Fig. 1

Meaningful change for symptoms. a Symptom domains. b Individual symptom items. The starting point when discussing meaningful change (denoted by the dots at the base of the arrows) was a hypothetical severity level of 4 (“Very severe”) or 2 (“Moderate”) for the symptom domains; for the symptom items, the starting point was the response given when completing the PAH-SYMPACT™. For each symptom item, only participants who scored the item as 2 or higher when completing the PAH-SYMPACT™ were included in the meaningful change discussions. Cardiopulmonary domain: shortness of breath, fatigue, lack of energy, swelling in the ankles or legs, swelling in the stomach area, and cough; cardiovascular domain: heart palpitations, rapid heartbeat, chest pain, chest tightness, and lightheadedness