Assessment of Respiratory Distress by the Roth Score

Abstract

Introduction Health care demand is increasing due to greater longevity of patients with chronic comorbidities. This increasing demand is occurring in a setting of resource scarcity. To address these changes, high‐value care initiatives, such as telemedicine, are valuable resource‐preservation strategies. This study introduces the Roth score as a telemedicine tool that uses patient counting times to accurately risk‐stratify dyspnea severity in terms of hypoxia. Hypothesis The Roth score has correlation with dyspnea severity. Methods This is a prospective, controlled‐cohort study. 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. Results There was a strongly positive correlation between pulse oximetry and both maximal count achieved in 1 breath (r = 0.67; P < 0.001) and counting time (r = 0.59; P < 0.001). For oxygen saturation <95%, the maximal count number area under the curve is 0.828 and counting time area under the curve is 0.764. Counting time >8 seconds had a sensitivity of 78% and specificity of 73% for pulse oximetry <95%. Conclusions The Roth score has strong correlation with dyspnea severity as determined by hypoxia. This tool is reproducible, low resource‐utilization, and amenable to telemedicine. It is not intended to replace full clinical workup and diagnosis of respiratory distress, but it is useful in risk‐stratifying severity of dyspnea that warrants further clinical evaluation.

Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: The HOME-CoV rule.

“…However,it corresponds to the value found in the epidemiological study ofCOVID-19 patients in China [17]. The ability to talk or to countwithout breathing is a less common criterion but currently used inthe unformal assessment of dyspneic patients [24,25]. By de ning 8seconds as the time cut-off, the HOME-CoV rule proposes astandardization of this criterion.…”

Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule

“…However, it corresponds to the value found in the epidemiological study of COVID-19 patients in China [ 17 ]. The ability to talk or to count without breathing is a less common criterion but currently used in the unformal assessment of dyspneic patients [ 24 , 25 ]. By defining 8 s as the time cut-off, the HOME-CoV rule proposes a standardization of this criterion.…”

Short term home oxygen therapy COVID-19 patients: The COVID-HOT algorithm

“…The Joint ACAIM-WACEM COVID-19 Clinical Management Taskforce (CCMT) presents the comprehensive COVID-HOT protocol [Figures 1 and 2 ][ 17 18 19 20 21 ] along with important risk stratification definitions, such as the SCRB-60 score [ Table 1 ],[ 22 ] as well as the Breathlessness Screening Tool [ Table 2 ]. [ 23 24 ] As with any other clinical assessment platform, the evaluation of each patient should always begin with, and be based on, a careful medical history and a detailed clinical examination. It is recognized herein that telepresence may not provide as robust of a clinical assessment as an in-person visit; however, we must acknowledge that the overall risk-benefit equation of in-person encounters in the midst of a pandemic is generally unfavourable.…”