Diagnostic tests of hyperventilation syndrome
Abstract
In 90 patients referred to the pulmonary function laboratory for evaluation of hyperventilation syndrome (HVS) and in whom somatic causes of the complaints had been excluded, we investigated the degree of concordance between three widely applied diagnostic methods: 1) the standardized Nijmegen questionnaire on major daily complaints; 2) the reproduction of the same symptoms during the hyperventilation provocation test (HVPT); and 3) the responses of end-tidal CO2 fraction (FETCO2) during the HVPT. In 86% of the patients a concordance was found between Nijmegen questionnaire (i.e. score of 24/64 or more) and symptom reproduction during HVPT (i.e. recognition of at least 2 major daily complaints). Based on these combined data we made a definite diagnosis of HVS in 37 patients, of non-HVS in 40 patients, and we retained only a possible HVS in 13 patients. Each of the 16 complaints in the questionnaire contributed significantly to the distinction between HVS and non-HVS patients, and a striking similarity in rank order of daily complaints and reproduced symptoms was found. The responses in FETCO, during HVPT had little additional diagnostic value. A spontaneous fall of at least 0.25% FETCO2 during the 5 min adaptation period before the HVPT, was most reliably correlated with the aforementioned diagnostic criteria of HVS: specificity 83%, sensitivity 57%, and accuracy 70%. Neither the 3 min FETCO2 ratio nor the 5 min FETCO2 ratio during recovery after the HVPT showed a good correl…
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The Nijmegen Questionnaire has a documented cut-off score of 23/64 suggesting a positive diagnosis of HVS, which is widely applied.
“The cut-off score of 23/64 for the Nijmegen Questionnaire that suggests a positive diagnosis of HVS is documented48,49 and widely applied.50,51”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [48]
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Chaitow, L., Brown, H. N., Buratovich, N., Isbell, B., Maeckel, L., Neary, D. E., Russ, D., & Turner, R. N. (2008) · Elsevier eBooks · doi:10.1016/b978-044310390-2.50015-8
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Troubles fonctionnels respiratoires chez l’enfant
Bidat, É., & Benoist, G. (2023) · Revue française d'allergologie · doi:10.1016/j.reval.2023.103669
- Authors
- Vansteenkiste, J., Rochette, F., & Demedts, M.
- Affiliations
- KU Leuven (BE)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 1991-04-01
- Volume
- 4
- Issue
- 4
- Pages
- 393-399
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2099211239
- Cited by
- 103
- References
- 9
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 7 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 5 · 2012: 5
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- 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, end-tidal carbon dioxide, Nijmegen questionnaire, diagnostic accuracy, hyperventilation
- MeSH terms
- Activities of Daily Living, Adult, Female, Humans, Hyperventilation, Male, Pulmonary Gas Exchange, Surveys and Questionnaires, Respiratory Function Tests
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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