Areas of uncertainty on the diagnosis, treatment, and follow-up of hypophosphatemia in adults: an Italian Delphi consensus.

IF 5.4 2区 医学 Q1 Medicine Journal of Endocrinological Investigation Pub Date : 2024-10-08 DOI:10.1007/s40618-024-02458-4
Iacopo Chiodini, Daniela d'Angela, Alberto Falchetti, Luigi Gennari, Nazzarena Malavolta, Laura Masi, Antonio Migliore, Massimiliano Orso, Barbara Polistena, Domenico Rendina, Alfredo Scillitani, Federico Spandonaro, Giuseppe Vezzoli, Fabio Vescini
{"title":"Areas of uncertainty on the diagnosis, treatment, and follow-up of hypophosphatemia in adults: an Italian Delphi consensus.","authors":"Iacopo Chiodini, Daniela d'Angela, Alberto Falchetti, Luigi Gennari, Nazzarena Malavolta, Laura Masi, Antonio Migliore, Massimiliano Orso, Barbara Polistena, Domenico Rendina, Alfredo Scillitani, Federico Spandonaro, Giuseppe Vezzoli, Fabio Vescini","doi":"10.1007/s40618-024-02458-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to present the results of a Delphi consensus involving Italian experts focusing on the management of hypophosphatemia in adults.</p><p><strong>Methods: </strong>A multidisciplinary advisory board of nine physicians, experts in hypophosphatemia management, was established. Next, a literature search was performed to identify international guidelines, consensus, and clinical pathways, which were later presented to the advisory board. Collaboratively, the advisory board and authoring team selected key statements for the consensus process and focused on areas of uncertainty related to the management of hypophosphatemia. The advisory board also indicated the experts to be invited to participate in the consensus process. The Delphi method was employed to reach a consensus.</p><p><strong>Results: </strong>The literature search yielded one guideline, five consensus documents, and one clinical pathway. While our search strategy aimed to identify documents on the management of all types of hypophosphatemia, most of the guidelines and consensus documents retrieved focused on X-linked hypophosphatemia. The consensus process focused on 11 key issues, achieving strong convergence (over 70% consensus) in the first Delphi round for 8 out of the 11 statements. Three statements proceeded to the second round, with strong agreement reached for two. Notably, consensus was not reached for the statement concerning the measurement of fibroblast growth factor 23 for diagnostic purposes.</p><p><strong>Conclusion: </strong>The study revealed that the community of clinical experts is well-informed and in agreement regarding hypophosphatemia management. It emphasized the importance of developing clear national guidance documents to support clinicians and multidisciplinary teams in patient management. These documents are crucial not only for healthcare professionals but also for those responsible for defining pathways and services, facilitating a more accurate management of hypophosphatemic patients.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Endocrinological Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40618-024-02458-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: The study aimed to present the results of a Delphi consensus involving Italian experts focusing on the management of hypophosphatemia in adults.

Methods: A multidisciplinary advisory board of nine physicians, experts in hypophosphatemia management, was established. Next, a literature search was performed to identify international guidelines, consensus, and clinical pathways, which were later presented to the advisory board. Collaboratively, the advisory board and authoring team selected key statements for the consensus process and focused on areas of uncertainty related to the management of hypophosphatemia. The advisory board also indicated the experts to be invited to participate in the consensus process. The Delphi method was employed to reach a consensus.

Results: The literature search yielded one guideline, five consensus documents, and one clinical pathway. While our search strategy aimed to identify documents on the management of all types of hypophosphatemia, most of the guidelines and consensus documents retrieved focused on X-linked hypophosphatemia. The consensus process focused on 11 key issues, achieving strong convergence (over 70% consensus) in the first Delphi round for 8 out of the 11 statements. Three statements proceeded to the second round, with strong agreement reached for two. Notably, consensus was not reached for the statement concerning the measurement of fibroblast growth factor 23 for diagnostic purposes.

Conclusion: The study revealed that the community of clinical experts is well-informed and in agreement regarding hypophosphatemia management. It emphasized the importance of developing clear national guidance documents to support clinicians and multidisciplinary teams in patient management. These documents are crucial not only for healthcare professionals but also for those responsible for defining pathways and services, facilitating a more accurate management of hypophosphatemic patients.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
成人低磷血症诊断、治疗和随访的不确定因素:意大利德尔菲共识。
目的:本研究旨在介绍由意大利专家参与的德尔菲共识的结果,其重点是成人低磷酸盐血症的管理:方法:成立了一个由九名低磷血症管理专家组成的多学科咨询委员会。随后,进行了文献检索,以确定国际指南、共识和临床路径,并将其提交给咨询委员会。顾问委员会和撰写团队共同合作,为达成共识过程选择了关键声明,并重点关注与低磷酸盐血症管理相关的不确定领域。咨询委员会还指出了应邀请参与共识进程的专家。结果:文献检索结果包括一份指南、五份共识文件和一份临床路径。虽然我们的搜索策略旨在确定所有类型低磷血症的管理文件,但检索到的大多数指南和共识文件都侧重于 X 连锁低磷血症。共识过程集中在 11 个关键问题上,在第一轮德尔菲讨论中,11 项声明中有 8 项达成了高度一致(超过 70% 的共识)。三项声明进入第二轮,其中两项达成了强烈共识。值得注意的是,关于为诊断目的测量成纤维细胞生长因子 23 的声明未达成共识:研究表明,临床专家群体对低磷酸盐血症的治疗有充分的了解并达成了一致。研究强调了制定明确的国家指导文件以支持临床医生和多学科团队管理患者的重要性。这些文件不仅对医护人员至关重要,而且对负责确定治疗路径和服务的人员也至关重要,有助于更准确地管理低磷酸盐血症患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Endocrinological Investigation
Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-
CiteScore
8.10
自引率
7.40%
发文量
242
期刊介绍: The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
期刊最新文献
Correction to: The diagnosis of hypophosphatasia in children as a multidisciplinary effort: an expert opinion. TFCP2L1, a potential differentiation regulator, predicts favorable prognosis and dampens thyroid cancer progression. Germline polymorphisms of the NOD2 pathway may predict the effectiveness of radioiodine in differentiated thyroid cancer treatment. The complexity of glucose time series is associated with short- and long-term mortality in critically ill adults: a multi-center, prospective, observational study. Total osteocalcin levels are independently associated with worse testicular function and a higher degree of hypothalamic-pituitary-gonadal axis activation in Klinefelter syndrome.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1