1 Comprehensive Support Service-Palliative Care, Institut Català d'Oncologia , Badalona, Spain .
2 Palliative Care Service, Complejo Hospitalario Universitario de Badajoz , Badajoz, Spain .
J Palliat Med. 2019 Apr;22(4):413-419. doi: 10.1089/jpm.2018.0273. Epub 2018 Nov 16.
Episodic dyspnea is an increasingly recognized phenomenon that occurs frequently in patients with cancer. Although numerous definitions have been proposed to describe episodic dyspnea, to date, no common widely accepted definition in Spanish has yet emerged. Without a clear well-accepted definition, it is difficult to design rigorous clinical trials to evaluate candidate treatments for this emerging entity and to compare outcomes among studies.
The aim of the study was to reach a consensus definition of episodic dyspnea in the Spanish language based on professional criteria in cancer patients.
A two-round Delphi study.
SETTING/SUBJECTS: Sixty-one Spanish specialists in medical oncology, radiation oncology, pneumology, palliative care, and pain management participated in the study.
Sixteen different questions on dyspnea-related terminology, including the definition of episodic dyspnea, were assessed.
The panel of experts reached a consensus on 75% of the 16 assessments proposed: 56.25% in agreement and 18.75% in disagreement. The term that most panelists considered most appropriate to define dyspnea exacerbation was dyspnea crisis. The panelists disagreed that dyspnea exacerbation is equivalent to dyspnea at effort and that the presence of dyspnea at rest is required for exacerbation to occur. However, there was wide agreement that exacerbation may or may not be predictable and can be triggered by comorbidities as well as emotional, environmental, or effort factors.
The broad consensus reached in this study is a necessary first step to design high-quality methodological studies to better understand episodic dyspnea and improve treatment.
发作性呼吸困难是一种越来越被认识到的现象，经常发生在癌症患者中。尽管已经提出了许多定义来描述发作性呼吸困难，但迄今为止，在西班牙语中尚未出现一个通用的被广泛接受的定义。如果没有一个明确的、被广泛接受的定义，就很难设计严格的临床试验来评估这种新出现的实体的候选治疗方法，并比较研究结果。
本研究旨在根据癌症患者的专业标准，就西班牙语中发作性呼吸困难达成共识定义。
两轮 Delphi 研究。
设置/研究对象：61 名西班牙医学肿瘤学、放射肿瘤学、肺病学、姑息治疗和疼痛管理专家参与了这项研究。
对与呼吸困难相关的术语进行了 16 个不同问题的评估，包括发作性呼吸困难的定义。
专家组就提出的 16 项评估中的 75%达成了共识：56.25%表示同意，18.75%表示不同意。大多数专家组成员认为最适合定义呼吸困难恶化的术语是呼吸困难危机。专家组成员不同意呼吸困难恶化等同于呼吸困难时的努力，并且需要在休息时出现呼吸困难才能发生恶化。然而，专家们广泛认为恶化可能是可预测的，也可能是由共病以及情绪、环境或努力因素引发的。
本研究达成的广泛共识是设计高质量方法学研究的必要第一步，以更好地理解发作性呼吸困难并改善治疗。
