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 .
Measuring health status in chronic airflow limitation.
A health status instrument for use in clinical trials must be valid ( measuring what it is supposed to measure ) and responsive ( able to detect clinical ly important change ) . Approaches to measuring health status in clinical trials include using a battery of instruments , a general instrument which provides a profile of the patient 's health , an instrument that generates a health utility , or an instrument that focuses on the problems associated with a particular disease . Disease-specific instruments have been used in clinical trials in chronic airflow limitation ( CAL ) . The Oxygen Cost Diagram is simple and easy to administer , but responsiveness and validity are unproven . The Transition Dyspnoea Index is valid and responsive , but is difficult to use in trials in which multiple measurements are desired . The Chronic Respiratory Disease Question naire has proved valid and responsive in controlled trials in CAL patients .  Health status measures  should be included in all clinical trials in CAL
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 .