Measurement properties of outcome measurement instruments for pediatric dysfunctional breathing: a systematic review.

Abstract

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.