COSMIN database

Measurement of dyspnoea in the clinical rather than the research setting

Bausewein, C., Booth, S., and Higginson, I. J.
PURPOSE OF REVIEW: Refractory dyspnoea is a common and difficult to treat symptom in advanced disease. Accurate assessment helps to guide treatment and prognosis.

RECENT FINDINGS: The absence of commonly agreed assessment tools has been a significant barrier to improving care through inhibition of clinical research and limitation of clinicians' ability to assess the effectiveness of their interventions. Two recently published systematic reviews on measurement tools for breathlessness identified a variety of tools but none could be recommended as gold standard. Validation of these tools in palliative care seems more appropriate than development of new tools. For clinical purposes, the combination of a unidimensional tool to assess dyspnoea severity and a multidimensional tool to evaluate the impact on a person's quality of life seem most appropriate. This review discusses the present evidence and puts forward a strategy for assessment and measurement of the symptom in clinical practice.

SUMMARY: Despite a variety of measurement tools none can be recommended as gold standard for the assessment of dyspnoea. A combination of unidimensional and multidimensional tools seems to be the best for clinical assessment. Measurement of dyspnoea has to be seen in context with the person's history, physical examination and diagnostic tests.
Curr Opin Support Palliat Care
1751-4266 (Electronic)
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the respiratory system
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
ALSFRS-R - revised ALS Functional Rating Scale
AQ20 - Airways Questionnaire 20
ATS-DLD-78 - American Thoracic Society Respiratory Questionnaire 78 items
BCSS - Breathlessness, Cough and Sputum Scale
BDI- Baseline Dyspnoea Index
Borg (RPE) Scale - Borg Rating of Perceived Exertion Scale   
Breathlessness Assessment Guide
CCQ - Clinical COPD Questionnaire    
CDS - Cancer Dyspnoe Scale
Chronic lung disease (CLD) severity index
CRDQ - Chronic Respiratory Disease Questionnaire [alias: CRQ]   
Dyspnoea Assessment Questionnaire
Dyspnoea Exertion Scale
Feinstein's Index of Dyspnoea
LCSS - Lung Cancer Symptom Scale
London Chest Activity Daily Living Scale
mBORG - modified BORG scale
MDRS - Motor Neurone Disease Dyspnoea Rating Scale
MRC Respiratory Symptoms Questionnaire - Medical Research Council Respiratory Symptoms Questionnaire
MRC Scale - Medical Research Council Scale   
NRS - Numeric Rating Scale   
OCD - Oxygen Cost Diagram
PFSDQ-M - modified Pulmonary Functional Status & Dyspnea Questionnaire
PFSDQ - Pulmonary Functional Status & Dyspnea Questionnaire
PFSS - Pulmonary Function Status Scale
QoL-RIQ - Quality-of-Life for Respiratory Illness Questionnaire    
RIQ-MON10 - Respiratory Illness Questionnaire-Monitoring 10    
RQLQ - Respiratory Quality of life Questionnaire
SGRQ - St. George's Respiratory Questionnaire   
SOLDQ - Seattle Obstructive Lung Disease Questionnaire
TDI - Transition Dyspnoea Index
UCDS - University of California St.Diego (UCDS) Shortness of Breath Questionnaire
University of Cincinnati Dyspnoea Questionnaire
VAS - Visual Analogue Scale