Tamarozzi Francesca, Mazzi Cristina, Antinori Spinello, Arsuaga Marta, Becker Sören L, Bottieau Emmanuel, Camprubi-Ferrer Daniel, Caumes Eric, Duvignaud Alexandre, Grobusch Martin P, Jaureguiberry Stephane, Jordan Sabine, Mueller Andreas, Neumayr Andreas, Perez-Molina Jose A, Salas-Coronas Joaquin, Salvador Fernando, Tomasoni Lina R, van Hellemond Jaap J, Vaughan Stephen D, Wammes Linda J, Zammarchi Lorenzo, Buonfrate Dora, Huits Ralph, van Lieshout Lisette, Gobbi Federico
Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
Lancet Infect Dis. 2024 Oct;24(10):e627-e637. doi: 10.1016/S1473-3099(24)00080-X. Epub 2024 Mar 8.
Terminology in schistosomiasis is not harmonised, generating misunderstanding in data interpretation and clinical descriptions. This study aimed to achieve consensus on definitions of clinical aspects of schistosomiasis in migrants and returning travellers. We applied the Delphi method. Experts from institutions affiliated with GeoSentinel and TropNet, identified through clinical and scientific criteria, were invited to participate. Five external reviewers revised and pilot-tested the statements. Statements focusing on the definitions of acute or chronic; possible, probable, or confirmed; active; and complicated schistosomiasis were managed through REDCap and replies managed in a blinded manner. Round 1 mapped the definitions used by experts; subsequent rounds were done to reach consensus, or quantify disagreement, on the proposed statements. Data were analysed with percentages, medians, and IQRs of a 5-point Likert scale. The study was terminated on the basis of consensus or stability-related and time-related criteria. 28 clinicians and scientists met the criteria for experts. 25 (89%) of 28 experts replied to Round 1, 18 (64%) of 28 to Round 2, 19 (68%) of 28 to Round 3, and 21 (75%) of 28 to at least two rounds. High-level consensus (79-100% agreement and IQRs ≤1) was reached for all definitions. Consensus definitions will foster harmonised scientific and clinical communication and support future research and development of management guidelines for schistosomiasis.
血吸虫病的术语并不统一，这在数据解读和临床描述中造成了误解。本研究旨在就移民和归国旅行者血吸虫病临床方面的定义达成共识。我们采用了德尔菲法。通过临床和科学标准，邀请了来自与全球监测网（GeoSentinel）和热带病监测网（TropNet）相关机构的专家参与。五名外部评审员对声明进行了修订和预测试。聚焦于急性或慢性、可能、很可能或确诊、活动性以及复杂性血吸虫病定义的声明通过REDCap进行管理，并以盲态方式处理回复。第一轮梳理了专家们使用的定义；随后几轮则是就提议的声明达成共识或量化分歧。数据采用5级李克特量表的百分比、中位数和四分位数间距进行分析。该研究根据共识、稳定性相关和时间相关标准终止。28名临床医生和科学家符合专家标准。28名专家中有25名（89%）回复了第一轮，28名中有18名（64%）回复了第二轮，28名中有19名（68%）回复了第三轮，28名中有21名（75%）回复了至少两轮。所有定义均达成了高度共识（79 - 100%的一致性且四分位数间距≤1）。共识定义将促进科学和临床交流的统一，并为未来血吸虫病管理指南的研究与制定提供支持。
