bodily resilience) due to COPD: 19.0%
Sleep quality due to COPD: 19.0%
Onset of action of the medication: 3.0%
Frequency of administration of the medication: 6.0%
Health state after awakening (day start) due to COPD: 13.0%
Emotional state due to COPD base medication: 4.0%
Effect of attribute levels on health state preference: part-worth utilities (higher value indicating more importance):
 Dyspnoea
  Never dyspnoea, except on strong exertion: 115.80
  Dyspnoea on exertion: 38.20
  Dyspnoea at normal walking pace: −6.60
  Dyspnoea on slight effort: −10.10
  Dyspnoea even at rest: −137.40
Polati et al. [56]Uncategorised survey: expectation of treatmentChoice or proportion of choice120 (24.1%) patients would like to have more ease with “breathing” due to treatment; if they were doctors, 215 (43.3%) patients would like to first heal shortness of breath. For both questions, breathing problems were considered most important compared with other symptoms.
Reinke et al. [57]Forced choice: treatmentChoice or proportion of choicePreferences about death and dying questionnaire. 52.6% of 357 patients chose “being able to breath comfortably in the last 7 days of life” as preferred characteristics of treatment.
Rocker et al. [31]Uncategorised survey: reasons to continue (or not) with opioidsChoice or proportion of choiceI would strongly prefer when followed up at 2 months, 8 (23.5%) and 1 (2.9%) patient claimed would “strongly prefer” and “prefer” to continue on opioids because they provide significant relief from dyspnoea; while at 4–6 months, 12 (29.3%) and 7 (17.1%) patients claimed would “strongly prefer” and “prefer” to continue on opioids because they provide significant relief from dyspnoea.
Wilson et al. [58]Importance of mechanical ventilation: scales for the specific questions about mechanical ventilationMedian (IQR)On a scale of 1–4 (0: not at all important; 1: a little; 2: quite a bit; 3: very much; 4: extremely important), the score for easing breathlessness was 2.5 (1.8–3.0) for those forego mechanical ventilation, and 3.0 (2.8–4.0) for those uncertain/accept mechanical ventilation.

EQ-5D: EuroQol-5D; VAS: visual analogue scale; COPD: chronic obstructive pulmonary disease; IQR: interquartile range.