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 .
Use of upper limb exercise to assess breathlessness in patients with cancer: tolerability, repeatability, and sensitivity.
We report the development of an arm exercise test to assess breathlessness in patients with lung cancer who are breathless at low levels of exertion .  Exercise consisted of raising the arm over 40 cm , either the dominant arm only ( n=10 ) or both arms alternating at minute intervals ( n=12 ) . Subjects breathed through a mouthpiece , and ventilation ( VE ) and oxygen uptake ( VO(2 ) ) were measured . Following familiarization , three tests were performed over one week to explore repeatability , and sensitivity was assessed in a fourth test . Arm exercise was generally well tolerated and increased breathlessness , VE , and VO(2 ) . The commonest factor limiting exercise was arm fatigue , although four patients in the two-arm test also reported breathlessness . Repeatability for breathlessness score and VE was best in the two-arm test . The added resistance used to assess sensitivity could not be detected . The two-arm test offers a potential means of assessing the effects of an intervention on breathlessness and E in patients for whom a cycle or treadmill exercise test is unsuitable
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 .