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mMRC (Modified Medical Research Council) Dyspnea Scale

Stratifies severity of dyspnea in respiratory diseases, such as COPD.

CriadorDr. Donald A. Mahler, MD
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Instruções

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.  
  • Walking ought to be assessed on level ground

 

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.

Formula

Grade

Symptom Severity

0

Dyspnea only with strenuous exercise

1

Dyspnea when hurrying on level ground or walking up a slight hill

2

Walks slower than people of the same age because of dyspnea, or has to stop for breath when walking at own pace on level ground

3

Stops for breath after walking 100 yards (91 m) or after a few minutes on level ground

4

Too 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.

Todas as perguntas e resultados possíveis

QuestionsTítulo não visível
Symptom Severity
  • Walking ought to be assessed on level ground

 

Select one option:

  • Dyspnea only with strenuous exercise
  • Dyspnea when hurrying or walking up a slight hill
  • Walks slower than people of the same age because of dyspnea or has to stop for breath when walking at own pace
  • Stops for breath after walking 100 yards (91 m) or after a few minutes
  • Too dyspneic to leave the house or breathless when dressing
Resultados possíveis
Dyspnea Grade 1 (out of 4)
  • Higher grade indicates higher severity.
  • The mMRC Dyspnea Scale score must be part of a comprehensive assessment, to include the patient's history, physical, and diagnostic test results.
Dyspnea Grade 0 (out of 4)
  • Higher grade indicates higher severity.
  • The mMRC Dyspnea Scale score must be part of a comprehensive assessment, to include the patient's history, physical, and diagnostic test results.
Dyspnea Grade 4 (out of 4)
  • Higher grade indicates higher severity.
  • 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.
Dyspnea Grade 2 (out of 4)
  • Higher grade indicates higher severity.
  • 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.
Dyspnea Grade 3 (out of 4)
  • Higher grade indicates higher severity.
  • 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.

Citação

Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988 Mar;93(3):580-6.

Literatura

  • Evaluation of clinical methods for rating dyspnea. Chest. 1988 Mar;93(3):580-6.

    Mahler DA, Wells CK.

    https://pubmed.ncbi.nlm.nih.gov/3342669/

  • Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998 Oct;158(4):1185-9.

    Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T.

    https://pubmed.ncbi.nlm.nih.gov/9769280/

  • A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J. 2010 Nov;36(5):1067-72.

    Nishiyama O, Taniguchi H, Kondoh Y, Kimura T, Kato K, Kataoka K, Ogawa T, Watanabe F, Arizono S.

    https://pubmed.ncbi.nlm.nih.gov/20413545/

  • The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study. BMC Pulm Med. 2012 Oct 1;12:61.

    Launois C, Barbe C, Bertin E, Nardi J, Perotin JM, Dury S, Lebargy F, Deslee G.

    https://pubmed.ncbi.nlm.nih.gov/23025326/

  • The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004 Mar 4;350(10):1005-12.

    Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ.

    https://pubmed.ncbi.nlm.nih.gov/14999112/

  • Evaluation of three scales of dyspnea in chronic obstructive pulmonary disease. Ann Thorac Med. 2009 Jul;4(3):128-32.

    Chhabra SK, Gupta AK, Khuma MZ.

    https://pmc.ncbi.nlm.nih.gov/articles/PMC2714566/

  • Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Eur Respir J. 2023 Apr 1;61(4):2300239.

    Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, Bourbeau J, Han MK, Martinez FJ, Montes de Oca M, Mortimer K, Papi A, Pavord I, Roche N, Salvi S, Sin DD, Singh D, Stockley R, López Varela MV, Wedzicha JA, Vogelmeier CF.

    https://pubmed.ncbi.nlm.nih.gov/36858443/

  • Global Initiative for Chronic Obstructive Lung Disease 2024 Report

    GOLD Science Committee Members (2023-2024)

    https://goldcopd.org/2024-gold-report/

  • The pathological diagnosis of emphysema. Proc R Soc Med. 1952 Sep;45(9):576-7.

    Gough J.

    https://pmc.ncbi.nlm.nih.gov/articles/PMC1987525/

  • Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J. 2002 Oct;20(4):799-805.

    Rennard S, Decramer M, Calverley PM, Pride NB, Soriano JB, Vermeire PA, Vestbo J.

    https://pubmed.ncbi.nlm.nih.gov/12412667/

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