P045 An international Delphi consensus to define a clinically appropriate definition of disease modification for plaque psoriasis
Notice bibliographique
Résumé
Abstract In moderate-to-severe psoriasis, biologic therapies have achieved high levels of complete skin clearance and maintenance of this response over several years for many patients. However, questions remain as to how the disease can be controlled, brought into remission, or modified. Current definitions and measurement of disease modification are of limited utility in a clinical setting. This work acknowledges that the rapidly developing therapeutic landscape for plaque psoriasis brings into focus the question of potential for disease modification. Our objective was to achieve consensus on a definition of disease modification that can be applied within a clinical setting. In May 2021, a literature review on the topic of disease modification in psoriasis was conducted using the PubMed database. Search terms included but were not limited to ‘disease modification’, ‘disease progression, ‘disease interception’, ‘treatment target’, ‘drug therapy’, ‘biomarker’ and ‘drug-free remission’. Following the review, a panel of experts in psoriasis care from across Europe and North America convened in October 2021. Employing Delphi methodology guided by an independent facilitator, the panellists identified six main topics of focus. These topics were discussed, and 35 statements were developed and used to inform an online Delphi survey. This was distributed through a convenience sampling method to 97 healthcare professionals specializing in psoriasis care across Europe and North America. Respondents were offered a four-point Likert scale to indicate their responses. Completed surveys were anonymously collated and analysed by the independent facilitator. The results were then shared with the expert panel to determine conclusions. Stopping criteria for consensus rounds were defined as a 3-month period to collect responses, a minimum of 50 responses within this timeframe, and 90% of statements passing the threshold for consensus. The a priori threshold for consensus agreement was set at 75% and was further defined to be ‘very high’ at ≥ 90%. In total 63 responses (65% response rate) were received. Consensus was achieved for 32 statements and was not achieved for three statements. Given the high level of agreement with the statements, and that the stopping criteria were met, a second round of testing was not performed. The authors offer a definition of disease modification for plaque psoriasis that could be utilized in a clinical setting: ‘A sustained improvement in the disease course of plaque psoriasis resulting from a change in pathophysiology that minimizes the need for treatment.’ To determine the strength of this definition, the next step will be to test it within a real-world clinical setting.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,299 | 0,243 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,004 |
| Bibliométrie | 0,007 | 0,004 |
| Études des sciences et des technologies | 0,005 | 0,009 |
| Communication savante | 0,006 | 0,008 |
| Science ouverte | 0,004 | 0,019 |
| Intégrité de la recherche | 0,005 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».