Systemic bias in medical consensus: how flawed panels and lack of evidence can distort definitions and guidelines: the case of Vogt-Koyanagi-Harada disease
Rattachement africain : sa, tw, pt, jp, us, ae. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: The creation of diagnostic criteria for a disease is always challenging in medicine. Consensus meetings and expert's opinions are sometimes responsible for establishing useful and precise diagnostic criteria but, unfortunately, not all the consensus meetings are based on evidence-based conclusions. METHODS: A perspective analysis of the historical evolution of diagnostic criteria for Vogt-Koyanagi-Harada. RESULTS: We examine the historical evolution of diagnostic criteria for Vogt-Koyanagi-Harada disease, an autoimmune condition targeting melanocyte-containing tissues, primarily affecting the choroid and potentially involving the skin, ears, and meninges. Early diagnostic criteria proposed in the late twentieth century were considered inadequate, leading to an international consensus conference in 1999 and the publication of revised diagnostic criteria in 2001. However, these criteria contained major conceptual flaws, notably the combination of acute and chronic clinical features that rarely occur simultaneously. In addition, important diagnostic tools such as indocyanine green angiography were largely excluded due to prevailing local practices and skepticism regarding their use. These limitations hindered accurate diagnosis and delayed recognition of VKH as a disease with distinct acute-onset and chronic forms requiring different diagnostic frameworks and management strategies. Subsequent studies corrected some deficiencies but often generated complex criteria difficult to apply in routine practice. CONCLUSION: We would like to emphasize the risks of poorly structured consensus processes and propose safeguards to ensure scientifically rigorous and clinically useful recommendations.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Systemic bias in medical consensus: how flawed panels and lack of evidence can distort definitions and guidelines: the case of Vogt-Koyanagi-Harada disease
- Date Crossref
- 09/07/2026
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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King Saud University pays non établi dans la noticeUniversité ou école supérieure
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National Yang Ming Chiao Tung University pays non établi dans la noticeUniversité ou école supérieure
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Taipei Veterans General Hospital Department of Ophthalmology pays non établi dans la noticeÉtablissement de santé
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Administração Regional de Saúde de Lisboa e Vale do Tejo pays non établi dans la noticeOrganisme public
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Taichung Veterans General Hospital Department of Ophthalmology pays non établi dans la noticeÉtablissement de santé
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The University of Osaka pays non établi dans la noticeUniversité ou école supérieure
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Cleveland Clinic Lerner College of Medicine Department of Ophthalmology pays non établi dans la noticeÉtablissement de santé
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Cleveland Clinic Abu Dhabi pays non établi dans la noticeÉtablissement de santé
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National Defense Medical College pays non établi dans la noticeUniversité ou école supérieure
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Tokyo Medical University Department of Ophthalmology pays non établi dans la noticeUniversité ou école supérieure
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Retinal and Inflammatory Eye Diseases pays non établi dans la noticeInstitution
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School of Medicine Department of Ophthalmology pays non établi dans la noticeUniversité ou école supérieure
King Saud University, National Yang Ming Chiao Tung University et Department of Ophthalmology — Taipei Veterans General Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.