Assembling a consensus on actinic cheilitis: A Delphi study

Abstract

Aims:To discuss the terminology to define and classify actinic cheilitis (AC) and to build a consensus on the diagnostic and therapeutic approaches to AC.Methods: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts' agreement was rated using a Likert scale (1-7).Results: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6-7)) and the lowest dispersion (VC = 21.33). 'Potentially malignant disorder' was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV < 50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4-7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5-7), particularly by inspection and palpation (median: 5; IQR: 4-6).Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5-7), even for homogeneous lesions (median: 5; IQR: 3.5-6). Consensus was reached on all treatment statements (VC < 50).Conclusions: AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorder.

Actinic Cheilitis: Epidemiological Study Among Rural Workers

“…Cigarette placement on the lip and continuous exposure to heat generated by smoke seem to potentiate lip changes induced by chronic exposure to solar radiation, also increasing the likelihood of malignant degeneration due to the synergistic action of various carcinogens. 9,11 Although there is no consensus on the influence of alcohol on the development of AK due to the difficulty of adequately quantifying this parameter, alcohol consumption and other factors, especially smoking, favor the development of these labral lesions. 8,12 It is important to discourage smoking, especially among people exposed to more than one risk factor involved in lip and oral carcinogenesis.…”

Developing consensus in Histopathology: the role of the Delphi method

“…In contrast, Seoane et al 17 provide a very good example of methodological detail in their multidisciplinary Table 1. Considerations and recommendation for the optimal design of a Delphi study based upon the findings from this literature review…”

“…In contrast, Seoane et al 17 . provide a very good example of methodological detail in their multidisciplinary Delphi study which aimed to reach consensus on the nomenclature for actinic cheilitis (a potentially malignant lesion of the lip).…”

Long‐term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach

“…This methodology is used to obtain consensus definitions that would be useful for daily practice, especially for areas in which evidence from well‐grounded studies is scant. 3 , 5 , 8 , 9 , 10 We have, therefore, conducted the ProActive Management (PAM) program, a nationwide Italian project, to reach a consensus on the role of proactive management of psoriasis, with a focus on Cal/BD, in terms of its rationale, therapeutic approaches, and optimization of a patient's journey. In particular, we used a combined approach of two different consensus methods, the nominal group technique (NGT) and the Delphi method.…”