Abstract
Background: A clinical syndrome is a cluster of clinical findings due to underlying aetiologies and has implications for clinical practice, research and health policy.
Aims: To address, “Is breathlessness that persists at rest or on minimal exertion despite the optimal treatment of underlying causes a distinct clinical syndrome and, if so, (a) what should it be called, and (b) how should it be defined?
Methods: A Delphi process was conducted amongst respiratory and cardiovascular medicine/nursing, respiratory physiology, neuroimaging, intensive care, oncology, palliative care and primary care experts:
1. Consultation to define areas for the survey (n=17).
2. Three Delphi survey rounds (n= 34; n=25; n=29).
Results:
1. Experts from US, Europe, Australia & Canada were consulted to frame the Delphi survey. It was agreed:
i) breathlessness despite optimal treatments of underlying causes was a clinical syndrome with negative consequences for patients;
ii) recognition should influence clinical practice, research, service provision and policy;
iii) to put forward suggested names and definitions.
2. By survey 3: 76% respondents agreed the name, “chronic breathlessness syndrome” defined as: breathlessness even though “…evidence-based treatments of underlying pathophysiology are optimised” (66%) and “contributes to physical limitations and/or a variety of adverse psychosocial, spiritual or other consequences” (83%). The term “chronic” did not need a stated duration (80%).
Conclusions: “Chronic breathlessness syndrome” is a valid and relevant clinical concept needing active diagnosis and use of evidence-based therapies to systematically reduce suffering for the millions of affected people.
- Copyright ©the authors 2016
