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Towards an individualized management strategy for patients with chronic venous disease: Results of a Delphi consensus
S K van der Velden1, R R van den Bos1, O Pichot2
11 Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
Insights
This study established management criteria for chronic venous disease (CVD) using expert consensus. While significant agreement was reached, research gaps remain for complex patient cases.
Area of Science:
- Vascular Medicine
- Phlebology
- Medical Consensus Building
Background:
- Chronic venous disease (CVD; C2-C6) with superficial venous reflux affects many patients.
- Establishing clear management criteria is crucial for effective patient care.
- Existing guidelines may not fully address diverse patient profiles.
Purpose of the Study:
- To achieve expert consensus on management criteria for symptomatic patients with CVD and superficial venous reflux.
- To identify areas of agreement and disagreement among phlebology experts.
- To highlight research gaps in CVD management.
Main Methods:
- A global Delphi method was employed, involving three rounds of emailed statements.
- Twenty-four phlebology experts participated in rating 36 statements on venous treatment criteria.
- Consensus was defined as at least 70% agreement or disagreement on a statement.
Main Results:
- Consensus was achieved on 25 out of 32 statements (78%).
- Agreement was reached on management criteria for various patient characteristics.
- Equivocal results were noted for ultrasound-guided foam sclerotherapy (UGFS), single phlebectomies, and patients with comorbidities or obesity.
Conclusions:
- Considerable expert consensus exists for managing symptomatic CVD patients.
- Specific areas, including UGFS and management of complex cases, require further research.
- The study highlights both areas of agreement and existing gaps in CVD research.
Abstract:
Objective To obtain consensus on management criteria for symptomatic patients with chronic venous disease (CVD; C2-C6) and superficial venous reflux. Method We used a Delphi method by means of 36 statements sent by email to experts in the field of phlebology across the world over the course of three rounds. The statements addressed criteria for different venous treatments in patients with different characteristics (e.g. extensive comorbidities, morbid obesity and peripheral arterial disease). If at least 70% of the ratings for a specific statement were between 6 and 9 (agreement) or between 1 and 3 (disagreement), experts' consensus was reached. Results Twenty-five experts were invited to participate, of whom 24 accepted and completed all three rounds. Consensus was reached in 25/32 statements (78%). However, several statements addressing UGFS, single phlebectomies, patients with extensive comorbidities and morbid obesity remained equivocal. Conclusion Considerable consensus was reached within a group of experts but also some gaps in available research were highlighted.
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