Vogt S, et al. - Given dyspnea represents a cardinal but often underestimated symptom in amyotrophic lateral sclerosis, researchers determined if dyspnea corresponds to parameters of respiratory status essentially used in clinical neurological practice. In addition, they assessed the DALS-15 for its ability to recognize patients for consideration of noninvasive ventilation (NIV) in whom neither spirometry nor blood gas parameters suggest the requirement for NIV (forced vital capacity  < 50% or probable <75%, pCO₂ ≥45  mmHg). In this study, it was obvious that the occurrence of dyspnea is possible independently of objective indicators of respiratory impairment such as spirometry or blood gases. Therefore, another aspect of respiratory impairment is covered by the DALS-15, relative to these tests. In addition, it refers to the subjective element of respiratory impairment. It allows dyspnea detection in a substantial proportion of patients in whom NIV is therefore recommended although their spirometric and blood gas findings do not point towards NIV. For more efficient symptom management and timely coordination of care, an enhanced stratification of patients with respiratory impairment may be achieved with the help of DALS-15.