Identification of diagnostic criteria for chronic hypersensitivity pneumonitis: an international modified Delphi survey
Identification of diagnostic criteria for chronic hypersensitivity pneumonitis: an international modified Delphi survey
RATIONALE: Current diagnosis of chronic hypersensitivity pneumonitis (cHP) involves considering a combination of clinical, radiological, and pathological information in multidisciplinary team discussions. However, this approach is highly variable with poor agreement between centers.
OBJECTIVES: We aimed to identify diagnostic criteria for cHP that reach consensus among international experts.
METHODS: A 3-round modified Delphi survey was conducted between April and August 2017. Forty-five experts in interstitial lung disease from 14 countries participated in the online survey. Diagnostic items included in round 1 were generated using expert interviews and literature review. During rounds 1 and 2, experts rated the importance of each diagnostic item on a 5-point Likert scale. The a priori threshold of consensus was ≥ 75% of experts rating a diagnostic item as very important or important. In the third round, experts graded the items that met consensus as important and provided their level of diagnostic confidence for a series of clinical scenarios.
MEASUREMENTS AND MAIN RESULTS: Consensus was achieved on 18 of the 40 diagnostic items. Among these, experts gave the highest level of importance to the identification of a causative antigen, time relation between exposure and disease, mosaic attenuation on chest imaging, and poorly formed non-necrotizing granulomas on pathology. In clinical scenarios, the diagnostic confidence of experts in cHP was heightened by the presence of these diagnostic items.
CONCLUSION: This consensus-based approach for the diagnosis of cHP represents a first step towards the development of international guidelines for the diagnosis of cHP.
Alveolitis, Extrinsic Allergic/diagnosis, Chronic Disease, Consensus, Delphi Technique, Female, Humans, Internationality, Male, Surveys and Questionnaires
1036-1044
Morisset, Julie
29376d04-9b12-4413-8d3e-51c74694755e
Johannson, Kerri A.
f8af7188-2510-4c11-8a87-24b8d05c374c
Jones, Kirk D.
22fb3000-abeb-4cb0-bf2f-4906230a76c0
Wolters, Paul J.
5f5e4081-2300-4ef2-96d5-5f7b02d4cb0b
Collard, Harold R.
6eee2ce5-3016-4c13-ac58-f30a77f7d141
Walsh, Simon L.F.
229a3dbd-04d7-4f46-9efa-aa8315293019
Ley, Brett
ccaf50c6-cd5b-4d4e-bb21-2b7b2f578231
Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1
15 April 2018
Morisset, Julie
29376d04-9b12-4413-8d3e-51c74694755e
Johannson, Kerri A.
f8af7188-2510-4c11-8a87-24b8d05c374c
Jones, Kirk D.
22fb3000-abeb-4cb0-bf2f-4906230a76c0
Wolters, Paul J.
5f5e4081-2300-4ef2-96d5-5f7b02d4cb0b
Collard, Harold R.
6eee2ce5-3016-4c13-ac58-f30a77f7d141
Walsh, Simon L.F.
229a3dbd-04d7-4f46-9efa-aa8315293019
Ley, Brett
ccaf50c6-cd5b-4d4e-bb21-2b7b2f578231
Jones, Mark
a6fd492e-058e-4e84-a486-34c6035429c1
Morisset, Julie, Johannson, Kerri A., Jones, Kirk D., Wolters, Paul J., Collard, Harold R., Walsh, Simon L.F. and Ley, Brett
,
HP Delphi Collaborators
(2018)
Identification of diagnostic criteria for chronic hypersensitivity pneumonitis: an international modified Delphi survey.
American Journal of Respiratory and Critical Care Medicine, 197 (8), .
(doi:10.1164/rccm.201710-1986OC).
Abstract
RATIONALE: Current diagnosis of chronic hypersensitivity pneumonitis (cHP) involves considering a combination of clinical, radiological, and pathological information in multidisciplinary team discussions. However, this approach is highly variable with poor agreement between centers.
OBJECTIVES: We aimed to identify diagnostic criteria for cHP that reach consensus among international experts.
METHODS: A 3-round modified Delphi survey was conducted between April and August 2017. Forty-five experts in interstitial lung disease from 14 countries participated in the online survey. Diagnostic items included in round 1 were generated using expert interviews and literature review. During rounds 1 and 2, experts rated the importance of each diagnostic item on a 5-point Likert scale. The a priori threshold of consensus was ≥ 75% of experts rating a diagnostic item as very important or important. In the third round, experts graded the items that met consensus as important and provided their level of diagnostic confidence for a series of clinical scenarios.
MEASUREMENTS AND MAIN RESULTS: Consensus was achieved on 18 of the 40 diagnostic items. Among these, experts gave the highest level of importance to the identification of a causative antigen, time relation between exposure and disease, mosaic attenuation on chest imaging, and poorly formed non-necrotizing granulomas on pathology. In clinical scenarios, the diagnostic confidence of experts in cHP was heightened by the presence of these diagnostic items.
CONCLUSION: This consensus-based approach for the diagnosis of cHP represents a first step towards the development of international guidelines for the diagnosis of cHP.
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More information
Accepted/In Press date: 21 November 2017
Published date: 15 April 2018
Keywords:
Alveolitis, Extrinsic Allergic/diagnosis, Chronic Disease, Consensus, Delphi Technique, Female, Humans, Internationality, Male, Surveys and Questionnaires
Identifiers
Local EPrints ID: 442231
URI: http://eprints.soton.ac.uk/id/eprint/442231
ISSN: 1073-449X
PURE UUID: 2db719b3-22e3-4207-a2e0-cf3b9f9169c8
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Date deposited: 09 Jul 2020 16:31
Last modified: 17 Mar 2024 03:11
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Contributors
Author:
Julie Morisset
Author:
Kerri A. Johannson
Author:
Kirk D. Jones
Author:
Paul J. Wolters
Author:
Harold R. Collard
Author:
Simon L.F. Walsh
Author:
Brett Ley
Corporate Author: HP Delphi Collaborators
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