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. 2022 Jul 26;22(4):376-379.
doi: 10.7861/clinmed.2021-0759.

Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19

Hannah Hylton  1 , Alex Long  1 , Charlotte Francis  1 , Rebecca R Taylor  1 , William M Ricketts  2 , Richa Singh  1 , Paul E Pfeffer  3
Affiliations

Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19

Hannah Hylton et al. Clin Med (Lond). .

Abstract

Introduction: Breathing pattern disorders (BPDs) are a common cause of chronic breathlessness, including after acute respiratory illnesses such as COVID pneumonia. BPD is however underdiagnosed, partly as a result of difficulty in clinically assessing breathing pattern. The Breathing Pattern Assessment Tool (BPAT) has been validated for use in diagnosing BPD in patients with asthma but to date has not been validated in other diseases.

Methods: Patients undergoing face-to-face review in a post-COVID clinic were assessed by a respiratory physician and specialist respiratory physiotherapist. Assessment included a Dyspnoea-12 (D12) questionnaire to assess breathlessness, physiotherapist assessment of breathing pattern including manual assessment of respiratory motion, and BPAT assessment. The sensitivity and specificity of BPAT for diagnosis of BPD in post-COVID patients was assessed.

Results: BPAT had a sensitivity of 89.5% and specificity of 78.3% for diagnosing BPD in post-COVID breathlessness. Patients with a BPAT score above the diagnostic cut-off had higher levels of breathlessness than those with lower BPAT scores (D12 score mean average 19.4 vs 13.2).

Conclusion: BPAT has high sensitivity and moderate specificity for BPD in patients with long COVID. This would support its use as a screening test in clinic, and as a diagnostic tool for large cohort studies.

Keywords: breathlessness; dysfunctional breathing; follow-up; long COVID; sequalae.

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Figures

Fig 1.
Fig 1.
AUC ROC curve for use of BPAT to diagnose breathing disorder.
Fig 2.
Fig 2.
D12 questionnaire scores for breathlessness in patients with/without positive BPAT score indicative of likely breathing pattern disorder. Violin with box-and-whisker plots of D12 questionnaire scores for patients with BPAT score ≥4, positive for likely breathing pattern disorder, and those patients with BPAT score <4, negative for likely breathing pattern disorder. P value for Wilcoxon-Mann-Whitney test.
Fig 3.
Fig 3.
Association between BPAT scores and D12 questionnaire scores for breathlessness. Scatter plot with trend line. P value for correlation coefficient.
See this image and copyright information in PMC

References

    1. Boulding R, Stacey R, Niven R, Fowler SJ. Dysfunctional breathing: a review of the literature and proposal for classification. Eur Respir Rev 2016;25:287–94. - PMC - PubMed
    1. Courtney R, van Dixhoorn J, Cohen M. Evaluation of breathing pattern: comparison of a Manual Assessment of Respiratory Motion (MARM) and respiratory induction plethysmography. Appl Psychophysiol Biofeedback 2008;33:91–100. - PubMed
    1. Todd S, Walsted ES, Grillo L, Livingston R, Menzies-Gow A, Hull JH. Novel assessment tool to detect breathing pattern disorder in patients with refractory asthma. Respirology 2018;23:284–90. - PubMed
    1. Bondarenko J, Hew M, Button B, et al. . Reliability of the breathing pattern assessment tool for in-person or remote assessment in people with asthma. Clin Exp Allergy 2021;51:1218–20. - PubMed
    1. Evans RA, McAuley H, Harrison EM, et al. . Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med 2021;9:1275–87. - PMC - PubMed