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Diagnostic pathways for earlier diagnosis and treatment towards better outcomes for adults living with chronic breathlessness

Doe, Gillian E. ; Olsson, Max LU orcid and Evans, Rachael A. (2025) In Respiratory Physiology and Neurobiology 336.
Abstract

Chronic breathlessness is a common and distressing symptom, negatively impacting physical function and quality of life. Many individuals presenting with chronic breathlessness wait years for an explanatory diagnosis, leading to delays in accessing effective treatments and worse individual outcomes including premature mortality. In addition, delays to diagnosis are associated with increased healthcare utilisation and therefore potentially avoidable burden on healthcare systems. Diagnosing the underlying causes of chronic breathlessness is complex and can be challenging for clinicians. The current clinical diagnostic approach, related guidelines, and healthcare service structure are typically aligned with a disease-based focus. For this... (More)

Chronic breathlessness is a common and distressing symptom, negatively impacting physical function and quality of life. Many individuals presenting with chronic breathlessness wait years for an explanatory diagnosis, leading to delays in accessing effective treatments and worse individual outcomes including premature mortality. In addition, delays to diagnosis are associated with increased healthcare utilisation and therefore potentially avoidable burden on healthcare systems. Diagnosing the underlying causes of chronic breathlessness is complex and can be challenging for clinicians. The current clinical diagnostic approach, related guidelines, and healthcare service structure are typically aligned with a disease-based focus. For this article, we are using a working definition of ‘Chronic Breathlessness’ to infer breathlessness that has persisted for at least eight weeks. In this narrative review, using the latest available evidence, we aimed to describe a symptom-based approach to diagnosis for adults presenting with chronic breathlessness alongside describing the potential for this approach to improve both clinical outcomes and efficiency for healthcare systems. Therefore, our objectives were to: 1) summarise what is currently known about the time to diagnosis for adults presenting with breathlessness, 2) describe the impact and possible explanations for the current delays to diagnosis, 3) describe potential solutions towards an effective symptom-based diagnosis, 4) review the potential for Artificial Intelligence (AI) to support several areas along the diagnostic pathway for breathlessness, 5) describe how a symptom-based approach to diagnosis can be directly utilised to enable a ‘matched’ personalised holistic approach to treatment.

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publication status
published
subject
in
Respiratory Physiology and Neurobiology
volume
336
article number
104439
publisher
Elsevier
external identifiers
  • scopus:105004925192
  • pmid:40324549
ISSN
1569-9048
DOI
10.1016/j.resp.2025.104439
language
English
LU publication?
yes
id
d80d0075-ce16-42f4-a5a3-9e6058da44b8
date added to LUP
2025-07-16 14:56:21
date last changed
2025-07-16 14:56:59
@article{d80d0075-ce16-42f4-a5a3-9e6058da44b8,
  abstract     = {{<p>Chronic breathlessness is a common and distressing symptom, negatively impacting physical function and quality of life. Many individuals presenting with chronic breathlessness wait years for an explanatory diagnosis, leading to delays in accessing effective treatments and worse individual outcomes including premature mortality. In addition, delays to diagnosis are associated with increased healthcare utilisation and therefore potentially avoidable burden on healthcare systems. Diagnosing the underlying causes of chronic breathlessness is complex and can be challenging for clinicians. The current clinical diagnostic approach, related guidelines, and healthcare service structure are typically aligned with a disease-based focus. For this article, we are using a working definition of ‘Chronic Breathlessness’ to infer breathlessness that has persisted for at least eight weeks. In this narrative review, using the latest available evidence, we aimed to describe a symptom-based approach to diagnosis for adults presenting with chronic breathlessness alongside describing the potential for this approach to improve both clinical outcomes and efficiency for healthcare systems. Therefore, our objectives were to: 1) summarise what is currently known about the time to diagnosis for adults presenting with breathlessness, 2) describe the impact and possible explanations for the current delays to diagnosis, 3) describe potential solutions towards an effective symptom-based diagnosis, 4) review the potential for Artificial Intelligence (AI) to support several areas along the diagnostic pathway for breathlessness, 5) describe how a symptom-based approach to diagnosis can be directly utilised to enable a ‘matched’ personalised holistic approach to treatment.</p>}},
  author       = {{Doe, Gillian E. and Olsson, Max and Evans, Rachael A.}},
  issn         = {{1569-9048}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Physiology and Neurobiology}},
  title        = {{Diagnostic pathways for earlier diagnosis and treatment towards better outcomes for adults living with chronic breathlessness}},
  url          = {{http://dx.doi.org/10.1016/j.resp.2025.104439}},
  doi          = {{10.1016/j.resp.2025.104439}},
  volume       = {{336}},
  year         = {{2025}},
}