Strengthening Altitude Knowledge: A Delphi Study to Define Minimum Knowledge of Altitude Illness for Laypersons Traveling to High Altitude

High Altitude Medicine & Biology, vol. 23, pp. 330–337

Abstract

Berendsen, Remco R., Peter Bärtsch, Buddha Basnyat, Marc Moritz Berger, Peter Hackett, Andrew M. Luks, Jean-Paul Richalet, Ken Zafren, Bengt Kayser, and the STAK Plenary Group. Strengthening altitude knowledge: a Delphi study to define minimum knowledge of altitude illness for laypersons traveling to high altitude. High Alt Med Biol . 23:330–337, 2022. Introduction: A lack of knowledge among laypersons about the hazards of high-altitude exposure contributes to morbidity and mortality from acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE) among high-altitude travelers. There are guidelines regarding the recognition, prevention, and treatment of acute-altitude illness for experts, but essential knowledge for laypersons traveling to high altitudes has not been defined. We sought expert consensus on the essential knowledge required for people planning to travel to high altitudes. Methods: The Delphi method was used. The panel consisted of two moderators, a core expert group and a plenary expert group. The moderators made a preliminary list of statements defining the desired minimum knowledge for laypersons traveling to high altitudes, based on the relevant literature. These preliminary statements were then reviewed, supplemented, and modified by a core expert group. A list of 33 statements was then presented to a plenary group of experts in successive rounds. Results: It took three rounds to reach a consensus. Of the 10 core experts invited, 7 completed all the rounds. Of the 76 plenary experts, 41 (54%) participated in Round 1, and of these 41 a total of 32 (78%) experts completed all three rounds. The final list contained 28 statements in 5 categories (altitude physiology, sleeping at altitude, AMS, HACE, and HAPE). This list represents an expert consensus on the desired minimum knowledge for laypersons planning high-altitude travel. Conclusion: Using the Delphi method, the STrengthening Altitude Knowledge initiative yielded a set of 28 statements representing essential learning objectives for laypersons who plan to travel to high altitudes. This list could be used to develop educational interventions.

Authors 43

1. Remco R. Berendsen corresponding Aachen Department of Anesthesiology, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Anesthesiology, Leiden University Medical Centre, Leiden, The Netherlands

2. Peter Bärtsch

   University Hospital Heidelberg

   Affiliation as printed

   Department of Internal Medicine, University Hospital, Heidelberg, Germany

3. Buddha Basnyat

   Patan Hospital · University of Oxford · Oxford University Clinical Research Unit Nepal

   Affiliation as printed

   Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal

4. Marc Moritz Berger

   Essen University Hospital · University of Duisburg-Essen

   Affiliation as printed

   Department of Anesthesiology and Intensive Care Medicine, Essen University Hospital, University Duisburg-Essen, Duisburg, Germany

5. Peter H. Hackett

   University of Colorado Anschutz

   Affiliation as printed

   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Altitude Research Center, University of Colorado, Aurora, Colorado, USA

6. Andrew M. Luks

   University of Washington

   Affiliation as printed

   Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

7. Jean‐Paul Richalet

   Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

   Affiliation as printed

   INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

8. Ken Zafren

   Stanford Medicine

   Affiliation as printed

   Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA

9. Bengt Kayser

   University of Lausanne

   Affiliation as printed

   Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

10. James D. Anholm
11. Paul S. Auerbach

    Patan Hospital · University of Oxford · Oxford University Clinical Research Unit Nepal

    Affiliation as printed

    Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal

12. Beth A. Beidleman

    Stanford Medicine

    Affiliation as printed

    Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA

13. Konrad Ernst Bloch

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

14. M Brodmann

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

15. Hermann Brugger

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

16. Martin Burtscher

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

17. Christoph Dehnert

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

18. Lionel Dumont

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

19. Martin Faulhaber

    University of Lausanne

    Affiliation as printed

    Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

20. R. Fischer

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

21. Hannes Gatterer

    Stanford Medicine

    Affiliation as printed

    Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA

22. Florian Gekeler

    University of Colorado Anschutz

    Affiliation as printed

    Division of Pulmonary and Critical Care Medicine, Department of Medicine, Altitude Research Center, University of Colorado, Aurora, Colorado, USA

23. Colin K. Grissom
24. Michael P. W. Grocott

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

25. David Hillebrandt

    University of Lausanne

    Affiliation as printed

    Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

26. Benjamin Honigman

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

27. Chris Imray
28. Michael S. Koehle
29. Grant S. Lipman
30. Jack A. Loeppky

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

31. Marco Maggiorini
32. LORNA GRINDLAY MOORE
33. Stephen Raymond Muza

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

34. Matiram Pun

    Essen University Hospital · University of Duisburg-Essen

    Affiliation as printed

    Department of Anesthesiology and Intensive Care Medicine, Essen University Hospital, University Duisburg-Essen, Duisburg, Germany

35. Robert C. Roach

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

36. Claudio Sergio Sartori

    Inserm · Université Sorbonne Paris Nord · Hypoxie et Poumon

    Affiliation as printed

    INSERM U1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Bobigny, France

37. Urs Scherrer

    University of Lausanne

    Affiliation as printed

    Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

38. Gaurav Sikri
39. Andrew W. Subudhi

    University of Lausanne

    Affiliation as printed

    Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

40. Erik Richard Swenson
41. Alfred A Roger Thompson

    University of Lausanne

    Affiliation as printed

    Institute of Sport Sciences (ISSUL), University of Lausanne, Switzerland

42. Samuel Vergès

    University of Washington

    Affiliation as printed

    Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine. University of Washington, Seattle, Washington, USA

43. D. R. Woods