Steffen T Simon1, Vera Weingärtner2, Irene J Higginson3, Raymond Voltz4, Claudia Bausewein5. 1. Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany; Centre for Integrated Oncology Cologne/Bonn, Clinical Trials Centre Cologne (BMBF 01KN1106), Cologne, Germany. Electronic address: steffen@steffensimon.de. 2. Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany. 3. King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation-WHO Collaborating Centre for Palliative Care and Older People, London, United Kingdom. 4. Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany; Centre for Integrated Oncology Cologne/Bonn, Clinical Trials Centre Cologne (BMBF 01KN1106), Cologne, Germany. 5. King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation-WHO Collaborating Centre for Palliative Care and Older People, London, United Kingdom; Department for Palliative Medicine, University Hospital of Munich, Munich, Germany.
Abstract
CONTEXT: Episodic breathlessness is a common and distressing symptom in patients with advanced disease. Still, it is not yet clearly defined. OBJECTIVES: The aim of this work was to develop an international definition, categorization, and terminology of episodic breathlessness. METHODS: An online Delphi survey was conducted with international breathlessness experts. We used a structured questionnaire to identify specific aspects and reach agreement on a definition, categorization, and terminology (five-point Likert scale). Consensus was defined in advance as ≥70% agreement. RESULTS: Thirty-one of 68 (45.6%), 29 of 67 (43.3%), and 33 of 67 (49.3%) experts responded in the first, second, and third rounds, respectively. Participants were 20-79 years old, about 60% male, and more than 75% rated their own breathlessness expertise as moderate to high. After three rounds, consensus was reached on a definition, categorization, and terminology (84.4%, 96.3%, and 92.9% agreement). The final definition includes general and qualitative aspects of the symptom, for example, time-limited severe worsening of intensity or unpleasantness of breathlessness in the patient's perception. Categories are predictable or unpredictable, depending on whether any triggers can be identified. CONCLUSION: There is high agreement on clinical and operational aspects of episodic breathlessness in advanced disease among international experts. The consented definition and categorization may serve as a catalyst for clinical and basic research to improve symptom control and patients' quality of life.
CONTEXT: Episodic breathlessness is a common and distressing symptom in patients with advanced disease. Still, it is not yet clearly defined. OBJECTIVES: The aim of this work was to develop an international definition, categorization, and terminology of episodic breathlessness. METHODS: An online Delphi survey was conducted with international breathlessness experts. We used a structured questionnaire to identify specific aspects and reach agreement on a definition, categorization, and terminology (five-point Likert scale). Consensus was defined in advance as ≥70% agreement. RESULTS: Thirty-one of 68 (45.6%), 29 of 67 (43.3%), and 33 of 67 (49.3%) experts responded in the first, second, and third rounds, respectively. Participants were 20-79 years old, about 60% male, and more than 75% rated their own breathlessness expertise as moderate to high. After three rounds, consensus was reached on a definition, categorization, and terminology (84.4%, 96.3%, and 92.9% agreement). The final definition includes general and qualitative aspects of the symptom, for example, time-limited severe worsening of intensity or unpleasantness of breathlessness in the patient's perception. Categories are predictable or unpredictable, depending on whether any triggers can be identified. CONCLUSION: There is high agreement on clinical and operational aspects of episodic breathlessness in advanced disease among international experts. The consented definition and categorization may serve as a catalyst for clinical and basic research to improve symptom control and patients' quality of life.
Authors: Vera Weingärtner; Claudia Bausewein; Irene J Higginson; Christine Scheve; Fliss E M Murtagh; Raymond Voltz; Steffen T Simon Journal: J Palliat Med Date: 2013-09-20 Impact factor: 2.947
Authors: Luis Cabezón-Gutiérrez; Parham Khosravi-Shahi; Sara Custodio-Cabello; Francisco Muñiz-González; Maria Del Puerto Cano-Aguirre; Soledad Alonso-Viteri Journal: Support Care Cancer Date: 2016-06-22 Impact factor: 3.603
Authors: Steffen T Simon; Nadine Altfelder; Bernd Alt-Epping; Claudia Bausewein; Vera Weingärtner; Raymond Voltz; Christoph Ostgathe; Lukas Radbruch; Gabriele Lindena; Friedemann Nauck Journal: Support Care Cancer Date: 2014-02-19 Impact factor: 3.603
Authors: Albert Balaguer; Cristina Monforte-Royo; Josep Porta-Sales; Alberto Alonso-Babarro; Rogelio Altisent; Amor Aradilla-Herrero; Mercedes Bellido-Pérez; William Breitbart; Carlos Centeno; Miguel Angel Cuervo; Luc Deliens; Gerrit Frerich; Chris Gastmans; Stephanie Lichtenfeld; Joaquín T Limonero; Markus A Maier; Lars Johan Materstvedt; María Nabal; Gary Rodin; Barry Rosenfeld; Tracy Schroepfer; Joaquín Tomás-Sábado; Jordi Trelis; Christian Villavicencio-Chávez; Raymond Voltz Journal: PLoS One Date: 2016-01-04 Impact factor: 3.240
Authors: Julia Strupp; Gloria Hanke; Nicolas Schippel; Holger Pfaff; Ute Karbach; Christian Rietz; Raymond Voltz Journal: BMJ Open Date: 2018-04-17 Impact factor: 2.692