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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