{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:29:36Z","timestamp":1791581376445,"version":"4.3.4"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T00:00:00Z","timestamp":1710547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T00:00:00Z","timestamp":1710547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2019-02081"],"award-info":[{"award-number":["2019-02081"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50\u201364\u00a0years. Breathlessness (modified Medical Research Council [mMRC]\u2009\u2265\u20092) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence\/absence of self-reported cardiorespiratory disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 25,948 people aged 57.5\u2009\u00b1\u2009[SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0\u201329.9), 21% obese (BMI\u2009\u2265\u200930); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6\u201366.0%), stress (31.6\u201376.8%), respiratory disease (20.1\u201337.1%), depression (17.1\u201326.6%), cardiac disease (6.3\u201312.7%), anemia (0.8\u20133.3%), and peripheral arterial disease (0.3\u20130.8%). Stress was the main factor in women and current smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breathlessness mainly relates to overweight\/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting\u2014supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12931-024-02766-6","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T10:01:44Z","timestamp":1710583304000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women"],"prefix":"10.1186","volume":"25","author":[{"given":"Magnus","family":"Ekstr\u00f6m","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefin","family":"Sundh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Anger\u00e5s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Blomberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"B\u00f6rjesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Caidahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6ssur Ingi","family":"Emilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Engvall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Frykholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludger","family":"Grote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristofer","family":"Hedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Jernberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Lindberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Malinovschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Nyberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rullman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Sandberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Sk\u00f6ld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Stenfors","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Tanash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suneela","family":"Zaigham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Johan","family":"Carlh\u00e4ll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,16]]},"reference":[{"key":"2766_CR1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1164\/rccm.201111-2042ST","volume":"185","author":"MB Parshall","year":"2012","unstructured":"Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, Calverley PM, Gift AG, Harver A, Lareau SC, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185:435\u201352.","journal-title":"Am J Respir Crit Care Med"},{"key":"2766_CR2","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1183\/09031936.00036813","volume":"43","author":"R Gronseth","year":"2014","unstructured":"Gronseth R, Vollmer WM, Hardie JA, Olafsdottir IS, Lamprecht B, Buist AS, Gnatiuc L, Gulsvik A, Johannessen A, Enright P. Predictors of dyspnoea prevalence: results from the BOLD study. Eur Respir J. 2014;43:1610\u201320.","journal-title":"Eur Respir J"},{"key":"2766_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000643","volume":"7","author":"J Sandberg","year":"2020","unstructured":"Sandberg J, Ekstr\u00f6m M, B\u00f6rjesson M, Bergstr\u00f6m G, Rosengren A, Anger\u00e5s O, Toren K. Underlying contributing conditions to breathlessness among middle-aged individuals in the general population: a cross-sectional study. BMJ Open Respir Res. 2020;7: e000643.","journal-title":"BMJ Open Respir Res"},{"key":"2766_CR4","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1136\/thx.54.7.581","volume":"54","author":"JC Bestall","year":"1999","unstructured":"Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54:581\u20136.","journal-title":"Thorax"},{"key":"2766_CR5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-001168","volume":"9","author":"S Kochovska","year":"2022","unstructured":"Kochovska S, Currow D, Chang S, Johnson M, Ferreira D, Morgan D, Olsson M, Ekstr\u00f6m M. Persisting breathlessness and activities reduced or ceased: a population study in older men. BMJ Open Respir Res. 2022;9: e001168.","journal-title":"BMJ Open Respir Res"},{"key":"2766_CR6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296016","volume":"18","author":"L Cristea","year":"2023","unstructured":"Cristea L, Olsson M, Sandberg J, Kochovska S, Currow D, Ekstr\u00f6m M. Which breathlessness dimensions associate most strongly with fatigue?-the population-based VASCOL study of elderly men. PLoS ONE. 2023;18: e0296016.","journal-title":"PLoS ONE"},{"key":"2766_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-000990","volume":"8","author":"L Cristea","year":"2021","unstructured":"Cristea L, Olsson M, Currow D, Johnson M, Sandberg J, Ekstr\u00f6m M. Breathlessness dimensions association with physical and mental quality of life: the population based VASCOL study of elderly men. BMJ Open Respir Res. 2021;8: e000990.","journal-title":"BMJ Open Respir Res"},{"key":"2766_CR8","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1378\/chest.121.5.1434","volume":"121","author":"K Nishimura","year":"2002","unstructured":"Nishimura K, Izumi T, Tsukino M, Oga T. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. Chest. 2002;121:1434\u201340.","journal-title":"Chest"},{"key":"2766_CR9","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1183\/09031936.00092613","volume":"43","author":"L Laviolette","year":"2014","unstructured":"Laviolette L, Laveneziana P. Dyspnoea: a multidimensional and multidisciplinary approach. Eur Respir J. 2014;43:1750\u201362.","journal-title":"Eur Respir J"},{"key":"2766_CR10","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/SPC.0000000000000568","volume":"15","author":"J Sandberg","year":"2021","unstructured":"Sandberg J, Olsson M, Ekstr\u00f6m M. Underlying conditions contributing to breathlessness in the population. Curr Opin Supportive and Palliative Care. 2021;15:219\u201325.","journal-title":"Curr Opin Supportive and Palliative Care"},{"key":"2766_CR11","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1111\/resp.14400","volume":"28","author":"YL Guo","year":"2022","unstructured":"Guo YL, Ampon MR, Poulos LM, Davis SR, Toelle BG, Marks GB, Reddel HK. Contribution of obesity to breathlessness in a large nationally representative sample of Australian adults. Respirology. 2022;28:350\u20136.","journal-title":"Respirology"},{"key":"2766_CR12","doi-asserted-by":"publisher","first-page":"1700558","DOI":"10.1183\/13993003.00558-2017","volume":"50","author":"DC Currow","year":"2017","unstructured":"Currow DC, Dal Grande E, Sidhu C, Ekstr\u00f6m M, Johnson MJ. The independent association of overweight and obesity with breathlessness in adults: a cross-sectional, population-based study. Eur Respir J. 2017;50:1700558.","journal-title":"Eur Respir J"},{"key":"2766_CR13","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1136\/thoraxjnl-2019-213349","volume":"74","author":"MP Ekstr\u00f6m","year":"2019","unstructured":"Ekstr\u00f6m MP, Blomberg A, Bergstr\u00f6m G, Brandberg J, Caidahl K, Engstr\u00f6m G, Engvall J, Eriksson M, Gr\u00e4nsbo K, Hansen T, et al. The association of body mass index, weight gain and central obesity with activity-related breathlessness: the Swedish Cardiopulmonary Bioimage Study. Thorax. 2019;74:958.","journal-title":"Thorax"},{"issue":"197\u2013205","key":"2766_CR14","volume":"59","author":"DC Currow","year":"2020","unstructured":"Currow DC, Chang S, Reddel HK, Kochovska S, Ferreira D, Kinchin I, Johnson M, Ekstr\u00f6m M. Breathlessness, anxiety, depression, and function-the BAD-F study: a cross-sectional and population prevalence study in adults. J Pain Symptom Manage. 2020;59(197\u2013205): e192.","journal-title":"J Pain Symptom Manage"},{"key":"2766_CR15","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1164\/rccm.201504-0841OC","volume":"193","author":"A Faisal","year":"2015","unstructured":"Faisal A, Alghamdi BJ, Ciavaglia CE, Elbehairy AF, Webb KA, Ora J, Neder JA, O\u2019Donnell DE. Common mechanisms of dyspnea in chronic interstitial and obstructive lung disorders. Am J Respir Crit Care Med. 2015;193:299\u2013309.","journal-title":"Am J Respir Crit Care Med"},{"key":"2766_CR16","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1097\/SPC.0000000000000516","volume":"14","author":"J Alberto Neder","year":"2020","unstructured":"Alberto Neder J, O\u2019Donnell DE. Heart, lungs, and muscle interplay in worsening activity-related breathlessness in advanced cardiopulmonary disease. Curr Opin Support Palliat Care. 2020;14:157\u201366.","journal-title":"Curr Opin Support Palliat Care"},{"key":"2766_CR17","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1089\/jpm.2011.0430","volume":"15","author":"MJ Johnson","year":"2012","unstructured":"Johnson MJ, Bowden JA, Abernethy AP, Currow DC. To what causes do people attribute their chronic breathlessness? A population survey. J Palliat Med. 2012;15:744\u201350.","journal-title":"J Palliat Med"},{"key":"2766_CR18","doi-asserted-by":"publisher","first-page":"3302","DOI":"10.1007\/s11606-021-07374-4","volume":"37","author":"CP Verschoor","year":"2022","unstructured":"Verschoor CP, Cakmak S, Lukina AO, Dales RE. Activity-related dyspnea in older adults participating in the Canadian Longitudinal Study on Aging. J Gen Intern Med. 2022;37:3302\u20139.","journal-title":"J Gen Intern Med"},{"key":"2766_CR19","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1111\/resp.14070","volume":"26","author":"LM Poulos","year":"2021","unstructured":"Poulos LM, Ampon RD, Currow DC, Marks GB, Toelle BG, Reddel HK. Prevalence and burden of breathlessness in Australian adults: the National Breathlessness Survey\u2014a cross-sectional web-based population survey. Respirology. 2021;26:768\u201375.","journal-title":"Respirology"},{"key":"2766_CR20","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1111\/joim.12384","volume":"278","author":"G Bergstrom","year":"2015","unstructured":"Bergstrom G, Berglund G, Blomberg A, Brandberg J, Engstrom G, Engvall J, Eriksson M, de Faire U, Flinck A, Hansson MG, et al. The Swedish CArdioPulmonary BioImage Study: objectives and design. J Intern Med. 2015;278:645\u201359.","journal-title":"J Intern Med"},{"key":"2766_CR21","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1161\/CIRCULATIONAHA.121.055340","volume":"144","author":"G Bergstr\u00f6m","year":"2021","unstructured":"Bergstr\u00f6m G, Persson M, Adiels M, Bj\u00f6rnson E, Bonander C, Ahlstr\u00f6m H, Alfredsson J, Anger\u00e5s O, Berglund G, Blomberg A, et al. Prevalence of subclinical coronary artery atherosclerosis in the general population. Circulation. 2021;144:916\u201329.","journal-title":"Circulation"},{"key":"2766_CR22","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","volume":"335","author":"EV Elm","year":"2007","unstructured":"Elm EV, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335:806.","journal-title":"BMJ"},{"key":"2766_CR23","doi-asserted-by":"publisher","first-page":"00553","DOI":"10.1183\/23120541.00553-2021","volume":"8","author":"M Olsson","year":"2022","unstructured":"Olsson M, Currow DC, Johnson MJ, Sandberg J, Engstr\u00f6m G, Ekstr\u00f6m M. Prevalence and severity of differing dimensions of breathlessness among elderly males in the population. ERJ Open Res. 2022;8:00553\u20132021.","journal-title":"ERJ Open Res"},{"key":"2766_CR24","first-page":"00592","volume":"9","author":"G David","year":"2023","unstructured":"David G, Viktor E, Linus S, Dennis J, Magnus E. The modified Medical Research Council scale misclassifies exertional breathlessness among people referred for exercise testing. ERJ Open Res. 2023;9:00592\u20132023.","journal-title":"ERJ Open Res"},{"key":"2766_CR25","unstructured":"From the global strategy for the diagnosis, management and prevention of COPD, global initiative for chronic obstructive lung disease (GOLD); 2023. http:\/\/goldcopd.org\/. Accessed 26 Jan 2024."},{"key":"2766_CR26","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1016\/0002-9149(91)90189-R","volume":"68","author":"A Rosengren","year":"1991","unstructured":"Rosengren A, Tibblin G, Wilhelmsen L. Self-perceived psychological stress and incidence of coronary artery disease in middle-aged men. Am J Cardiol. 1991;68:1171\u20135.","journal-title":"Am J Cardiol"},{"key":"2766_CR27","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/S0140-6736(04)17019-0","volume":"364","author":"A Rosengren","year":"2004","unstructured":"Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:953\u201362.","journal-title":"Lancet"},{"key":"2766_CR28","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1183\/09031936.00080312","volume":"40","author":"PH Quanjer","year":"2012","unstructured":"Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, Enright PL, Hankinson JL, Ip MS, Zheng J, Stocks J. Multi-ethnic reference values for spirometry for the 3\u201395-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40:1324\u201343.","journal-title":"Eur Respir J"},{"key":"2766_CR29","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1183\/09031936.00161011","volume":"40","author":"PH Quanjer","year":"2012","unstructured":"Quanjer PH, Hall GL, Stanojevic S, Cole TJ, Stocks J. Age- and height-based prediction bias in spirometry reference equations. Eur Respir J. 2012;40:190\u20137.","journal-title":"Eur Respir J"},{"key":"2766_CR30","doi-asserted-by":"publisher","first-page":"1602047","DOI":"10.1183\/13993003.02047-2016","volume":"49","author":"M Ekstr\u00f6m","year":"2017","unstructured":"Ekstr\u00f6m M, Schi\u00f6ler L, Gr\u00f8nseth R, Johannessen A, Svanes C, Leynaert B, Jarvis D, Gislason T, Demoly P, Probst-Hensch N, et al. Absolute values of lung function explain the sex difference in breathlessness in the general population. Eur Respir J. 2017;49:1602047.","journal-title":"Eur Respir J"},{"key":"2766_CR31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190876","volume":"13","author":"M Ekstr\u00f6m","year":"2018","unstructured":"Ekstr\u00f6m M, Sundh J, Schioler L, Lindberg E, Rosengren A, Bergstrom G, Angeras O, Hedner J, Brandberg J, Bake B, Toren K. Absolute lung size and the sex difference in breathlessness in the general population. PLoS ONE. 2018;13: e0190876.","journal-title":"PLoS ONE"},{"key":"2766_CR32","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/oxfordjournals.aje.a121617","volume":"99","author":"OS Miettinen","year":"1974","unstructured":"Miettinen OS. Proportion of disease caused or prevented by a given exposure, trait or intervention. Am J Epidemiol. 1974;99:325\u201332.","journal-title":"Am J Epidemiol"},{"key":"2766_CR33","doi-asserted-by":"publisher","first-page":"15","DOI":"10.2105\/AJPH.88.1.15","volume":"88","author":"B Rockhill","year":"1998","unstructured":"Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. Am J Public Health. 1998;88:15\u20139.","journal-title":"Am J Public Health"},{"key":"2766_CR34","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/1471-2458-11-33","volume":"11","author":"JA Bowden","year":"2011","unstructured":"Bowden JA, To TH, Abernethy AP, Currow DC. Predictors of chronic breathlessness: a large population study. BMC Public Health. 2011;11:33.","journal-title":"BMC Public Health"},{"key":"2766_CR35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0214083","volume":"14","author":"J Sandberg","year":"2019","unstructured":"Sandberg J, Engstr\u00f6m G, Ekstr\u00f6m M. Breathlessness and incidence of COPD, cardiac events and all-cause mortality: A 44-year follow-up from middle age throughout life. PLoS ONE. 2019;14: e0214083.","journal-title":"PLoS ONE"},{"key":"2766_CR36","unstructured":"World Health Organization (WHO). Mental health. https:\/\/www.who.int\/health-topics\/mental-health#tab=tab_1. Assessed 10 Apr 2023."},{"key":"2766_CR37","unstructured":"World Health Organization (WHO). Obesity and overweight. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight. Assessed 10 Apr 2023."},{"key":"2766_CR38","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1093\/eurjhf\/hft064","volume":"15","author":"R Zarrinkoub","year":"2013","unstructured":"Zarrinkoub R, Wettermark B, W\u00e4ndell P, Mejhert M, Szulkin R, Ljunggren G, Kahan T. The epidemiology of heart failure, based on data for 2.1 million inhabitants in Sweden. Eur J Heart Fail. 2013;15:995\u20131002.","journal-title":"Eur J Heart Fail"},{"key":"2766_CR39","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1136\/thoraxjnl-2015-207953","volume":"71","author":"T Soumagne","year":"2016","unstructured":"Soumagne T, Laveneziana P, Veil-Picard M, Guillien A, Claud\u00e9 F, Puyraveau M, Annesi-Maesano I, Roche N, Dalphin J-C, Degano B. Asymptomatic subjects with airway obstruction have significant impairment at exercise. Thorax. 2016;71:804\u201311.","journal-title":"Thorax"},{"key":"2766_CR40","doi-asserted-by":"publisher","first-page":"1800486","DOI":"10.1183\/13993003.00486-2018","volume":"51","author":"M Ekstrom","year":"2018","unstructured":"Ekstrom M, Elmberg V, Lindow T, Wollmer P. Breathlessness measurement should be standardised for the level of exertion. Eur Respir J. 2018;51:1800486.","journal-title":"Eur Respir J"},{"key":"2766_CR41","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1097\/SPC.0000000000000617","volume":"16","author":"M Ekstr\u00f6m","year":"2022","unstructured":"Ekstr\u00f6m M. Tests to uncover and assess breathlessness: a proposed framework. Curr Opin Support Palliat Care. 2022;16:188\u201394.","journal-title":"Curr Opin Support Palliat Care"},{"key":"2766_CR42","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.2147\/COPD.S277523","volume":"16","author":"H Lewthwaite","year":"2021","unstructured":"Lewthwaite H, Jensen D, Ekstr\u00f6m M. How to assess breathlessness in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2021;16:1581\u201398.","journal-title":"Int J Chron Obstruct Pulmon Dis"}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-024-02766-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12931-024-02766-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12931-024-02766-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T10:04:36Z","timestamp":1710583476000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/s12931-024-02766-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,16]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2766"],"URL":"https:\/\/doi.org\/10.1186\/s12931-024-02766-6","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,16]]},"assertion":[{"value":"25 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The SCAPIS multicenter study was approved by the ethics committee at Ume\u00e5 University, Sweden (Dnr 2010-228-31\u00a0M), and the present analysis was approved by the Swedish Ethical Review Authority (2021-00288). Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AA reports personal fees outside the submitted manuscript for lectures in pulmonary medicine from Astra-Zeneca, Boehringer-Ingelheim, Chiesi and TEVA. LG reports grants from Bayer AG (Unrestricted grant for collaboration with the European Sleep Apnea Database network), Swedish Heart and Lung Foundation (unrestricted institutional grant) and grants from the Swedish state under the ALF agreement (unrestricted institutional grant). LG reports speaker fees from Resmed, Lundbeck and Astra Zeneca. LG reports a licensed patent for Desitin (pharmacological treatment of sleep apnea). KH reports a travel grant from the Swedish Association for Clinical Physiology. AN reports grants from the Heart and Lung Foundation and the Swedish Research Council (both paid to the institution). NS reports being the primary investigator for a pharmaceutical study sponsored by GSK. JS has received honoraria for lectures and educational activities from AstraZeneca, Boehringer Ingelheim, Chiesi and Novartis. J Sundstr\u00f6m reports stock ownership in Anagram kommunikation AB and Symptoms Europe AB, unrelated to this study. SZ reports grants from Magnus Bergvalls stiftelse and Bror Hjerpstedts stiftelse. SZ reports travel support from the Swedish Heart and Lung Foundation. The rest of the authors report no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"127"}}