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Baseline Dyspnea Index (BDI) & Transition Dyspnea Index (TDI)

Name of questionnaire Baseline Dyspnea Index (BDI) Transition Dyspnea Index (TDI)
Type of questionnaire-description Interviewer-administered rating of severity of dyspnea at a single state. It provides a multidimensional measurement of dyspnea based on 3 components that evoke dyspnea in activities of daily living, in symptomatic individuals. Measures changes in dyspnea severity from the baseline as established by the BDI. 
Number of items 24 24
Number of domains & categories 3 3
Name of categories/domains   Functional Impairment, Magnitude of Task, Magnitude of Effort. Recall: during the last two weeks Change in Functional Impairment, Change in Magnitude of Task, Change in Magnitude of Effort
Scaling of items Rated in five grades from 0 (very severe) to 4 (no impairment) for each category.  Rated by seven grades ranging from -3 (major deterioration) to +3 (major improvement). 
Scoring Ranging from 0 to 12. The lower the score, the worse the severity of dyspnea. Three additional options in each category, which do not contribute to the scoring, allow circumstances in which dyspnea cannot be rated. Total score ranging - 9 to + 9. The lower the score, the more deterioration in severity of dyspnea. One additional option in each category, which does not contribute to the score, allows for circumstances in which impairment is due to reasons other than dyspnea.
Test-retest reproducibility Assessed by: - interobserver agrements for total score (92-94% agreement and weighted K=0.65-0.70) and each category; - test-retest correlation coefficient r=0.76. Assessed by interobserver agrements for total score (88-90% agreement and weighted K=0.63-0.65) and each category.
Internal consistency Yes, Cronbach α=0.80  Not reported 
Validity Reported relative to: -12 min walk test and lung function, 6MW, lung function and qualifty of life, dyspnea diary scores, FEV1, symptom and activity components on SGRQ and physician's global evaluation.  Reported relative to: -12 min walk test (Mahler DA, Weinberg DH, Wells CK, Feinstein AR. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest 1984, 85: 751-758); -dyspnea diary scores, FEV1, symptom and activity components on SGRQ and physician's global evaluation (Witek TJ, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J 2003, 21: 267–272).
Minimally important difference NA Change of ≥1 unit (assessed relative to physician's global evaluation) Witek TJ, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J 2003, 21: 267–272)
Language English for the USA
Translations in other languages (if yes, then list the languages) 73 translations, for a current list click here
Developer name Donald A Mahler, MD, FCCP; David H. Weinberg, MD; Carolyn K. Wells, MPH; and Alvan R. Feinstein, MD
Developer contact information Dr. Donald A Mahler
Pulmonary Section/Medicine
Dartmouth-Hitchcock Medical Center
Hanover, New Hampshire 03754
donald.a.mahler@hitchcock.org
Availability of questionnaire: needs permission from developer, cost or freely available Permission needed. User is required to complete and sign a User Agreement. A fee may be incurred depending on context of use and study design: see instructions at MAPI Research Trust site click here
References (including original publication) Mahler DA, Weinberg DH, Wells CK, Feinstein AR. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest 1984, 85: 751-758. Eakin EG, Sassi-Dambron DE, Ries AL, Kaplan RM. Reliability and validity of dyspnea measures in patients with obstructive lung disease. Int J Behav Med. 1995, 2(2):118-34. Witek TJ, Mahler DA. Minimal important difference of the transition dyspnoea index in a multinational clinical trial. Eur Respir J 2003, 21: 267–272.
Limitations few specific instructions included in the instrument 
Link to the questionnaire (if available) For review purposes only: Click Here
Other comments A self-administered computerized version has been validated with performance comparable to the interviewer-administred instrument (Mahler DA, Waterman LA, Ward J, McCusker C, ZuWallack R, Baird JC. Validity and responsiveness of the self-administered computerized versions of the baseline and transition dyspnea indexes. Chest. 2007 Oct, 132(4):1283-90) 
Last Reviewed: June 2016