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Measurement properties of outcome measurement instruments for pediatric dysfunctional breathing: a systematic review
Vikram Mohan1, Chandrasekar Rathinam2, Derick Yates2
1Department of Rehabilitation and Sports Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK. vmohan@bournemouth.ac.uk.
Insights
This review found limited evidence for the psychometric properties of outcome measurement instruments (OMIs) for assessing dysfunctional breathing (DB) in children. The SHAPE questionnaire shows promise, but the Nijmegen Questionnaire needs pediatric validation.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Assessment
Background:
- Dysfunctional breathing (DB) is common in children, impacting their respiratory health.
- Clinicians utilize various outcome measurement instruments (OMIs) to assess DB in pediatric populations.
- A critical gap exists in understanding the psychometric properties of these OMIs for children.
Purpose of the Study:
- To systematically review and evaluate the psychometric properties of OMIs used for assessing pediatric dysfunctional breathing.
- To identify reliable and valid instruments for clinical use in children with DB.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (CINAHL, Cochrane, Embase, EMCare, Medline) up to October 2024.
- Included studies focused on the development or evaluation of OMIs for pediatric DB.
- The COSMIN methodology was employed to assess the methodological quality and psychometric properties of identified OMIs.
Main Results:
- Only three articles met the inclusion criteria, evaluating two OMIs: the SHAPE questionnaire and the Nijmegen Questionnaire (NQ).
- The SHAPE questionnaire demonstrated 'doubtful' OMI development and content validity, with mixed results on other psychometric properties.
- The NQ showed 'inadequate' methodological quality for convergent validity, despite the property being rated 'sufficient', and lacks specific pediatric validation.
Conclusions:
- The SHAPE questionnaire has preliminary psychometric support, suggesting potential utility in assessing pediatric DB.
- The Nijmegen Questionnaire requires further validation in pediatric populations.
- There is a pressing need for the development of age-appropriate and clinically relevant OMIs for accurate DB assessment in children.
Purpose:
Clinicians commonly use various outcome measurement instruments (OMIs) to assess dysfunctional breathing (DB) in children. However, no review has examined their psychometric properties. This article systematically reviewed the psychometric properties of OMIs in pediatric DB.
Methods:
Articles that developed or evaluated measurement properties of OMIs for pediatric DB were included. EbscoHost CINAHL Ultimate, Cochrane Library, Ovid Embase, EMCare, and Medline were searched from inception to October 10, 2024. Methodological quality and psychometric properties were assessed and synthesised using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology.
Results:
After screening 14,240 references, three articles met the inclusion criteria, identifying two OMIs: the Hyperventilation Syndrome Ambroise-Paré (SHAPE) in French and the Nijmegen Questionnaire (NQ). SHAPE showed 'doubtful' OMI development and content validity with an 'indeterminate' rating for the results. One study reported 'inadequate' methodological quality for structural validity, though the property itself was rated 'sufficient'. Another study had 'very good' methodological quality, with 'sufficient' ratings for the criterion and discriminative validity. The NQ was evaluated for convergent validity; the methodological quality was 'inadequate', but the property was rated 'sufficient'. GRADE quality of evidence for SHAPE's development and content validity was not graded due to indeterminate results. For the remaining measurement properties, evidence quality ranged from low to very low across studies.
Conclusions:
The SHAPE questionnaire has preliminary support from OMI development and shows promise in some psychometric domains. The NQ lacks pediatric validation. Development of age-appropriate, clinically relevant OMIs is essential for accurate DB assessment in children. PROSPERO No: CRD42024530540.
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