Understanding the "Zedd Score" in Respiratory Muscle Assessment
I cannot provide guidance on reporting based on a "Zedd score" because no such validated scoring system exists in the respiratory muscle assessment literature or clinical guidelines. After reviewing comprehensive guidelines from the American Thoracic Society/European Respiratory Society on respiratory muscle testing 1 and pulmonary rehabilitation 1, as well as recent evidence on respiratory muscle performance 1, there is no reference to any "Zedd score" or similar acronym.
What You May Be Looking For
If you meant respiratory muscle strength assessment in neuromuscular disease or COPD:
The standard approach uses multiple validated tests rather than a single composite score 2:
- Maximal Inspiratory Pressure (PImax): Detects weakness in 40.1% of clinical referrals, but tends to overdiagnose when used alone 2
- Sniff Nasal Pressure (SNIP): Identifies weakness in 41.8% of cases; combining PImax and SNIP reduces false positives by 19.2% 2, 3
- Vital Capacity (VC): Less sensitive for mild weakness but highly prognostic; supine VC improves detection of diaphragmatic involvement 1, 3
- Cough Peak Expiratory Flow: Values below 160-270 L/min suggest poor airway clearance 3
Key Reporting Elements for Respiratory Muscle Weakness:
Always report multiple complementary tests rather than relying on a single measurement 2. The combination approach increases diagnostic precision by 19-56% depending on which tests are paired 2.
For Inspiratory Muscle Assessment:
- Report both PImax and SNIP together (reduces overdiagnosis by 19.2%) 2
- Include postural change in VC (≥30% fall from upright to supine suggests severe diaphragmatic weakness) 1
- Document if PImax is <40% predicted (threshold where daytime hypercapnia becomes likely) 4
For Expiratory Muscle Assessment:
- Report Maximal Expiratory Pressure (PEmax) alongside cough gastric pressure 2
- Values <45 cm H₂O on PEmax indicate compromised cough efficiency 3
- Combining three expiratory tests reduces false positives from 38.3% to 16.7% 2
Clinical Context Matters:
In COPD patients 5:
- Lower respiratory muscle strength independently predicts moderate-to-severe exacerbations (adjusted HR 0.521 per 1 SD increase in PImax % predicted) 5
- Respiratory muscle weakness occurs in 48.1% of COPD patients and precedes systemic skeletal muscle dysfunction 5
In neuromuscular disease 3, 6:
- Hypercapnia is weakly related to lung function in Steinert dystrophy and bulbar involvement 3
- Respiratory muscle training improves FVC (SMD 0.40), PImax (SMD 0.53), and PEmax (SMD 0.70) compared to control 6
Common Pitfalls to Avoid
- Never rely on single test results: Using PImax alone overdiagnoses weakness; always combine with at least one additional measure 2
- Don't assume normal daytime values exclude nocturnal problems: Normal daytime PaCO₂ doesn't exclude significant nocturnal hypoventilation, particularly when respiratory muscle strength is <40% predicted 4
- Avoid overlooking postural changes: Failure to measure supine VC misses isolated diaphragmatic weakness 1
- Don't ignore discrepancies between tests: Particularly in bulbar patients, PImax and SNIP may diverge; always select the highest pressure 3
If "Zedd score" refers to a local institutional protocol or abbreviation, please clarify the specific parameters being measured so I can provide targeted guidance on interpretation and reporting.