International Multi-Specialty Delphi Survey: Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection

Marten A. Lantinga, Alexander J M Darding, Ruud G L de Sévaux, Ahsan Alam, Chantal P. Bleeker-Rovers, Mickaël Bobot, Emilie Cornec-Le Gall, Tom J G Gevers, Ziad Hassoun, Esther Meijer, Michal Mrug, Frederik Nevens, Luiz F. Onuchic, York Pei, Giorgina B. Piccoli, Yves Pirson, Gopala K. Rangan, Roser Torra, Folkert W. Visser, François JouretNada Kanaan, Wim J G Oyen, Tatsuya Suwabe, Vicente Torres, Marie C Hogan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Cyst infection is one of the complications of autosomal dominant polycystic kidney disease and polycystic liver disease. The diagnosis is typically made on a mix of clinical, laboratory and imaging abnormalities but the importance of individual items is uncertain. We aimed to perform a Delphi survey amongst physicians to achieve consensus on diagnostic criteria. Methods: We retrieved diagnostic items from the literature and conducted physician and patient interviews. All items were combined to create the online questionnaire. Participants rated each item during 3 consecutive rounds. Items were rated for diagnostic helpfulness for hepatic and renal cyst infection on a 9-point scale with anchors, from extremely unimportant (n = 1) to extremely important (n = 9). We determined consensus with the disagreement index. The median rating of each item was calculated and categorized into inappropriate (≤3.4), uncertain (3.5-6.4) or appropriate (≥6.5). By combining all items that reached an appropriate consensus rating, we developed a diagnostic algorithm based on expert consensus. Results: We invited 58 physicians to participate in the survey. In total, 35 (60%) responded to round 1 of which 91% (n = 32) and 86% (n = 30) responded to round 2 and 3, respectively. The final panel included 23 nephrologists, 5 hepatologists, a nuclear medicine specialist and an infectious disease physician from 11 countries (male 67%, mean age 47 ± 11 years, median clinical experience 21 years). The panel rated the diagnostic helpfulness of 59 potential items. Ultimately, 22 hepatic and 26 renal items were rated appropriate, including positive blood cultures and fluorodeoxyglucose positron-emission CT imaging. Ultrasonography and absence of intracystic bleeding were amongst those deemed uncertain or inappropriate. Subsequently, by combining items rated appropriate, we developed a clinical tool to diagnose hepatic and renal cyst infection. Conclusions: We identified diagnostic items for hepatic and renal cyst infection and developed an expert-based diagnostic algorithm, which may aid physicians in the diagnostic work-up. A prospective study is necessary to validate this algorithm.

Original languageEnglish (US)
Pages (from-to)205-214
Number of pages10
JournalNephron
DOIs
StateAccepted/In press - Sep 3 2016

Fingerprint

Cysts
Physicians
Kidney
Liver
Infection
Autosomal Dominant Polycystic Kidney
Nuclear Medicine
Communicable Diseases
Ultrasonography
Surveys and Questionnaires
Prospective Studies
Electrons
Interviews
Hemorrhage

Keywords

  • Autosomal dominant polycystic kidney disease
  • Diagnosis
  • Infection
  • Polycystic kidney disease

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Urology
  • Physiology (medical)

Cite this

Lantinga, M. A., Darding, A. J. M., de Sévaux, R. G. L., Alam, A., Bleeker-Rovers, C. P., Bobot, M., ... Hogan, M. C. (Accepted/In press). International Multi-Specialty Delphi Survey: Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection. Nephron, 205-214. https://doi.org/10.1159/000446664

International Multi-Specialty Delphi Survey : Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection. / Lantinga, Marten A.; Darding, Alexander J M; de Sévaux, Ruud G L; Alam, Ahsan; Bleeker-Rovers, Chantal P.; Bobot, Mickaël; Cornec-Le Gall, Emilie; Gevers, Tom J G; Hassoun, Ziad; Meijer, Esther; Mrug, Michal; Nevens, Frederik; Onuchic, Luiz F.; Pei, York; Piccoli, Giorgina B.; Pirson, Yves; Rangan, Gopala K.; Torra, Roser; Visser, Folkert W.; Jouret, François; Kanaan, Nada; Oyen, Wim J G; Suwabe, Tatsuya; Torres, Vicente; Hogan, Marie C.

In: Nephron, 03.09.2016, p. 205-214.

Research output: Contribution to journalArticle

Lantinga, MA, Darding, AJM, de Sévaux, RGL, Alam, A, Bleeker-Rovers, CP, Bobot, M, Cornec-Le Gall, E, Gevers, TJG, Hassoun, Z, Meijer, E, Mrug, M, Nevens, F, Onuchic, LF, Pei, Y, Piccoli, GB, Pirson, Y, Rangan, GK, Torra, R, Visser, FW, Jouret, F, Kanaan, N, Oyen, WJG, Suwabe, T, Torres, V & Hogan, MC 2016, 'International Multi-Specialty Delphi Survey: Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection', Nephron, pp. 205-214. https://doi.org/10.1159/000446664
Lantinga MA, Darding AJM, de Sévaux RGL, Alam A, Bleeker-Rovers CP, Bobot M et al. International Multi-Specialty Delphi Survey: Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection. Nephron. 2016 Sep 3;205-214. https://doi.org/10.1159/000446664
Lantinga, Marten A. ; Darding, Alexander J M ; de Sévaux, Ruud G L ; Alam, Ahsan ; Bleeker-Rovers, Chantal P. ; Bobot, Mickaël ; Cornec-Le Gall, Emilie ; Gevers, Tom J G ; Hassoun, Ziad ; Meijer, Esther ; Mrug, Michal ; Nevens, Frederik ; Onuchic, Luiz F. ; Pei, York ; Piccoli, Giorgina B. ; Pirson, Yves ; Rangan, Gopala K. ; Torra, Roser ; Visser, Folkert W. ; Jouret, François ; Kanaan, Nada ; Oyen, Wim J G ; Suwabe, Tatsuya ; Torres, Vicente ; Hogan, Marie C. / International Multi-Specialty Delphi Survey : Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection. In: Nephron. 2016 ; pp. 205-214.
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abstract = "Background: Cyst infection is one of the complications of autosomal dominant polycystic kidney disease and polycystic liver disease. The diagnosis is typically made on a mix of clinical, laboratory and imaging abnormalities but the importance of individual items is uncertain. We aimed to perform a Delphi survey amongst physicians to achieve consensus on diagnostic criteria. Methods: We retrieved diagnostic items from the literature and conducted physician and patient interviews. All items were combined to create the online questionnaire. Participants rated each item during 3 consecutive rounds. Items were rated for diagnostic helpfulness for hepatic and renal cyst infection on a 9-point scale with anchors, from extremely unimportant (n = 1) to extremely important (n = 9). We determined consensus with the disagreement index. The median rating of each item was calculated and categorized into inappropriate (≤3.4), uncertain (3.5-6.4) or appropriate (≥6.5). By combining all items that reached an appropriate consensus rating, we developed a diagnostic algorithm based on expert consensus. Results: We invited 58 physicians to participate in the survey. In total, 35 (60{\%}) responded to round 1 of which 91{\%} (n = 32) and 86{\%} (n = 30) responded to round 2 and 3, respectively. The final panel included 23 nephrologists, 5 hepatologists, a nuclear medicine specialist and an infectious disease physician from 11 countries (male 67{\%}, mean age 47 ± 11 years, median clinical experience 21 years). The panel rated the diagnostic helpfulness of 59 potential items. Ultimately, 22 hepatic and 26 renal items were rated appropriate, including positive blood cultures and fluorodeoxyglucose positron-emission CT imaging. Ultrasonography and absence of intracystic bleeding were amongst those deemed uncertain or inappropriate. Subsequently, by combining items rated appropriate, we developed a clinical tool to diagnose hepatic and renal cyst infection. Conclusions: We identified diagnostic items for hepatic and renal cyst infection and developed an expert-based diagnostic algorithm, which may aid physicians in the diagnostic work-up. A prospective study is necessary to validate this algorithm.",
keywords = "Autosomal dominant polycystic kidney disease, Diagnosis, Infection, Polycystic kidney disease",
author = "Lantinga, {Marten A.} and Darding, {Alexander J M} and {de S{\'e}vaux}, {Ruud G L} and Ahsan Alam and Bleeker-Rovers, {Chantal P.} and Micka{\"e}l Bobot and {Cornec-Le Gall}, Emilie and Gevers, {Tom J G} and Ziad Hassoun and Esther Meijer and Michal Mrug and Frederik Nevens and Onuchic, {Luiz F.} and York Pei and Piccoli, {Giorgina B.} and Yves Pirson and Rangan, {Gopala K.} and Roser Torra and Visser, {Folkert W.} and Fran{\cc}ois Jouret and Nada Kanaan and Oyen, {Wim J G} and Tatsuya Suwabe and Vicente Torres and Hogan, {Marie C}",
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T2 - Identification of Diagnostic Criteria for Hepatic and Renal Cyst Infection

AU - Lantinga, Marten A.

AU - Darding, Alexander J M

AU - de Sévaux, Ruud G L

AU - Alam, Ahsan

AU - Bleeker-Rovers, Chantal P.

AU - Bobot, Mickaël

AU - Cornec-Le Gall, Emilie

AU - Gevers, Tom J G

AU - Hassoun, Ziad

AU - Meijer, Esther

AU - Mrug, Michal

AU - Nevens, Frederik

AU - Onuchic, Luiz F.

AU - Pei, York

AU - Piccoli, Giorgina B.

AU - Pirson, Yves

AU - Rangan, Gopala K.

AU - Torra, Roser

AU - Visser, Folkert W.

AU - Jouret, François

AU - Kanaan, Nada

AU - Oyen, Wim J G

AU - Suwabe, Tatsuya

AU - Torres, Vicente

AU - Hogan, Marie C

PY - 2016/9/3

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N2 - Background: Cyst infection is one of the complications of autosomal dominant polycystic kidney disease and polycystic liver disease. The diagnosis is typically made on a mix of clinical, laboratory and imaging abnormalities but the importance of individual items is uncertain. We aimed to perform a Delphi survey amongst physicians to achieve consensus on diagnostic criteria. Methods: We retrieved diagnostic items from the literature and conducted physician and patient interviews. All items were combined to create the online questionnaire. Participants rated each item during 3 consecutive rounds. Items were rated for diagnostic helpfulness for hepatic and renal cyst infection on a 9-point scale with anchors, from extremely unimportant (n = 1) to extremely important (n = 9). We determined consensus with the disagreement index. The median rating of each item was calculated and categorized into inappropriate (≤3.4), uncertain (3.5-6.4) or appropriate (≥6.5). By combining all items that reached an appropriate consensus rating, we developed a diagnostic algorithm based on expert consensus. Results: We invited 58 physicians to participate in the survey. In total, 35 (60%) responded to round 1 of which 91% (n = 32) and 86% (n = 30) responded to round 2 and 3, respectively. The final panel included 23 nephrologists, 5 hepatologists, a nuclear medicine specialist and an infectious disease physician from 11 countries (male 67%, mean age 47 ± 11 years, median clinical experience 21 years). The panel rated the diagnostic helpfulness of 59 potential items. Ultimately, 22 hepatic and 26 renal items were rated appropriate, including positive blood cultures and fluorodeoxyglucose positron-emission CT imaging. Ultrasonography and absence of intracystic bleeding were amongst those deemed uncertain or inappropriate. Subsequently, by combining items rated appropriate, we developed a clinical tool to diagnose hepatic and renal cyst infection. Conclusions: We identified diagnostic items for hepatic and renal cyst infection and developed an expert-based diagnostic algorithm, which may aid physicians in the diagnostic work-up. A prospective study is necessary to validate this algorithm.

AB - Background: Cyst infection is one of the complications of autosomal dominant polycystic kidney disease and polycystic liver disease. The diagnosis is typically made on a mix of clinical, laboratory and imaging abnormalities but the importance of individual items is uncertain. We aimed to perform a Delphi survey amongst physicians to achieve consensus on diagnostic criteria. Methods: We retrieved diagnostic items from the literature and conducted physician and patient interviews. All items were combined to create the online questionnaire. Participants rated each item during 3 consecutive rounds. Items were rated for diagnostic helpfulness for hepatic and renal cyst infection on a 9-point scale with anchors, from extremely unimportant (n = 1) to extremely important (n = 9). We determined consensus with the disagreement index. The median rating of each item was calculated and categorized into inappropriate (≤3.4), uncertain (3.5-6.4) or appropriate (≥6.5). By combining all items that reached an appropriate consensus rating, we developed a diagnostic algorithm based on expert consensus. Results: We invited 58 physicians to participate in the survey. In total, 35 (60%) responded to round 1 of which 91% (n = 32) and 86% (n = 30) responded to round 2 and 3, respectively. The final panel included 23 nephrologists, 5 hepatologists, a nuclear medicine specialist and an infectious disease physician from 11 countries (male 67%, mean age 47 ± 11 years, median clinical experience 21 years). The panel rated the diagnostic helpfulness of 59 potential items. Ultimately, 22 hepatic and 26 renal items were rated appropriate, including positive blood cultures and fluorodeoxyglucose positron-emission CT imaging. Ultrasonography and absence of intracystic bleeding were amongst those deemed uncertain or inappropriate. Subsequently, by combining items rated appropriate, we developed a clinical tool to diagnose hepatic and renal cyst infection. Conclusions: We identified diagnostic items for hepatic and renal cyst infection and developed an expert-based diagnostic algorithm, which may aid physicians in the diagnostic work-up. A prospective study is necessary to validate this algorithm.

KW - Autosomal dominant polycystic kidney disease

KW - Diagnosis

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