Summary
The Medical Research Council (MRC) scale was developed in the 1950s (Fletcher, 1952) to assess shortness of breath in the Pneumoconiosis Research Unit in Cardiff, Wales, and has been used in numerous research studies over the past 60 years. The MRC was modified in a study in 1988 (Mahler, 1988). The Global Initiative for Obstructive Lung Disease (GOLD) treatment guidelines include the mMRC as a component of a multi-faceted assessment and treatment approach to patients with COPD. The mMRC Dyspnea Scale score, or another dyspnea measurement, such as the COPD Assessment Test (CAT), is combined with the patient's FEV1 precent predicted and the frequency of COPD exacerbations to guide treatment interventions. FormulaGradeSymptom Severity0Dyspnea only with strenuous exercise1Dyspnea when hurrying on level ground or walking up a slight hill2Walks slower than people of the same age because of dyspnea, or has to stop for breath when walking at own pace on level ground3Stops for breath after walking 100 yards (91 m) or after a few minutes on level ground4Too dyspneic to leave house or breathless when dressing Intervention: The mMRC Dyspnea Scale score must be part of a comprehensive assessment, to include the patient's history, physical, and diagnostic test results. Consider spirometry (e.g., FEV1 and FVC), determining the GOLD stage, and pursuing relevant diagnostic or therapeutic interventions as appropriate if the mMRC score is ≥ 2.