Sistema de Salut de Catalunya
Institut Català de la Salut
[Loebinger MR] Royal Brompton Hospital and NHLI, Imperial College London, London, UK. [Aliberti S] Department of Biomedical Sciences, Humanitas University, Milan, Italy. Respiratory Unit, IRCCS Humanitas Research Hospital, Milan, Italy. [Haworth C] Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge, UK. Department of Medicine, University of Cambridge, Cambridge, UK. [Jankovic Makek M] Clinic for Respiratory Diseases, University Hospital Center Zagreb, Zagreb, Croatia. University of Zagreb, School of Medicine, Zagreb, Croatia. [Lange C] Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany. German Center for Infection Research (DZIF). Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany. Global TB Program, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA. [Lorent N] Department of Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium. Department of Chrometa, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium. [Polverino E] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Ciber de Enfermedades Respiratorias, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-11-21T13:44:16Z
2024-11-21T13:44:16Z
2024-09
Delphi process; Nontuberculous mycobacterial pulmonary disease
Procés Delphi; Malaltia pulmonar micobacteriana no tuberculosa
Proceso Delphi; Enfermedad pulmonar micobacteriana no tuberculosa
Background Identifying patients at risk of nontuberculous mycobacterial pulmonary disease (NTM-PD) is challenging. Delays in NTM-PD identification and management are associated with declining lung function and increased morbidity and mortality. Study design and methods European NTM-PD experts (n=12) participated in a three-round modified Delphi process to score symptoms and comorbidities potentially associated with NTM-PD as reasons to test for nontuberculous mycobacteria. Results Experts reached a consensus on the symptoms and comorbidities that should and should not prompt testing for nontuberculous mycobacteria. Requirements for testing were scored as high (mean ≥7), medium (mean ≥4–<7) or low (mean <4). Nontuberculous mycobacteria testing should be undertaken when multiple suggestive symptoms are present simultaneously in all patients except those with cancer (7.3–8.8), or when radiology is indicative of NTM-PD (≥8.9). Symptoms of persistent sputum production, recurrent respiratory infection and haemoptysis should prompt testing for nontuberculous mycobacteria, particularly in those with underlying respiratory diseases. Symptomatic patients with bronchiectasis or previous tuberculosis/NTM-PD or those being prescribed or undergoing long-term macrolide therapy for a respiratory condition should also be tested. Testing is not warranted in patients without an underlying respiratory disorder or in those without a history of respiratory disorders unless presenting with multiple symptoms. Conclusions Assessing patients’ risk of NTM-PD is challenging. This Delphi consensus process provides insight into symptoms and clinical characteristics that should prompt NTM-PD assessment. Timely testing and diagnosis would enable initiation of appropriate management.
Article
Published version
English
Decisió de grup; Pulmons - Malalties - Factors de risc; Micobacteriosis - Diagnòstic; Micobacteriosis - Factors de risc; Pulmons - Malalties - Diagnòstic; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; DISEASES::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Actinomycetales Infections::Mycobacterium Infections::Mycobacterium Infections, Nontuberculous; DISEASES::Respiratory Tract Diseases::Lung Diseases; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso; ENFERMEDADES::infecciones bacterianas y micosis::infecciones bacterianas::infecciones por bacterias grampositivas::infecciones por Actinomycetales::micobacteriosis::infecciones por micobacterias no tuberculosas; ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::diseño de la investigación epidemiológica::sensibilidad y especificidad::valor predictivo de las pruebas
European Respiratory Society
ERJ Open Research;10(5)
https://doi.org/10.1183/23120541.00791-2023
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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