Figure 1 Mean click here Within-subjects differences (95% CI) Time 0a–0b (during ED visit) for individual items and subscales for Immediate Perception and Emotional Response (n=141–145). Time 0a: time of decision to come

to ED recalled at … For the test–retest interval between the ED visit and follow-up visit (Time 0a to 0c; Figure ​Figure2)2) mean differences for individual items ranged from −0.55 to +0.33 points, with all but 2 falling between −0.1 and −0.5 points. The mean differences for the two mean domain scores were approximately −0.2 points for Immediate Perception and −0.5 points for Emotional Response. All but Inhibitors,research,lifescience,medical one of the mean differences were negative, indicating that the follow-up ratings 4 to 6weeks later were consistently Inhibitors,research,lifescience,medical higher (more severe) at Time 0c (during follow-up) than the initial ratings in the ED (Time 0a). However, the 95% CIs for the Time 0a–Time 0c differences (Figure ​(Figure2)2) all contained 0 difference and were much wider than the 95% CIs for Time 0a–Time 0b differences

(Figure Inhibitors,research,lifescience,medical ​(Figure11). Figure 2 Mean within-subjects differences (95% CI) Time 0a–0c (ED to follow-up) for individual items and subscales for Immediate Perception and Emotional Response (n=67–68). Time 0a: time of decision to come to ED recalled at … Percentiles of agreement were narrower (i.e., agreement was closer) for the Immediate Perception items compared with the Emotional Response items for both recall intervals (see Additional file 1: Table A2 — Percentiles of within-subjects differences). For the Time 0a to 0b interval (during the ED visit), 80% of subjects (10th, 90th percentiles) had scores within±1 point for the mean Immediate Inhibitors,research,lifescience,medical Perception domain score and within±2 points for the mean Emotional Response domain score. The ranges between percentiles of agreement were considerably wider for the Time 0a to 0c interval. Discussion Overall, internal Inhibitors,research,lifescience,medical consistency reliability (Cronbach’s alpha) was strong for both MDP domains (Immediate

Perception and Emotional Response) across all three recall administrations. During already the ED visit, test–retest reliability in recall MDP ratings for dyspnea at the time participants decided to seek care in the ED was strong for individual items and very strong for the two domains (Table ​(Table3).3). Within-subjects agreement (intra-rater reliability) was satisfactory for both domains (Additional file 1: Table A2). In contrast, for the much longer recall interval between the ED and follow-up visits, the test–retest reliability (Table ​(Table3)3) and within-subjects agreement (Additional file 1: Table A2) were poor for individual items and significantly attenuated for the two domains. For the short recall interval during the ED visit, the median within-subjects difference in scores was 0 for individual items and from 0 to 0.2 for the mean domain scores (Additional file 1: Table A2).