COTS Con
This unique survey uses a tiered approach using modified delphi protocol to pool the expertise of Uveitis experts to generate a classification for the strength of clinical suspicion associated with individual clinical findings on history taking or examination; with regards to whether these phenotypes warrant treatment with anti-tubercular therapy (ATT).
COTS Con Nomenclature
COTS Nomenclature done during ARVO Vancouver
Documents
COTS Con Choroiditis - Round #1
In round #1 of Delphi, 81 participants with different level of experience from both endemic and non-endemic regions for TB have ranked 486 statements for consensus on initiating ATT. The responses with median score of 5 ( with IQR of 0,1,2,3) have been recorded as consensus statements to consider initiaitng ATT as recommended by the panel of experts and the responses with median score of 1 ( with IQR of 0,1,2,3) have been recorded as consensus statements to not consider ATT in that patient. The statements with responses of 2 and 3 have significant disagreement between different experts and those need to be addressed in the prospective arm of the study - COTS-2. However, statements with median score of 4 are considered for further brainstorming through the literature review and knowledge sharing session and critical discussion. 71 questions with borderline consensus were deliberated on 16th November 2018 COTS Con Choroidits meeting at PGIMER, India.
Documents
- COTS Con Handbook
- Antitubercular therapy in Serpiginous choroiditis
- Antitubercular therapy in tubercular multifocal or unifocal choroiditis
- Antitubercular therapy in tuberculoma
Methodology:
SCORING OF Expert opinions:
Expert opinions will be awarded a score based on their experience and inputs, whereby initiating anti-tubercular therapy (ATT) is warranted and each score is recorded on the scale of 1-5.
- very low probability to start ATT (<20%)
- lower probability to start ATT (21-40%)
- mixed probability to start ATT (41-60%)
- higher probability to start ATT (61-80%)
- very high probability to start ATT (81-100%)
Experts will provide their inputs based on the scale above.
COTS Con Choroiditis - Round #2
Questions related to anterior uveitis, retinal vasculitis, panuveitis and intermediate uveitis will now be discussed and deliberated and a revoting will be done as a part of Delphi process ( Delphi round 2).
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