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Agreeing Language in Veterinary Endocrinology (ALIVE): Cushing’s Syndrome and Hypoadrenocorticism—A Modified Delphi-Method-Based System to Create Consensus Definitions
Journal article   Open access   Peer reviewed

Agreeing Language in Veterinary Endocrinology (ALIVE): Cushing’s Syndrome and Hypoadrenocorticism—A Modified Delphi-Method-Based System to Create Consensus Definitions

Stijn J. M. Niessen, Ellen N. Behrend, Federico Fracassi, David B. Church, Sue F. Foster, Sara Galac, Carlos Melian, Álan G. Pöppl, Ian K. Ramsey, Nadja S. Sieber-Ruckstuhl, …
Veterinary sciences, Vol.12(8), 761
2025
DOI: https://doi.org/10.3390/vetsci12080761
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Published635.02 kBDownloadView
CC BY V4.0,  Open Access

Abstract

consensus terminology adrenals Cushing's hypoadrenocorticism endocrinology
To make progress in the field of hormonal diseases in companion animals, it helps when researchers, clinicians, and educators use the same language. Currently, there is no consensus on basic concepts such as what constitutes the correct definition of diseases affecting the adrenal glands, important hormone-producing glands situated next to the kidneys. This publication reports on the second cycle of a novel project called “Agreeing Language in Veterinary Endocrinology” (ALIVE) that brings experts and those interested in the field together to try and achieve consensus on such disease definitions. The cycle’s methods were adapted from previous ones to improve efficiency and were completed successfully, accomplishing a majority-based consensus. It also delivered agreement on diagnostic criteria for adrenal diseases in companion animals. It is hoped the work will improve education, diagnosis, and treatment in this field, ultimately leading to improvements in the quality of life of animals suffering from adrenal disease. Progress in clinical practice, research, and teaching needs a common language. Agreement among veterinary endocrinologists on definitions of concepts related to Cushing’s syndrome (CS) and hypoadrenocorticism is lacking. After a successful inaugural cycle on diabetes mellitus terminology, project Agreeing Language in Veterinary Endocrinology (ALIVE) held a second cycle, with simplified methodology, and brought together 10 experts of the European Society of Veterinary Endocrinology (ESVE) and the Society of Comparative Endocrinology (SCE). It employed a four-round modified Delphi Method to generate draft definitions and try and achieve consensus. A final round used an endorsement survey of the expert-generated definitions distributed to the ESVE and SCE memberships, seeking a simple majority endorsement. A minimum of 20% membership participation was sought. The 10 experts achieved 100% consensus on the definition of 35 adrenal disease-associated concepts, including disease definitions, diagnostic criteria, and test definitions, a disease classification system for CS and hypoadrenocorticism, and a clinical scoring system for CS. Definitions were subsequently assessed by 78 ESVE and SCE members (26% of combined memberships). All definitions achieved a simple majority, ranging from 83.1 to 100%. ALIVE proved effective in creating a body of terminology for adrenal disease in companion animals, which met the overall approval of a majority of those participating in the endorsement phase. The prospective use of these definitions could help improve comparability and standards for adrenal disease research, education, and clinics.

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Collaboration types
Domestic collaboration
International collaboration
Citation topics
3 Agriculture, Environment & Ecology
3.232 Veterinary Sciences
3.232.1715 Canine Orthopedics
Web Of Science research areas
Veterinary Sciences
ESI research areas
Plant & Animal Science
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