SUMMARY Despite a variety of measurement tools none can be recommended as gold st and ard for the assessment of dyspnoea .
A combination of unidimensional and multidimensional tools seems to be the best for clinical assessment .
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 review s on measurement tools for breathlessness identified a variety of tools but none could be recommended as gold st and ard .
For clinical purpose s , 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 .
Verbal numerical scales are as reliable and sensitive as visual analog scales for rating dyspnea in young and older subjects
This study compared the use of a simple verbal 0 - 10 numerical rating scale ( verbal NRS ) and a visual analog scale ( VAS ) for the rating of dyspnea during exercise in a group of young and older subjects . Twelve younger ( 32+/-9 yr ) and 12 older ( 71+/-7 yr ) subjects used either the verbal NRS or the VAS in a r and omised fashion to rate dyspnea during 60 s of uphill treadmill walking ( range 5.6 - 8.8 km h(-1 ) ) performed at either a low ( 17 % grade ) or high workload ( 26 % grade ) and then during recovery . Rating scales were evaluated twice on separate days ( day 1 and day 2 ) at each workload . While the verbal NRS scores proved to be reliable throughout exercise and recovery , VAS scores were significantly ( p<0.05 ) lower on day 2 during the low workload test ( younger group ) and the high workload test ( older group ) . Verbal NRS ratings were consistently greater than VAS ratings at both workloads ( p<0.001 ) for both young and older groups . The intra-class correlation coefficients for rating peak dyspnea using either the VAS or verbal NRS were consistently lower for the older subjects ( range : r=0.54 - 0.67 ) than the younger subjects ( range : r=0.70 - 0.86 ) . Overall , subjects preferred the verbal NRS to the VAS . These results suggest that the verbal NRS compares favourably with the VAS for rating dyspnea during exercise without mask or mouthpiece . However , when rating peak dyspnea both scales appear less reliable when used by the older compared to young subjects
SUMMARY Despite a variety of measurement tools none can be recommended as gold st and ard for the assessment of dyspnoea .
A combination of unidimensional and multidimensional tools seems to be the best for clinical assessment .
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 review s on measurement tools for breathlessness identified a variety of tools but none could be recommended as gold st and ard .
For clinical purpose s , 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 .