TY - JOUR
T1 - Delphi
T2 - A Democratic and Cost-Effective Method of Consensus Generation in Transplantation
AU - Afrouzian, Marjan
AU - Kozakowski, Nicolas
AU - Liapis, Helen
AU - Broecker, Verena
AU - Truong, Luan
AU - Avila-Casado, Carmen
AU - Regele, Heinz
AU - Seshan, Surya
AU - Ambruzs, Josephine M.
AU - Farris, Alton Brad
AU - Buob, David
AU - Chander, Praveen N.
AU - Cheraghvandi, Lukman
AU - Clahsen-van Groningen, Marian C.
AU - de Almeida Araujo, Stanley
AU - Ertoy Baydar, Dilek
AU - Formby, Mark
AU - Galesic Ljubanovic, Danica
AU - Herrera Hernandez, Loren
AU - Honsova, Eva
AU - Mohamed, Nasreen
AU - Ozluk, Yasemin
AU - Rabant, Marion
AU - Royal, Virginie
AU - Stevenson, Heather L.
AU - Toniolo, Maria Fernanda
AU - Taheri, Diana
N1 - Funding Information:
The authors declare that this study received funding from Alexion Pharmaceuticals (grant # 100288) and the Banff Foundation on Allograft Pathology (for publication fees). The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.
Publisher Copyright:
Copyright © 2023 Afrouzian, Kozakowski, Liapis, Broecker, Truong, Avila-Casado, Regele, Seshan, Ambruzs, Farris, Buob, Chander, Cheraghvandi, Clahsen-van Groningen, de Almeida Araujo, Ertoy Baydar, Formby, Galesic Ljubanovic, Herrera Hernandez, Honsova, Mohamed, Ozluk, Rabant, Royal, Stevenson, Toniolo and Taheri.
PY - 2023
Y1 - 2023
N2 - The Thrombotic Microangiopathy Banff Working Group (TMA-BWG) was formed in 2015 to survey current practices and develop minimum diagnostic criteria (MDC) for renal transplant TMA (Tx-TMA). To generate consensus among pathologists and nephrologists, the TMA BWG designed a 3-Phase study. Phase I of the study is presented here. Using the Delphi methodology, 23 panelists with >3 years of diagnostic experience with Tx-TMA pathology listed their MDC suggesting light, immunofluorescence, and electron microscopy lesions, clinical and laboratory information, and differential diagnoses. Nine rounds (R) of consensus resulted in MDC validated during two Rs using online evaluation of whole slide digital images of 37 biopsies (28 TMA, 9 non-TMA). Starting with 338 criteria the process resulted in 24 criteria and 8 differential diagnoses including 18 pathologic, 2 clinical, and 4 laboratory criteria. Results show that 3/4 of the panelists agreed on the diagnosis of 3/4 of cases. The process also allowed definition refinement for 4 light and 4 electron microscopy lesions. For the first time in Banff classification, the Delphi methodology was used to generate consensus. The study shows that Delphi is a democratic and cost-effective method allowing rapid consensus generation among numerous physicians dealing with large number of criteria in transplantation.
AB - The Thrombotic Microangiopathy Banff Working Group (TMA-BWG) was formed in 2015 to survey current practices and develop minimum diagnostic criteria (MDC) for renal transplant TMA (Tx-TMA). To generate consensus among pathologists and nephrologists, the TMA BWG designed a 3-Phase study. Phase I of the study is presented here. Using the Delphi methodology, 23 panelists with >3 years of diagnostic experience with Tx-TMA pathology listed their MDC suggesting light, immunofluorescence, and electron microscopy lesions, clinical and laboratory information, and differential diagnoses. Nine rounds (R) of consensus resulted in MDC validated during two Rs using online evaluation of whole slide digital images of 37 biopsies (28 TMA, 9 non-TMA). Starting with 338 criteria the process resulted in 24 criteria and 8 differential diagnoses including 18 pathologic, 2 clinical, and 4 laboratory criteria. Results show that 3/4 of the panelists agreed on the diagnosis of 3/4 of cases. The process also allowed definition refinement for 4 light and 4 electron microscopy lesions. For the first time in Banff classification, the Delphi methodology was used to generate consensus. The study shows that Delphi is a democratic and cost-effective method allowing rapid consensus generation among numerous physicians dealing with large number of criteria in transplantation.
KW - Banff
KW - Delphi
KW - kidney
KW - thrombotic microangiopathy
KW - transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=85169921615&partnerID=8YFLogxK
U2 - 10.3389/ti.2023.11589
DO - 10.3389/ti.2023.11589
M3 - Article
C2 - 37680647
AN - SCOPUS:85169921615
SN - 0934-0874
VL - 36
JO - Transplant International
JF - Transplant International
M1 - 11589
ER -