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Table 2 Respiratory Health Screening Questionnaire (RHSQ), modified

From: The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*

Question Answer Score
1. Age 40 -49 0
 Age-group (years) 50-59 4
 60–69 60-69 8
2. (a) Are you an active smoker? No O Yes O
 (b) How many cigarettes do you smoke per day? Cigarettes  
 (c) For how many years have you been smoking? Years  
3. Using the answers to question 2, calculate your pack/years
N.B. To calculate the pack years you have to do the following operation:
number of cigarettes smoked per day x years you have smoked divided by 20.
  0-14 0
  15-24 2
  25-49 3
  50+ 7
4. What is your weight? kg
5. What is your height? m
6. Using the answers to questions 4 and 5, calculate your body mass index:
N.B. To calculate the body mass index you have to do the following operation:
Weight expressed in kg divided by height expressed in metres squared
Body mass index (BMI), kg/m2   
  > 29.7 0
  25.4-29.7 1
  < 25.4 5
6. If you have respiratory symptoms (cough, breathlessness) does the weather influence your symptoms?
  Yes 3
  No 0
  I never have symptoms 0
7. Do you sometimes have a lot of phlegm even if you don’t have a cold or ‘flu?
  Yes 3
  No 0
8. Do you ever cough up phlegm in the morning?
  Yes 0
  No 4
9. Do you ever hear “whistling” sounds or other noises inside your chest when breathing?
  Never 0
  Sometimes/often 4
10. Have you ever suffered from allergies?
  Yes 0
  No 3