Measurement of dyspnoea in the clinical rather than the research setting.
OBJECTIVE
Refractory dyspnoea is a common and difficult to treat symptom in advanced disease. Accurate assessment helps to guide treatment and prognosis.


RESULTS
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 reviews on measurement tools for breathlessness identified a variety of tools but none could be recommended as gold standard. Validation of these tools in palliative care seems more appropriate than development of new tools. For clinical purposes, 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.


CONCLUSIONS
Despite a variety of measurement tools none can be recommended as gold standard for the assessment of dyspnoea. A combination of unidimensional and multidimensional tools seems to be the best for clinical assessment. Measurement of dyspnoea has to be seen in context with the person's history, physical examination and diagnostic tests.
Bausewein
Claudia
C
Department of Palliative Care, Policy & Rehabilitation, King's College London School of Medicine, UK. Claudia.Bausewein@kcl.ac.uk
Booth
Sara
S
Higginson
Irene J
IJ
D004417:Dyspnea / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D017079:Exercise Tolerance; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010166:Palliative Care; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires