mMRC (Modified Medical Research Council) Dyspnea Scale
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- The mMRC Dyspnea Scale is best used to establish baseline functional impairment due to dyspnea attributable to respiratory disease; tracking the mMRC over time or with therapeutic interventions is of less certain clinical utility.
- Furthermore, while the mMRC is correlated with morbidity and mortality for patients with respiratory disease, currently-available data do not confirm attributable cause and effect between mMRC Dyspnea Scale scores and patient-centered outcomes.
- While measuring mMRC Dyspnea Scale scores in patients with respiratory disease (particularly COPD) to establish baseline functional dyspnea burden is appropriate, mMRC scores are not independently used in clinical practice to guide clinical management or therapeutic interventions.
- However, the Global Initiative for Obstructive Lung Disease (GOLD) treatment guidelines have, since 2011, included the mMRC as a component of a multi-faceted assessment and treatment approach to patients with COPD.
- A patient’s mMRC Dyspnea Scale score, or another dyspnea measurement, such as the COPD Assessment Test (CAT), is combined with the patient’s FEV₁ percent predicted and the frequency of COPD exacerbations to guide treatment interventions
The mMRC Dyspnea Scale score must be contextualized with an individual patient’s history, physical, and available diagnostic test results. For patients with a higher mMRC grade (e.g. ≥2) and clinical circumstances consistent with respiratory disease, measuring spirometry (e.g., FEV₁ and FVC), determining the patient’s BODE Index and/or GOLD stage, and pursuing further targeted diagnostic and/or therapeutic interventions is appropriate.
- Jeremy B. Richards, MD