Why the study?
The functional impact of breathlessness is assessed using the mMRC scale for chronic respiratory disease and the NYHA scale for heart failure, but agreement between the scales and their concurrent validity in cardiorespiratory disease required evaluation.
Do the mMRC and NYHA scales show agreement and concurrent validity in assessing the impact of breathlessness in outpatients with stable chronic respiratory disease or heart failure?
Do the mMRC and NYHA scales show agreement and concurrent validity in assessing the impact of breathlessness in outpatients with stable chronic respiratory disease or heart failure?
The mMRC and NYHA scales are comparable and show moderate to strong correlations when assessing the functional impact of breathlessness in patients with cardiorespiratory disease.
Moderate agreement between mMRC and NYHA supports cautious cross-disease use; leaves open need for unified dyspnea tools in cardiorespiratory patients.
BACKGROUND: The functional impact of breathlessness is assessed using the modified Medical Research Council (mMRC) scale for chronic respiratory disease and with the New York Heart Association Functional Classification (NYHA) scale for heart failure. We evaluated agreement between the scales and their concurrent validity with other clinically relevant patient-reported outcomes in cardiorespiratory disease. METHODS: Outpatients with stable chronic respiratory disease or heart failure were recruited. Agreement between the mMRC and NYHA scales was analysed using Cramér's V and Kendall's tau B tests. Concurrent validity was evaluated using correlations with clinically relevant measures of breathlessness, anxiety, depression, and health-related quality of life. Analyses were conducted for all participants and separately in chronic obstructive pulmonary disease (COPD) and heart failure. RESULTS: In a total of 182 participants with cardiorespiratory disease, the agreement between the mMRC and NYHA scales was moderate (Cramér's V: 0.46; Kendall's tau B: 0.57) with similar results for COPD (Cramér's V: 0.46; Kendall's tau B: 0.66) and heart failure (Cramér's V: 0.46; Kendall's tau B: 0.67). In the total population, the scales correlated in similar ways to other patient-reported outcomes. CONCLUSION: In outpatients with cardiorespiratory disease, the mMRC and NYHA scales show moderate to strong correlations and similar associations with other patient-reported outcomes. This supports that the scales are comparable when assessing the impact of breathlessness on function and patient-reported outcomes.
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Ahmadi et al. (2021) studied this question.
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