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

Autor: Chiodini I; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, 20100, Italy.; Unit of Endocrinology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., d'Angela D; C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy., Falchetti A; Unit of Endocrinology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Gennari L; Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy., Malavolta N; Madre Fortunata Toniolo Private Hospital, Bologna, Italy., Masi L; Metabolic Bone Diseases Unit, University Hospital of Florence (AOUC), Florence, Italy., Migliore A; C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy., Orso M; C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy. m.orso@creasanita.it., Polistena B; C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy., Rendina D; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Scillitani A; U.O. di Endocrinologia, Ospedale 'Casa Sollievo della Sofferenza', IRCCS, San Giovanni Rotondo, FG, Italy., Spandonaro F; C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), Rome, Italy.; University of Rome Tor Vergata, Rome, Italy., Vezzoli G; Nephrology and Dialysis Unit, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy., Vescini F; Endocrinology Unit, University-Hospital of Udine, Udine, Italy.
Jazyk: angličtina
Zdroj: Journal of endocrinological investigation [J Endocrinol Invest] 2024 Oct 08. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1007/s40618-024-02458-4
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: