Evaluating the need for standardised disease manifestation categories in patients infected with the tick-borne encephalitis virus: A Delphi panel.

Categorization systems for tick-borne encephalitis virus (TBEV) infection lack consistency in classifying disease severity. To evaluate the need for a standard, consensus-based categorisation system for TBEV infection across subtypes, we gathered an expert panel of clinicians and scientists with diverse expertise in TBEV infection. Consensus was sought using the Delphi technique, which consisted of 2 web-based survey questionnaires and a final, virtual, consensus-building exercise. Ten panellists representing 8 European countries participated in the Delphi exercise, with specialities in neurology, infectious disease, paediatrics, immunology, virology, and epidemiology. Panellists reached unanimous consensus on the need for a standardised, international categorisation system to capture both clinical presentation and severity of TBEV infection. Ideally, such a system should be feasible for use at bedside, be clear and easy to understand, and capture both the acute and follow-up phases of TBEV infection. Areas requiring further discussion were (1) the timepoints at which assessments should be made and (2) whether there should be a separate system for children. This Delphi panel study found that a critical gap persists in the absence of a feasible and practical classification system for TBEV infection. Specifically, the findings of our Delphi exercise highlight the need for the development of a user-friendly classification system that captures the acute and follow-up (i.e., outcome) phases of TBEV infection and optimally reflects both clinical presentation and severity. Development of a clinical categorisation system will enhance patient care and foster comparability among studies, thereby supporting treatment development, refining vaccine strategies, and fortifying public health surveillance.
Competing Interests: Declaration of competing interest J.R. and M.P. are full-time employees of RTI Health Solutions, an independent nonprofit research organisation, which received funding from Pfizer in connection with the development of this manuscript. Their compensation is unconnected to the studies on which they work. M.G. was a full-time employee of RTI Health Solutions at the time this study was conducted. K.H., H.M., F.J.A., and A.P. are employees of Pfizer Inc. and hold stock and stock options in Pfizer Inc. W.E. was an employee of Pfizer Inc. at the time of the project, and holds stock options in Pfizer Inc. A.E. does not receive any personal grants or honoraria from corporate or pharmaceutical companies. Encephalitis International (of whom A.E. is Chief Executive) does receive grants, expenses, and honoraria from a range of corporate partners, including the sponsor of this study (Pfizer) and other pharmaceutical companies involved in tick-borne encephalitis. J.S. received consulting fees from Pfizer. F.S. served on the scientific advisory board on Lyme disease serological diagnostics for Roche, served on the scientific advisory board on Lyme disease and panel on TBE for Pfizer, and is an unpaid member of the steering committee of the ESCMID Study Group on Lyme Borreliosis/ESGBOR. M.V. has received consultancy funding from Bavarian Nordic and Pfizer Vaccines. D.Z. declares a research grant within the Research Collaboration to Rıga Stradinš University (employer) from Pfizer Vaccines. U.K.M.-L has received consulting and lecture fees from Pfizer and Biogen. G.D., G.K., L.K., J.K., and J.Z. have no conflicts of interest to disclose.
(Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)