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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    mMRC (Modified Medical Research Council) Dyspnea Scale

    Stratifies severity of dyspnea in respiratory diseases, particularly COPD.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with respiratory diseases, to assess degree of baseline functional disability due to dyspnea.

    • The mMRC Dyspnea Scale quantifies disability attributable to breathlessness, and is useful for characterizing baseline dyspnea in patients with respiratory diseases.
    • Describes baseline dyspnea, but does not accurately quantify response to treatment of chronic obstructive pulmonary disease (COPD).
    • Does not capture patient effort, such that dyspnea from pulmonary disease (and not behavioral responses to disability) are reflected in mMRC Dyspnea Scale scores.
    • Does not consistently correlate with spirometric measurements (e.g. FEV₁) for patients with respiratory disease due to COPD.
    • Demonstrates at least moderate positive correlation with other dyspnea scores, including the baseline dyspnea index (BDI) and oxygen cost diagram (OCD) (Chhabra 2009).
    • At least moderately correlated with healthcare-associated quality of life, particularly for patients with COPD (Henoch 2016).
    • Scores are variably associated with patients’ perceptions of respiratory symptom burden or disease severity (Rennard 2002).
    • Scores are associated with morbidity (hospitalization and adverse cardiovascular outcomes) and, in some studies, mortality.
    • Used as a component of the BODE Index, which predicts adverse outcomes, including mortality and risk of hospitalization (Celli 2004).
    • Easy and efficient to calculate.
    • Provides a baseline assessment of functional impairment attributable to dyspnea from respiratory disease.
    • Correlates with healthcare-associated quality of life, morbidity, and possibly mortality for patients with respiratory diseases (particularly COPD).  
    • Has been used for almost two decades in multiple different heterogeneous patient populations.
    • Correlates with other clinical and research dyspnea indices.
    • Inter-rater reliability is very high.
    Dyspnea only with strenuous exercise
    0
    Dyspnea when hurrying or walking up a slight hill
    +1
    Walks slower than people of the same age because of dyspnea or has to stop for breath when walking at own pace
    +2
    Stops for breath after walking 100 yards (91 m) or after a few minutes
    +3
    Too dyspneic to leave house or breathless when dressing
    +4

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Donald A. Mahler

    About the Creator

    Donald A. Mahler, MD, is a professor emeritus at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. Clinically, he is a practicing pulmonologist and the director of respiratory services at Valley Regional Hospital in Claremont, NH. Dr. Mahler's research focus is management of COPD.

    To view Dr. Donald A. Mahler's publications, visit PubMed

    Are you Dr. Donald A. Mahler? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Jeremy B. Richards, MD
    About the Creator
    Dr. Donald A. Mahler
    Are you Dr. Donald A. Mahler?
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