Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Modified Medical Research Council (mMRC) dyspnea scale is used to evaluate the level of breathlessness an individual experiences in everyday life. The tool involves selecting the statement that best describes one's experience with dyspnea. Based on this selection, the mMRC dyspnea scale assigns a numerical score that indicates the severity, with higher scores corresponding to more significant breathlessness.

Here's how the process works:

- You are provided with a list of scenarios reflecting different levels of breathlessness.
- Choose the statement that most accurately represents your current condition:
  - Dyspnea only with strenuous exercise
  - Dyspnea when hurrying or walking up a slight hill
  - Walks slower than people of the same age due to dyspnea or needs 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 dyspneic when dressing or undressing
  
Each option correlates to a specific score:

| Description                                                            | Score |
|-----------------------------------------------------------------------|-------|
| Dyspnea only with strenuous exercise                                  | 0     |
| Dyspnea when hurrying or walking up a slight hill                      | 1     |
| Walks slower than peers due to dyspnea or needs frequent stops        | 2     |
| Stops for breath after brief exertion                                  | 3     |
| Too dyspneic to leave the house or when dressing/undressing           | 4     |

Upon selecting the most suitable statement, you are assigned a score that provides a measure of breathlessness severity. The interpretation of this score is straightforward:

- Score of 0 suggests minimal dyspnea; this is Grade 0.
- Score of 1 indicates mild dyspnea when engaged in moderate activity; this is Grade 1.
- Score of 2 reflects moderate dyspnea affecting pace and ability compared to peers; this is Grade 2.
- Score of 3 shows severe dyspnea causing frequent pauses in activity; this is Grade 3.
- Score of 4 denotes very severe dyspnea, restricting everyday activities significantly; this is Grade 4.

Each grade is a clear indicator of the level of breathlessness experienced and aids in assessing the need for further medical evaluation or treatment adjustments.

The Modified Medical Research Council (mMRC) Dyspnea Scale is a clinical calculator used to assess the level of breathlessness in patients with respiratory diseases, particularly chronic obstructive pulmonary disease (COPD). The scale ranges from 0 to 4, with 0 indicating no breathlessness except with strenuous exercise and 4 indicating breathlessness while at rest. The mMRC Dyspnea Scale is a simple and effective tool for evaluating the impact of dyspnea on daily activities and quality of life. It is also used to guide treatment decisions and predict health outcomes in patients with COPD. There are no specific exclusion criteria for its use, but it may be less accurate in patients with conditions that cause dyspnea other than COPD.

Modified Medical Research Council (mMRC) dyspnea scale

Connective tissue disease-associated interstitial lung disease

Pulmonary rehabilitation

Setting of care

Medical history

Oxygen therapy

Management of progressive disease

Management of progressive disease, antifibrotic agents

Bronchoalveolar lavage

Management of pulmonary hypertension

Management of pulmonary hypertension, pharmacotherapy

Management of rapidly progressive disease

Management of rapidly progressive disease (combination therapy)

Management of progressive disease (corticosteroids)

Initial treatment

Initial treatment (antifibrotic agents)

Management of chronic cough

Chest computed tomography

Chest CT

Management of rapidly progressive disease, stem cell and/or lung transplantation

Management of rapidly progressive disease, corticosteroids

Management of pulmonary hypertension, setting of care

Transbronchial lung biopsy

Transbronchial lung biopsy, indications

Management of progressive disease, immunosuppressants

Initial treatment, corticosteroids

Management of rapidly progressive disease, immunosuppressants

Pulmonary function testing

Management of progressive disease, stem cell and/or lung transplantation

Management of progressive disease (IVIG/plasma exchange)

Laboratory testing

Laboratory testing, serologic tests

Follow-up

Initial treatment, immunosuppressants

Smoking cessation

Laboratory testing, other tests

As per ALAT/ATS/ERS/JRS 2022 guidelines, 

Management of acute respiratory failure

Initial treatment (IVIG/plasma exchange)

Management of pulmonary hypertension, supportive care

As per ALAT/ATS/ERS/JRS 2018 guidelines, 

Management of pulmonary hypertension, anticoagulant therapy

Management of pulmonary hypertension (general principles)

Surgical lung biopsy

Management of rapidly progressive disease (antifibrotic agents)

Indications for screening

Management of rapidly progressive disease (IVIG/plasma exchange)

Transbronchial lung biopsy, technical considerations

Transthoracic echocardiogram

Laboratory testing (initial tests)

Updated 2024 BSR guidelines for the management ofinterstitial lung disease in systemic sclerosis


Connective tissue disease-associated interstitial lung disease

Guidelines

Key sources