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 .
Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group.
OBJECTIVES : To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions . To vali date the measure in various specialist and non-specialist palliative care setting s throughout the UK . DESIGN : A systematic literature review of measures appropriate for use in palliative care setting s was conducted . In conjunction with a multidisciplinary project advisory group , questions were chosen for inclusion into the scale based on whether they measured aspects of physical , psychological , or spiritual domains pertinent to palliative care , and whether similar items had shown to be valid as part of another measure . A staff completed version was developed to facilitate data collection on all patients throughout their care , and a patient completed version was design ed to enable the patient to contribute to the assessment of their outcomes when possible . A full validation study was conducted to evaluate construct validity , internal consistency , responsiveness to change over time , and test-retest reliability . Assessment s were timed . SETTING : Eight centres in Engl and and Scotl and providing palliative care , including inpatient care , outpatient care , day care , home care , and primary care . PATIENTS : A total of 450 patients entered care during the study period . Staff collected data routinely on patients in care long enough to be assessed ( n = 337 ) . Of these , 262 were eligible for patient participation ; 148 ( 33 % ) went on to complete a question naire . MAIN MEASURES : The Palliative Care Outcome Scale ( POS ) , the European Organisation for Research on Cancer Treatment , and the Support Team Assessment Schedule . RESULTS : The POS consists of two almost identical measures , one of which is completed by staff , the other by patients . Agreement between staff and patient ratings was found to be acceptable for eight out of 10 items at the first assessment . The measure demonstrated construct validity ( Spearman rho = 0.43 to 0.80 ) . Test/re-test reliability was acceptable for seven items . Internal consistency was good ( Cronbach 's alpha = 0.65 ( patients ) , 0.70 ( staff ) ) . Change over time was shown , but did not reach statistical significance . The question naire did not take more than 10 minutes to complete by staff or patients . CONCLUSION : The POS has acceptable validity and reliability . It can be used to assess prospect ively palliative care for patients with advanced cancer
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 .