general-medicine respiratory

Roth Score for Hypoxia Screening

Bedside screening test for low oxygen levels: the patient counts aloud from 1 to 30 as fast as possible in a single breath. A low count suggests hypoxaemia. Small studies disagree on its accuracy, so it never replaces pulse oximetry.

Score interpretation

Count Below 7 — Hypoxaemia Likely 0–6

Chorin 2016: a count below 7 identified SpO₂ < 90 % with 87 % sensitivity.

→ Check pulse oximetry now and assess for respiratory distress. Screening only — not a substitute for oximetry.

Count Below 20 — SpO₂ Below 95 % Possible 7–19

ten Broeke 2021 (general practice, n = 105): a count below 20 detected SpO₂ < 95 % with 93 % sensitivity and 78 % specificity.

→ Check pulse oximetry and assess clinically.

Count 20 or More — Hypoxaemia Less Likely 20–30

Screening only: an emergency department study (Vallejo-De la Hoz 2023) found the Roth score not valid for hypoxaemia screening.

→ Measure SpO₂ with a pulse oximeter whenever there is clinical concern.

Interpretation bands for the Roth Score. Apply clinical judgement and local guidance.

References

Chorin E, et al. Assessment of respiratory distress by the Roth score. Clin Cardiol. 2016;39(11):636–639.
ten Broeke CEM, et al. The Roth score as a triage tool for detecting hypoxaemia in general practice: a diagnostic validation study in patients with possible COVID-19. Prim Health Care Res Dev. 2021;22:e56.
Vallejo-De la Hoz G, et al. Validity of the "Roth score" for hypoxemia screening. Am J Emerg Med. 2023;66:129–134.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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