How do we diagnose dysfunctional breathing (breathing pattern disorder) in children and young people: an eDelphi consensus.

Abstract

Objective: To assess current UK expert knowledge of breathing disorders, commonly referred to as dysfunctional breathing or breathing pattern disorders, in children and young people (CYP) with a view to constructing a clinical assessment tool for validation in this population.

Design: Modified three-stage eDelphi process.

Setting: Experts from UK paediatric respiratory centres INTERVENTIONS AND MAIN OUTCOME MEASURES: Responses over three stages were used to achieve consensus on aspects of this condition such as the accepted name, reported symptoms, clinical signs, usual patient characteristics and comorbidities. The a priori threshold for consensus was 75% of those who selected 'somewhat agree', 'agree' or 'strongly agree' on a 7-point Likert scale.

Results: 39 participants (physiotherapists, nurses and doctors) participated in round 1, with 29 completing round 3. While no clear consensus was agreed between the two most popular names for this condition-dysfunctional breathing or breathing pattern disorder-there was a strong consensus on the common clinical features. Ten clinical features were agreed to be consistent with dysfunctional breathing/breathing pattern disorder, with 6 descriptive terms, 12 common phrases used by CYP and 7 signs and symptoms.

Conclusions: There is currently no validated diagnostic tool for breathing disorders in CYP. This eDelphi consensus provides a basis for the future development of a clinical tool for use in primary, secondary and tertiary settings to aid the assessment of CYP with suspected dysfunctional breathing/breathing pattern disorder.