Use of Roth score in virtual assessments

In response to the commentary in the January issue of Canadian Family Physician,¹ I note that virtual assessments have limitations but that the indiscriminate use of in-person examinations and imaging risks overusing resources that are already critically limited during the pandemic. We urgently need research to help identify mild cases of coronavirus disease 2019 (COVID-19) in community contexts and need to know how to manage low-risk patients presenting with dyspnea through virtual assessment.

The Roth score was suggested as a potential tool to assist in the virtual evaluation of patients with dyspnea.² There has been substantial controversy surrounding the Roth score. It was the topic of multiple expert reviews.^3-5 In essence, the Roth score is not validated and should not be used in isolation or at all.

While it is essential for clinicians not to be swayed by an unvalidated tool, we are disheartened that there has not been additional research into the Roth score. We are only aware of 1 study that further investigated the correlation between Roth score and saturation of oxygen.⁶ Further research needs to be conducted on clinical assessment tools of this kind if any validated methods of virtual evaluation are to be established.

We are currently undertaking a research study, “Assessing dyspnea using virtual care during COVID pandemic (ADViC2),” which aims to investigate any correlation between the Roth score, saturation of oxygen, and other patient-oriented outcomes (eg, hospital admission and additional clinical visits). Additional information is available at http://advicstudy.ca.