Towards a harmonized bronchopulmonary dysplasia definition: a study protocol for an international Delphi procedure
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Updated: Jul 12, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Trixie A Katz1,2, Eduardo Bancalari3, Sanne J Gordijn4
1Amsterdam Reproduction & Development, Amsterdam, The Netherlands.
Insights
Bronchopulmonary dysplasia (BPD) affects preterm infants, with varied definitions hindering care and research. This study uses a Delphi procedure to identify key features for a unified BPD definition, aiming for clinical consensus.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Clinical Epidemiology
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication of preterm birth with long-term health implications.
- Current use of multiple BPD definitions complicates clinical practice, research, and benchmarking.
- Establishing a uniform definition for BPD is crucial for advancing patient care and scientific understanding.
Purpose of the Study:
- To determine the essential features for defining Bronchopulmonary dysplasia (BPD) through expert consensus.
- To facilitate the development of a standardized diagnostic criterion for BPD.
- To improve consistency in clinical care, research, and performance measurement related to BPD.
Main Methods:
- A Delphi procedure, a semi-anonymous iterative technique, will be employed.
- An international, multidisciplinary panel of experts in preterm infant care and BPD will participate.
- Surveys and consensus meetings will be used to gather and refine opinions on key BPD definition features.
Main Results:
- The Delphi procedure will identify consensus on critical elements for BPD diagnosis.
- Expert opinions on the 'why, when, and how' of BPD diagnosis will be systematically collected.
- Likert scale ratings will quantify agreement on proposed features for BPD definitions.
Conclusions:
- The study aims to advance the consensus process for diagnosing Bronchopulmonary dysplasia (BPD).
- Results will contribute to a more unified approach to BPD definition and diagnosis.
- Findings will be disseminated through peer-reviewed publication and conference presentations.
Introduction:
Bronchopulmonary dysplasia (BPD) remains the most common complication of preterm birth with lifelong consequences. Multiple BPD definitions are currently used in daily practice. Uniformity in defining BPD is important for clinical care, research and benchmarking. The aim of this Delphi procedure is to determine what clinicians and researchers consider the key features for defining BPD. With the results of this study, we hope to advance the process of reaching consensus on the diagnosis of BPD.
Methods And Analysis:
A Delphi procedure will be used to establish why, when and how clinicians propose BPD should be diagnosed. This semi-anonymous iterative technique ensures an objective approach towards gaining these insights. An international multidisciplinary panel of clinicians and researchers working with preterm infants and/or patients diagnosed with BPD will participate. Steering committee members will recruit potential participants in their own region or network following eligibility guidelines to complete a first round survey online. This round will collect demographic information and opinions on key features of BPD definitions. Subsequent rounds will provide participants with the results from the previous round, for final acceptance or rejection of key features. Statements will be rated using a 5-point Likert scale. After completing the Delphi procedure, an (online) consensus meeting will be organised to discuss the results.
Ethics And Dissemination:
For this study, ethical approval a waiver has been provided. However, all participants will be asked to provide consent for the use of personal data. After the Delphi procedure is completed, it will be published in a peer-reviewed journal and disseminated at international conferences.
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