Appendix 5

Table of Minimum Clinically Important Differences (MCID) (Cazzola 2015b)

Health status measures

Patient Reported Outcome Measure (PROM)PurposeDomainsNo. itemsReliabilityValidityMCID
St George’s Respiratory Questionnaire
Assess health status impairment in airways disease(COPD, Asthma, Bronchiectasis) Symptoms, activity, impacts 50 4 units
St George’s Respiratory Questionnaire COPD
Assess health status in COPD – weakest items removed Symptoms, activity, impacts 404 units
Chronic Respiratory Questionnaire
(short form also available)
Health-related quality of life in chronic respiratory disease Mastery, fatigue, emotional function and dyspnoea 200.5 units
Clinical COPD Questionnaire
Health status assessment in a primary care setting Symptoms,
functional state, mental state
100.4 units
COPD Assessment Test
Quantifies symptom burden of COPD, health status measurement Energy, Sleep, confidence, activities, breathlessness, chest tightness, phlegm, cough 82 units

Symptom measures

Patient Reported Outcome Measure (PROM)PurposeDomainsNo. itemsReliabilityValidityMCID
Modified Medical Research Council
Disability from COPD related to breathlessness Uni-dimensional 1 - 5 point scale ~ 1, but limited data
Baseline Dyspnoea Index (BDI)
Transitional Dyspnea Index (TDI)
Measurement of dyspnea based on activities of daily living BDI: functional impairment, magnitude of task, magnitude of effort BDI 3
1 unit in TDI
The Breathlessness Cough and Sputum Scale (BCSS) Tracks severity of resp symptoms and evaluate efficacy in clinical trials - COPD Breathlessness, cough, sputum 3AcceptableAcceptable>1 substantial
.6 mod
.3 small
Dyspnoea 12 Current level of breathlessness severity Uni-dimensional 12Not yet established


Patient Reported Outcome Measure (PROM)PurposeDomainsNo. itemsReliabilityValidityMCID
The EXAcerbations of Chronic Pulmonary Disease Tool (EXACT®)Evaluates frequency, severity and duration of an AE COPD
Breathlessness, cough and sputum, chest symptoms 14Not yet established
Evaluating Respiratory Symptom
Derivative instrument of the EXACT, designed to address the need for a standardized daily diary to assess respiratory symptoms in patients with stable COPD Breathlessness, cough and sputum, chest symptoms 11 3 point Δ(total score)
2 point Δ(breathless-ness)
1 point Δ(cough & sp)
1 point Δ(chest symptoms)