Table 1.
Assessment tools for dyspnea
| Questionnaire | Overview | Practice considerations |
|---|---|---|
| Baseline Dyspnea Index, Transition Dyspnea Index45–47 | Multidimensional scales designed to provide information on the individual components of dyspnea:
|
Most commonly used as a research tool in clinical trials Assesses the impact of an intervention Can be interview-based or self-administered |
| Chronic Respiratory Questionnaire81 | 20-item measure Four aspects are examined: dyspnea, fatigue, emotional function, and mastery |
Self-administered version available Not a dyspnea-specific measure |
| Clinical COPD Questionnaire26,82 | 10-item measure divided into three domains: symptoms, functional, and mental state Questions focus on symptoms during the past week, including dyspnea symptoms and their impact on physical, daily, and social activities |
Recommended by GOLD Most commonly used as a research tool in clinical trials Correlates well with SGRQ Not a dyspnea-specific measure |
| COPD Assessment Test26,83 | Eight items, three relevant to dyspnea, to measure the impact of COPD on well-being and day-to-day activities Five-point Likert scale determines the level of breathlessness after walking up a hill or one flight of stairs, and assesses the extent of activity limitation at home |
Recommended by GOLD to evaluate symptoms, including dyspnea; scoring ≥10 indicates a high level of symptoms (equivalent to SGRQ score ≥25) Not a dyspnea-specific measure |
| Dyspnea-1284,85 | 12-item measure across physical (seven items) and affective (five items) domains Items are scored on a scale of 0 (none), 1 (mild), 2 (moderate), or 3 (severe) Total scores range 0–36, with high scores indicating greater severity |
Self-administered Asks patients to reflect on how they are experiencing dyspnea in their daily lives, rather than in response to a specific activity |
| mMRC breathlessness scale26,86,87 | Five statements that describe almost the entire range of respiratory disability from “none“ (grade 0) to “almost complete incapacity“ (grade 4) The MRC scale does not quantify breathlessness itself but enables a numeric value to be placed on exercise capacity |
Recommended by GOLD to evaluate symptoms, including dyspnea. Grade ≥2 signifies a high level of symptoms Self-administered; patients choose a phrase that best describes their condition Widely used in clinical practice |
| Multidimensional Dyspnea Profile88 | 11-item measure that assess dyspnea across a sensory domain and two affective domains (unpleasantness and emotional response) Designed to examine individual items that are thought to be aligned to separate mechanisms |
Can be self-administered, with support of HCP or trial investigator |
| SGRQ26 | 50-item measure divided into two parts Scores range from 0 to 100, with higher scores indicating greater limitation; a score of ≥25 is used as a threshold for considering regular treatment of symptoms |
Recommended by GOLD Too complex for use in routine practice, but often used in clinical studies Not a dyspnea-specific measure |
| UCSD SOBQ89 | 24-item measure Assesses self-reported shortness of breath while performing various daily activities If the activities listed are not typically performed by the patient, the patient is asked to estimate the degree of shortness of breath that they would anticipate when completing the specified task Three additional items ask about limitations due to shortness of breath, fear of harm from overexertion, and fear of shortness of breath |
Self-administered Provides comprehensive assessment of dyspnea, but its length may present a less practical option than other measures for day-to-day clinical use |
Abbreviations: GOLD, global initiative for chronic obstructive lung disease; HCP, healthcare professional; mMRC, modified Medical Research Council; MRC, Medical Research Council; SGRQ, St George’s respiratory questionnaire; UCSD SOBQ, University of California, San Diego shortness of breath questionnaire.