Development of a Consensus-Based List of Potential Quality Indicators for Fever and Inflammation of Unknown Origin

Wright, William F; Betrains, Albrecht; Stelmash, Lauren; Mulders-Manders, Catharina M; Rovers, Chantal P; Vanderschueren, Steven; Auwaerter, Paul G

doi:10.1093/ofid/ofad671

Cited by 1 publication

(4 citation statements)

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“…The primary purpose of round 4 was to provide context for a round 5 video meeting among the primary research panelists (all authors) on 9 of 10 topics that had not reached consensus in the previous rounds. The primary research panelists addressed quality clinical metrics for these conditions in a separate publication [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“… Abbreviations: CT, computed tomography; FUO, fever of unknown origin; IUO, inflammation of unknown origin; PDCs, potential diagnostic clues; PET, positron emission tomography. a The round 4 question regarding quality clinical metrics for these conditions were addressed by the primary research panelists in a separate publication [ 20 ]. …”

Section: Resultsmentioning

confidence: 99%

“… a The round 4 question regarding quality clinical metrics for these conditions were addressed by the primary research panelists in a separate publication [ 20 ]. …”

Section: Resultsmentioning

confidence: 99%

“…Recommendations must also be assessed for feasibility in routine clinical practice with minimal unintended consequences, such as increasing clinician and patient burdens, implementation costs, or clinical workflow changes. Therefore, a trial design of quality indicators comparing management strategies using desirability of outcomes rankings end points could provide the pragmatic and patient-centered information clinicians need to make informed decisions about patient care that could be developed through a survey of clinician-scientists and clinical trialists using case vignettes [ 20 , 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Recommendations for Updating Fever and Inflammation of Unknown Origin From a Modified Delphi Consensus Panel

Wright,

Stelmash,

Betrains

et al. 2024

Open Forum Infectious Diseases

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Background Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are syndromes commonly used as medical diagnoses. Since the existing literature has a mixture of diagnostic approaches, developing consensus-based recommendations would be helpful for clinicians, researchers, and patients. Methods A modified Delphi process was performed from October 2022 to July 2023, involving 4 rounds of online surveys and 2 live video conferences. The panel comprised international experts recruited based on peer-reviewed published publications and studies. Results Among 50 invited experts, 26 (52.0%) agreed to participate. Twenty-three panelists completed round 1 of the survey, 21 completed rounds 2 and 3, 20 completed round 4, and 7 participated in round 5 live video discussions. Of the participants, 18 (78.3%) were academic-based clinicians and researchers, 5 (21.7%) practiced in a community-based hospital, and 6 (26.1%) were female. Consensus was reached on 5 themes: (1) incorporating epidemiologic factors, such as geographic location and travel history; (2) updated criteria for classifying FUO or IUO; (3) initial evaluation approaches; (4) a classification system for diagnoses; and (5) recommendations for judicious limitation of empiric therapies. Experts strongly disagreed with using 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography/computed tomography as part of the diagnostic criteria for FUO. There were mixed opinions about the importance of the temperature measurement site, the 3-week minimum illness criterion, the need for a standard definition of relapsing fevers, and the use of similar evaluation strategies for FUO and IUO. Conclusions These Delphi-generated consensus-based recommendations offer potential improvements compared with earlier definitions and a guide for clinical practice and future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… a The round 4 question regarding quality clinical metrics for these conditions were addressed by the primary research panelists in a separate publication [ 20 ]. …”

Section: Resultsmentioning

confidence: 99%