PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: These Delphi-generated consensus-based recommendations offer potential improvements compared with earlier definitions and a guide for clinical practice and future research.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: These Delphi-generated consensus-based recommendations offer potential improvements compared with earlier definitions and a guide for clinical practice and future research.
摘要：
■不明原因发热（FUO）和不明原因炎症（IUO）是通常用作医学诊断的综合征。由于现有文献混合了诊断方法，制定基于共识的建议将对临床医生有所帮助，研究人员,和病人。
■从2022年10月到2023年7月进行了修改的Delphi流程，涉及4轮在线调查和2次实时视频会议。该小组由根据同行评审的已发表出版物和研究招募的国际专家组成。
■在50位受邀专家中，26人（52.0%）同意参加。二十三名小组成员完成了第一轮调查，21个完成第2和第3轮，20个完成第4轮，7个参加了第5轮视频直播讨论。在参与者中，18人(78.3%)是以学术为基础的临床医生和研究人员，5人(21.7%)在社区医院执业，女性6人(26.1%)。就5个主题达成共识：(1)纳入流行病学因素，例如地理位置和旅行历史；（2）更新的FUO或IUO分类标准；（3）初始评估方法；（4）诊断分类系统；（5）对经验性治疗的明智限制的建议。专家强烈不同意使用2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描作为FUO诊断标准的一部分。关于温度测量站点的重要性，意见不一，3周最低疾病标准，需要一个标准的定义，以及对FUO和IUO使用类似的评估策略。
■这些Delphi生成的基于共识的建议与早期定义相比提供了潜在的改进，并为临床实践和未来研究提供了指导。
■从2022年10月到2023年7月进行了修改的Delphi流程，涉及4轮在线调查和2次实时视频会议。该小组由根据同行评审的已发表出版物和研究招募的国际专家组成。
■在50位受邀专家中，26人（52.0%）同意参加。二十三名小组成员完成了第一轮调查，21个完成第2和第3轮，20个完成第4轮，7个参加了第5轮视频直播讨论。在参与者中，18人(78.3%)是以学术为基础的临床医生和研究人员，5人(21.7%)在社区医院执业，女性6人(26.1%)。就5个主题达成共识：(1)纳入流行病学因素，例如地理位置和旅行历史；（2）更新的FUO或IUO分类标准；（3）初始评估方法；（4）诊断分类系统；（5）对经验性治疗的明智限制的建议。专家强烈不同意使用2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描作为FUO诊断标准的一部分。关于温度测量站点的重要性，意见不一，3周最低疾病标准，需要一个标准的定义，以及对FUO和IUO使用类似的评估策略。
■这些Delphi生成的基于共识的建议与早期定义相比提供了潜在的改进，并为临床实践和未来研究提供了指导。
