dc.contributor | Vall d'Hebron Barcelona Hospital Campus |
dc.contributor.author | Mehta, Atul |
dc.contributor.author | Kuter, David J. |
dc.contributor.author | Salek, Sam S. |
dc.contributor.author | Belmatoug, Nadia |
dc.contributor.author | Bembi, Bruno |
dc.contributor.author | Bright, Jeremy |
dc.contributor.author | Pérez López, Jorge |
dc.date.accessioned | 2021-04-20T12:10:28Z |
dc.date.available | 2021-04-20T12:10:28Z |
dc.date.issued | 2019-05 |
dc.identifier.citation | Mehta A, Kuter DJ, Salek SS, Belmatoug N, Bembi B, Bright J, et al. Presenting signs and patient co‐variables in Gaucher disease: outcome of the Gaucher Earlier Diagnosis Consensus (GED‐C) Delphi initiative. Intern Med J. 2019 May 13;49(5):578–91. |
dc.identifier.issn | 1445-5994 |
dc.identifier.uri | https://hdl.handle.net/11351/5880 |
dc.description | Lysosomal storage disease; Metabolism; Algorithm |
dc.description.abstract | Background
Gaucher disease (GD) presents with a range of signs and symptoms. Physicians can fail to recognise the early stages of GD owing to a lack of disease awareness, which can lead to significant diagnostic delays and sometimes irreversible but avoidable morbidities.
Aim
The Gaucher Earlier Diagnosis Consensus (GED‐C) initiative aimed to identify signs and co‐variables considered most indicative of early type 1 and type 3 GD, to help non‐specialists identify ‘at‐risk’ patients who may benefit from diagnostic testing.
Methods
An anonymous, three‐round Delphi consensus process was deployed among a global panel of 22 specialists in GD (median experience 17.5 years, collectively managing almost 3000 patients). The rounds entailed data gathering, then importance ranking and establishment of consensus, using 5‐point Likert scales and scoring thresholds defined a priori.
Results
For type 1 disease, seven major signs (splenomegaly, thrombocytopenia, bone‐related manifestations, anaemia, hyperferritinaemia, hepatomegaly and gammopathy) and two major co‐variables (family history of GD and Ashkenazi‐Jewish ancestry) were identified. For type 3 disease, nine major signs (splenomegaly, oculomotor disturbances, thrombocytopenia, epilepsy, anaemia, hepatomegaly, bone pain, motor disturbances and kyphosis) and one major co‐variable (family history of GD) were identified. Lack of disease awareness, overlooking mild early signs and failure to consider GD as a diagnostic differential were considered major barriers to early diagnosis.
Conclusion
The signs and co‐variables identified in the GED‐C initiative as potentially indicative of early GD will help to guide non‐specialists and raise their index of suspicion in identifying patients potentially suitable for diagnostic testing for GD. |
dc.language.iso | eng |
dc.publisher | Wiley |
dc.relation.ispartofseries | Internal Medicine Journal;49(5) |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.source | Scientia |
dc.subject | Gaucher, Malaltia de |
dc.subject | Prognosi |
dc.subject.mesh | Gaucher Disease |
dc.subject.mesh | Delphi Technique |
dc.subject.mesh | Early Diagnosis |
dc.title | Presenting signs and patient co‐variables in Gaucher disease: outcome of the Gaucher Earlier Diagnosis Consensus (GED‐C) Delphi initiative |
dc.type | info:eu-repo/semantics/article |
dc.identifier.doi | 10.1111/imj.14156 |
dc.subject.decs | enfermedad de Gaucher |
dc.subject.decs | técnica Delfos |
dc.subject.decs | diagnóstico precoz |
dc.relation.publishversion | https://onlinelibrary.wiley.com/doi/10.1111/imj.14156 |
dc.type.version | info:eu-repo/semantics/publishedVersion |
dc.audience | Professionals |
dc.contributor.organismes | Institut Català de la Salut |
dc.contributor.authoraffiliation | [Mehta A] Lysosomal Storage Disorders Unit, Department of Haematology, Royal Free Hospital, UCL Medical School, London. [Kuter DJ] Center for Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. [Salek SS] School of Life and Medical Sciences, University of Hertfordshire, Hatfield. [Belmatoug N] Referral Center for Lysosomal Diseases, University Hospital Paris Nord Val de Seine, site Beaujon, Clichy, Paris, France. [Bembi B] Centre for Rare Diseases, Academic Medical Centre Hospital of Udine, Udine. [Bright J] Research Evaluation Unit, Oxford PharmaGenesis Ltd, Oxford, UK. [Pérez-López J] Unitat de Malalties minoritàries, Vall d’Hebron Hospital Universitari, Barcelona, Spain |
dc.identifier.pmid | 30414226 |
dc.identifier.wos | 000467848600005 |
dc.rights.accessrights | info:eu-repo/semantics/openAccess |