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Assessment of respiratory distress by the Roth Score

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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


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

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