Feizhou Lyu1, Chaojun Zheng2, Hongli Wang2, Cong Nie2, Xiaosheng Ma2, Xinlei Xia2, Wei Zhu2, Xiang Jin2, Yongcheng Hu3, Yu Sun4, Yu Zhu5, Satoshi Kuwabara6, Rosa Cortese7, Kaukab Maqbool Hassan8, Keisuke Takai9, Igor Paredes10, Robert Webere5, Margaret Turk5, Jun Kimura11, Jianyuan Jiang12. 1. Department of Orthopedics, Huashan Hospital, Fudan University Shanghai 200040, China; Department of Orthopedics, The Fifth People's Hospital, Fudan University Shanghai 200240, China. 2. Department of Orthopedics, Huashan Hospital, Fudan University Shanghai 200040, China. 3. Department of Spine, Tianjin Hospital, Tianjin 300000, China. 4. Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China. 5. Department of Physical Medicine and Rehabilitation, Upstate University Hospital, Syracuse, NY 13210, USA. 6. Department of Neurology, School of Medicine, Chiba University Hospital, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan. 7. NMR Research Unit, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK. 8. Department of Neurology, Jaypee Hospital, Sector 128, Noida UP - 201304, Delhi NCR, India. 9. Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042, Japan. 10. Department of Neurosurgery, University Hospital 12 de Octubre, Av. Cordoba, s/n, 28041 Madrid, Spain. 11. Department of Neurology, University of Iowa Health Care, Iowa City, IA 52242, USA. Electronic address: kimurakyoto@aol.com. 12. Department of Orthopedics, Huashan Hospital, Fudan University Shanghai 200040, China. Electronic address: Jianyuanjiang05@126.com.
Abstract
OBJECTIVE: To establish a clinician-led guideline for the diagnosis and treatment of Hirayama disease (HD) using a modified Delphi technique. METHODS: Based on a combination of a systematic review and opinion of ten experts, a protocol for the consensus of the diagnosis, treatment and follow-up assessment of HD was established. A modified 3-round Delphi survey was then performed by more than 40 panelists from various countries of the world. Both levels of evidence and levels of agreement were derived in all statements of finial guideline. RESULTS: A total of 47 experts from 6 countries were enrolled in the expert panel in this study. Highly consistent results were achieved during the three Delphi rounds. An expert-led guideline finally constructed includes 24 statements related to diagnosis, treatment and follow-up assessment of HD. CONCLUSIONS: The modified Delphi technique used in this study resulted in an expert-led guideline concerning several clinical aspects of HD. SIGNIFICANCE: This clinician-led guideline may provide a helpful direction for clinical practice with regard to the diagnosis and treatment of HD.
OBJECTIVE: To establish a clinician-led guideline for the diagnosis and treatment of Hirayama disease (HD) using a modified Delphi technique. METHODS: Based on a combination of a systematic review and opinion of ten experts, a protocol for the consensus of the diagnosis, treatment and follow-up assessment of HD was established. A modified 3-round Delphi survey was then performed by more than 40 panelists from various countries of the world. Both levels of evidence and levels of agreement were derived in all statements of finial guideline. RESULTS: A total of 47 experts from 6 countries were enrolled in the expert panel in this study. Highly consistent results were achieved during the three Delphi rounds. An expert-led guideline finally constructed includes 24 statements related to diagnosis, treatment and follow-up assessment of HD. CONCLUSIONS: The modified Delphi technique used in this study resulted in an expert-led guideline concerning several clinical aspects of HD. SIGNIFICANCE: This clinician-led guideline may provide a helpful direction for clinical practice with regard to the diagnosis and treatment of HD.