Table 1

The domains and content of the comprehensive respiratory assessment

AssessmentDiagnosticOutcome
Exercise/symptom domain
  • MRC scale

  • Drug therapy

  • Attendance at PR

  • CAT score

  • Lung function

  • Hyperinflation

  • Exercise desaturation

  • Exercise testing

  • Muscle strength

  • Prescription, eg, bronchodilator

  • Referral for PR

  • Consider LVR

  • Ambulatory oxygen

Exacerbation domain
  • Exacerbation frequency

  • Hospital admission

  • Vaccination history

  • Drug therapy

  • Sputum microbiology

  • Blood eosinophilia

  • CT imaging

  • Exacerbation management strategy

  • Prescription, eg, ICS/mucolytic

  • Antibiotic prophylaxis

  • Vaccination

Comorbidity domain
  • Medical history

  • Weight loss

  • History of anxiety or depression

  • Fracture history

  • BMI

  • Bone mineral density (DEXA)

  • Vitamin D

  • FFMI and SMI (DEXA)

  • ECG/BNP

  • Framingham risk score

  • Serum testosterone

  • HADS

  • Osteoporosis secondary prevention

  • CV risk reduction

  • Nutritional therapy

  • Hormone replacement

  • Psychological therapies

Prognostic indicator domain
  • Smoking status

  • Home oxygen use

  • NIV use (acute and home)

  • Oedema

  • 'Surprise' question

  • Blood gases

  • iBODE

  • Smoking cessation

  • Home oxygen or ventilation

  • EoL/advance care planning

  • Palliative care referral

  • ‘Surprise’ question indicates 'would you be surprised if your patient died in the next year'; iBODE, see Williams et al.12

  • BMI, body mass index; BNP, brain natriuretic peptide; CV, cardiovascular; DEXA, dual emission X-ray absorptiometry; EoL, end of life; FFMI, fat-free mass index; HADS, hospital anxiety and depression score; iBODE, Body mass index, airflow Obstruction, Dyspnoea, and Exercise; ICS, inhaled corticosteroid; LVR, lung volume reduction therapy; MRC, Medical Research Council; NIV, non-invasive ventilation; PR, pulmonary rehabilitation; SMI, skeletal muscle index.