Validity and reliability of the Cold Discomfort Scale: a subjective judgement scale for the assessment of patient thermal state in a cold environment

Research output: Contribution to journalArticle


Complementary measures for the assessment of patient thermoregulatory state, such as subjective judgement scales, might be of considerable importance in field rescue scenarios where objective measures such as body core temperature, skin temperature, and oxygen consumption are difficult to obtain. The objective of this study was to evaluate, in healthy subjects, the reliability of the Cold Discomfort Scale (CDS), a subjective judgement scale for the assessment of patient thermal state in cold environments, defined as test–retest stability, and criterion validity, defined as the ability to detect a difference in cumulative cold stress over time. Twenty-two healthy subjects performed two consecutive trials (test–retest). Dressed in light clothing, the subjects remained in a climatic chamber set to -20 C for 60 min. CDS ratings were obtained every 5 min. Reliability was
analysed by test–retest stability using weighted kappa coefficient that was 0.84 including all the 5-min interval measurements. When analysed separately at each 5-min interval the weighted kappa coefficients were was 0.48–0.86. Criterion validity was analysed by comparing median CDS ratings of a moving time interval. The comparison revealed that CDS ratings were significantly increased for every interval of 10, 15, and 30 min (p\0.001) but not for every interval of 5 min. In conclusion, in a prehospital scenario, subjective judgement scales might be a valuable measure for the assessment of patient thermal state. The results of this study indicated that, in concious patients, the CDS may be both reliable and valid for such purpose.


  • Peter Lundgren
  • Otto Henriksson
  • Kalev Kuklane
  • Ingvar Holmér
  • Peter Naredi
  • Ulf Björnstig
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Production Engineering, Human Work Science and Ergonomics


  • Hypothermia Prehospital trauma care Emergency medical services Reliability Validity Subjective judgement scale Thermal comfort
Original languageEnglish
Pages (from-to)287-291
JournalJournal of Clinical Monitoring and Computing
Issue number3
Publication statusPublished - 2014
Publication categoryResearch

Bibliographic note

Open access