NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, UK Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK School of Applied Psychology, University College Cork, Cork, Ireland
School of Applied Psychology, University College Cork, Cork, Ireland.
Eur Respir J. 2016 Oct;48(4):1096-1107. doi: 10.1183/13993003.02018-2015. Epub 2016 Aug 4.
Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by progressive sino-pulmonary disease, with symptoms starting soon after birth. A European Respiratory Society (ERS) Task Force aims to address disparities in diagnostics across Europe by providing evidence-based clinical practice guidelines. We aimed to identify challenges faced by patients when referred for PCD diagnostic testing.A patient survey was developed by patient representatives and healthcare specialists to capture experience. Online versions of the survey were translated into nine languages and completed in 25 countries. Of the respondents (n=365), 74% were PCD-positive, 5% PCD-negative and 21% PCD-uncertain/inconclusive. We then interviewed 20 parents/patients. Transcripts were analysed thematically.35% of respondents visited their doctor more than 40 times with PCD-related symptoms prior to diagnostic referral. Furthermore, the most prominent theme among interviewees was a lack of PCD awareness among medical practitioners and failure to take past history into account, leading to delayed diagnosis. Patients also highlighted the need for improved reporting of results and a solution to the "inconclusive" diagnostic status.These findings will be used to advise the ERS Task Force guidelines for diagnosing PCD, and should help stakeholders responsible for improving existing services and expanding provision for diagnosis of this rare disease.
原发性纤毛运动障碍(PCD)是一种罕见的遗传性疾病,其特征是进行性鼻窦-肺部疾病,症状在出生后不久就出现。一个欧洲呼吸学会(ERS)工作组旨在通过提供基于证据的临床实践指南来解决欧洲各地诊断方面的差异。我们旨在确定患者在接受 PCD 诊断测试时面临的挑战。患者代表和医疗保健专家制定了一份患者调查,以了解患者的经验。该调查的在线版本被翻译成九种语言,并在 25 个国家完成。在受访者(n=365)中,74%为 PCD 阳性,5%为 PCD 阴性,21%为 PCD 不确定/不确定。然后,我们采访了 20 位家长/患者。对抄本进行了主题分析。35%的受访者在诊断转诊前因 PCD 相关症状就诊超过 40 次。此外,受访者最突出的主题是医疗从业者缺乏对 PCD 的认识,并且没有考虑过去的病史,导致诊断延迟。患者还强调需要改进结果报告,并解决“不确定”的诊断状况。这些发现将用于为 ERS 工作组诊断 PCD 的指南提供建议,并应有助于负责改善现有服务和扩大此类罕见疾病诊断服务的利益相关者。