Chest
Original ResearchDiffuse Lung DiseaseManagement of Cardiac Sarcoidosis in the United States: A Delphi Study
Section snippets
Materials and Methods
To learn about current clinical practices and attempt to see if consensus existed regarding these practices, a Delphi study design was used.9, 10 The institutional review board at National Jewish Health approved the study under exempt status (HS#2513). Two rounds of questionnaires were e-mailed to sarcoidosis specialists in the United States. The questions were in the multiple choice format but also included an “other” choice for free-text comments.
The experts were chosen based on their known
Characteristics of the Study Participants
Forty-two sarcoid experts were invited to participate (36 pulmonologists, three cardiologists, three electrophysiologists, one rheumatologist). Thirty-one of the 42 (73.8%) responded to the first round of questions, and 27 of the 31 (87.1%) who responded to the first questionnaire responded to the second round of questions. Characteristics of the experts are shown in Table 1. The majority were pulmonologists and 64.5% have been practicing for > 10 years, and 87.1% (27/31) manage on average >
Discussion
In an editorial titled “Cardiac sarcoidosis: there is no instant replay,” Dr Marc Judson8 exemplified the anguish physicians have to deal with when caring for patients with sarcoidosis. Detected clinically in 5% of cases2 but most likely present in at least 40%,11 sarcoid physicians struggle to narrow this gap. There is a significant lack of prospective studies that can guide physicians on the best screening, diagnostic, and management strategies. In addition, the lack of a gold standard for
Acknowledgments
Authors contributions: Dr Hamzeh had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Hamzeh: contributed to the study concept, design, and implementation; data analysis and interpretation; and the writing of the manuscript.
Dr Wamboldt: contributed to the study concept and reviewed and critiqued the manuscript.
Dr Weinberger: contributed to the study design and data analysis and reviewed and critiqued the
References (26)
- et al.
Myocardial sarcoidosis
Chest
(1993) - et al.
Sarcoidosis mortality in the United States 1979-1991: an analysis of multiple-cause mortality data
Am J Med
(1996) Myocardial sarcoidosis. A wolf in sheep's clothing
Chest
(1994)Cardiac sarcoidosis: there is no instant replay
Chest
(2005)- et al.
Cardiac involvement in patients with sarcoidosis: diagnostic and prognostic value of outpatient testing
Chest
(2008) - et al.
Diagnostic and prognostic value of myocardial scintigraphy with thallium-201 and gallium-67 in cardiac sarcoidosis
Chest
(1995) - et al.
Holter monitoring as a noninvasive indicator of cardiac involvement in sarcoidosis
Chest
(1994) - et al.
Value of MRI for the diagnosis of cardiac involvement in sarcoidosis [in French]
Rev Med Interne
(2003) - et al.
The additional value of gadolinium-enhanced MRI to standard assessment for cardiac involvement in patients with pulmonary sarcoidosis
Chest
(2005) - et al.
Effectiveness of prolonged fasting 18F-FDG PET-CT in the detection of cardiac sarcoidosis
J Nucl Cardiol
(2009)
Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis
J Am Coll Cardiol
Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone
Am J Cardiol
Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS), and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999
Am J Respir Crit Care Med
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Funding/Support: Supported by NIH/NCATS Colorado CTSI Grant Number UL1 TR000154. Contents are the authors' sole responsibility and do not necessarily represent official NIH views.
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