Recurrence of Dupuytren's contracture: A consensus-based definition
Recurrence of Dupuytren's contracture: A consensus-based definition
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DOI：
10.1371/journal.pone.0164849
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发表时间：
2017-05-15
期刊：
影响因子：
3.7
通讯作者：
Selles, Ruud W.
中科院分区：
文献类型：
--
作者：
Kan, Hester J.;Verrijp, Frank W.;Selles, Ruud W.
目的挛缩的复发是决定Dupyutren病（DD）治疗效果的主要因素之一。不幸的是，在文献中缺乏关于什么构成复发的一致意见，使得几乎不可能比较当今可用的多种治疗方案。本研究的目的是使一个公正的专家库，以商定什么将被视为DD治疗后复发;并从这一共识中建立一个更-为了就复发的定义达成专家共识，我们使用德尔菲法，并邀请来自10个国家的43位Dupuytren研究和治疗专家通过回答一系列问卷来参与轮每轮调查结束后，专家们都会对答案进行分析，并收到一份反馈报告，以及另一轮调查问卷，以进一步完善定义。我们定义的共识时，至少有70%的专家同意一个topic.ResultsTwenty-one专家同意参加这项研究。经过四轮协商一致，我们同意DD复发应定义为“治疗后一年与治疗后六周相比，任何治疗关节的挛缩复发超过20度”。此外，“复发应单独报告每个治疗的关节”，之后的测量应重复和每年报告。ConclusionThis study provides the most comprehensive to date definition of what should be considered recurrence of DD.这些标准化的标准应该使我们能够更好地评估许多治疗方案。
PurposeOne of the major determinants of Dupyutren disease (DD) treatment efficacy is recurrence of the contracture. Unfortunately, lack of agreement in the literature on what constitutes recurrence makes it nearly impossible to compare the multiple treatments alternatives available today. The aim of this study is to bring an unbiased pool of experts to agree upon what would be considered a recurrence of DD after treatment; and from that consensus establish a much-needed definition for DD recurrence.MethodsTo reach an expert consensus on the definition of recurrence we used the Delphi method and invited 43 Dupuytren's research and treatment experts from 10 countries to participate by answering a series of questionnaire rounds. After each round the answers were analyzed and the experts received a feedback report with another questionnaire round to further hone in of the definition. We defined consensus when at least 70% of the experts agreed on a topic.ResultsTwenty-one experts agreed to participate in this study. After four consensus rounds, we agreed that DD recurrence should be defined as "more than 20 degrees of contracture recurrence in any treated joint at one year post-treatment compared to six weeks post-treatment". In addition, "recurrence should be reported individually for every treated joint" and afterwards measurements should be repeated and reported yearly.ConclusionThis study provides the most comprehensive to date definition of what should be considered recurrence of DD. These standardized criteria should allow us to better evaluate the many treatment alternatives.