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

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.