The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome
Abstract
Background Hyperventilation syndrome (HVS) describes a set of somatic and psychological symptoms thought to result from episodic or chronic hyperventilation. Recognition of symptoms during the hyperventilation provocation test (HVPT) is the most widely used criterion for diagnosis of HVS. We have investigated the validity of the HVPT and of the concept of HVS. Methods In a randomised, double-blind, crossover design, the ability of 115 patients with suspected HVS to recognise symptoms during the HVPT was compared with the ability to recognise symptoms during a placebo test (isocapnic overbreathing, with carbon dioxide levels maintained by manual titration). 30 patients who had positive results on the HVPT underwent ambulatory transcutaneous monitoring of pCO2 to ascertain whether they hyperventilated during spontaneous symptom attacks. Findings Of the 115 patients who underwent the HVPT and the placebo test, 85 (74%) reported symptom recognition during the HVPT (positive diagnosis HVS). Of that subset, 56 were also positive on the placebo test (false-positive), and 29 were negative on the placebo test (true-positive). False-positive and true-positive patients did not differ in symptom profile or in physiological variables. During ambulatory monitoring (15 true-positive, 15 false-positive) 22 attacks were registered. Transcutaneous end-tidal, pCO2 decreased during only seven. The decreases were slight and apparently followed the onset of the attack, which suggests that hyperven…
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“A score of >23 is commonly used as a cut-off for HVS, although this was calculated using a positive hyperventilation provocation test as the gold standard, which itself is no longer considered a reliable way of diagnosing HVS [26].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [26]
In the citing paper
“A score of >23 is commonly used as a cut-off for HVS, although this was calculated using a positive hyperventilation provocation test as the gold standard, which itself is no longer considered a reliable way of diagnosing HVS [26].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [26]
In the citing paper
“A score of >23 is commonly used as a cut-off for HVS, although this was calculated using a positive hyperventilation provocation test as the gold standard, which itself is no longer considered a reliable way of diagnosing HVS [26].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [26]
In the citing paper
“It was felt these symptoms were due to low end-tidal carbon dioxide, but a study in the Lancet found a high rate of false positives in patients where end-tidal carbon dioxide was controlled via a facemask [26].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [26]
In the citing paper
“many of these symptoms can occur in normocapnia [26, 55, 56]”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [26]
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Metadata
- Authors
- Hornsveld, H., Garssen, B., Dop, M. F., van Spiegel, P., & de Haes, J.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Slotervaartziekenhuis (NL)
- ORCID
- Garssen, B
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1996-07
- Volume
- 348
- Issue
- 9021
- Pages
- 154-158
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2102303952
- Cited by
- 168
- References
- 34
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 1 · 2023: 6 · 2022: 7 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 8
- FWCI
- 6.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Keywords
- hyperventilation syndrome, diagnostic validity, false-positive diagnosis, transcutaneous carbon dioxide monitoring, end-tidal PCO2, hyperventilation, symptom recognition, ambulatory monitoring
- MeSH terms
- Adult, Blood Gas Monitoring, Transcutaneous, Double-Blind Method, False Positive Reactions, Female, Humans, Hyperventilation, Male, Reproducibility of Results, Case-Control Studies, Cross-Over Studies
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