Should we measure dyspnoea in everyone?

The paper by Nielsen et al in this journal reports the prevalence of dyspnea in 15 countries throughout the world as 27%. Dyspnea is a powerfully aversive sensation frequently overlooked despite its prevalence and the severity of distress it causes. Despite its ‘subjective’ nature, dyspnea is a powerful predictor of morbidity and mortality. We suggest that this is because the information provided by enteroceptors is so rich that it is as valuable as the more precise but relatively sparse information provided by clinical tests. Relatively simple measures of dyspnea, such as the Medical Research Council Breathlessness Scale used by Nielsen et al, can provide meaningful information at very little cost.