OBJECTIVE To establish a clinician-led guideline for the diagnosis and treatment of Hirayama disease (HD) using a modified Delphi technique. METHODS Based on a combination of a systematic review and opinion of ten experts, a protocol for the consensus of the diagnosis, treatment and follow-up assessment of HD was established. A modified 3-round Delphi survey was then performed by more than 40 panelists from various countries of the world. Both levels of evidence and levels of agreement were derived in all statements of finial guideline. RESULTS A total of 47 experts from 6 countries were enrolled in the expert panel in this study. Highly consistent results were achieved during the three Delphi rounds. An expert-led guideline finally constructed includes 24 statements related to diagnosis, treatment and follow-up assessment of HD. CONCLUSIONS The modified Delphi technique used in this study resulted in an expert-led guideline concerning several clinical aspects of HD. SIGNIFICANCE This clinician-led guideline may provide a helpful direction for clinical practice with regard to the diagnosis and treatment of HD.

中文翻译：

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使用改良的 Delphi 技术建立由临床医生主导的平山病诊断和治疗指南

目的 使用改良的 Delphi 技术建立临床医生主导的平山病 (HD) 诊断和治疗指南。方法结合系统评价和10位专家意见，建立HD诊断、治疗和随访评估共识方案。然后由来自世界不同国家的 40 多名小组成员进行了经过修改的 3 轮德尔福调查。最终指南的所有声明都得出了证据水平和一致性水平。结果 共有来自 6 个国家的 47 名专家入选本研究的专家组。在德尔福的三轮中取得了高度一致的结果。最终构建的专家主导的指南包括与 HD 的诊断、治疗和后续评估相关的 24 条陈述。结论 本研究中使用的改良 Delphi 技术产生了一个由专家主导的关于 HD 几个临床方面的指南。意义 本临床医生主导的指南可为 HD 诊断和治疗的临床实践提供有用的指导。