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Development of a standardized definition for Hirschsprung's-associated enterocolitis: a Delphi analysis
Aimee C Pastor1, Fahima Osman, Daniel H Teitelbaum
1Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Pediatric Surgery
|January 23, 2009
Summary
A Delphi consensus identified key diagnostic criteria for Hirschsprung's-associated enterocolitis (HAEC). This standardized HAEC score improves outcome measure reliability in Hirschsprung's disease research.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Diagnostics
Background:
- Hirschsprung's-associated enterocolitis (HAEC) incidence varies widely.
- A standardized definition is needed for comparable studies and interpretable outcomes in Hirschsprung's disease.
Purpose of the Study:
- To establish a standardized definition and diagnostic criteria for HAEC.
- To develop a reliable outcome measure for future research in Hirschsprung's disease.
Main Methods:
- Utilized the Delphi method with 27 pediatric surgeons and gastroenterologists.
- Experts ranked 38 potential diagnostic criteria using Likert scales over multiple survey rounds.
- Developed and validated a "HAEC score" based on expert consensus.
Main Results:
- Achieved high expert consensus (Cronbach's alpha 0.97).
- Key criteria identified: diarrhea, explosive stools, abdominal distension, bowel obstruction, and mucosal edema.
- The validated HAEC score correctly identified HAEC in 9 out of 10 cases.
Conclusions:
- Identified essential clinical diagnostic criteria for HAEC through expert consensus.
- Developed a validated HAEC score for standardized, reproducible outcome measurement.
- The score facilitates future prospective studies in children with Hirschsprung's disease.
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