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Assessment of respiratory distress by the Roth Score

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Roth score index is measured by having the patient count from 1 to 30 in their native language, in a single breath, as rapidly as possible. The primary result of the Roth score is the duration of time and the highest number reached.

  • Roth Score is a tool for quantifying the level of breathlessness, which is assumed to correlate to the level of hypoxia. It combines maximal count reached (starting from 1 to 30 in one’s native language) during a single exhalation and the time taken to reach the maximum count (the second score is called the “counting time”)
  • study evidence showed that a counting time <8 seconds had a sensitivity of 78% and specificity of 71% for identifying a room-air pulse oximetry <95%

However a review states (2)

Do not use the Roth score to assess breathlessness over the phone.

  • There are no validated tests for assessing breathlessness over the phone in an acute primary care setting
  • Measuring a patient’s respiratory rate over the phone using the Roth Score does not provide an accurate assessment of hypoxia and may lead to false reassurance
  • Experts recommend an overall clinical assessment, including questions about the nature and rate of change of the breathlessness

Reference:

On behalf of the Oxford COVID-19 Evidence Service Team Nuffield Department of Primary Care Health Sciences University of Oxford

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