A Nationwide Survey of Pulmonary Sarcoidosis Clinics in the United States
Received Date: Jan 26, 2017 / Accepted Date: Feb 07, 2017 / Published Date: Feb 14, 2017
Rationale: Management of sarcoidosis patients with the potential for multi-organ involvement can be complex and require the expertise of multiple specialties.
Objectives: Our goal was to estimate the current number of clinics dedicated to the management of patients with sarcoidosis, and to evaluate what clinic structures and definitions currently exist. Methods: A link to an online survey was emailed to Division Directors of Pulmonary and Critical Care Programs at academic medical centers in the United States. The survey email included 126 of the 142 U.S. academic pulmonary and critical care programs. The National Inpatient Sample database (2010) was used to identify yearly hospitalizations for sarcoidosis patients by state, as a surrogate indicator of prevalence of sarcoidosis across the United States.
Measurements and main results: A total of 40 (31.8%) Pulmonary Division Directors responded to the survey. Our survey results suggest a minority of academic medical centers have dedicated sarcoidosis clinics (40%), and that the existence of a dedicated sarcoidosis clinic is associated with the number of sarcoidosis patients seen annually. Only three centers (7.5%) reported having a multidisciplinary sarcoidosis clinic in which providers from different specialties see sarcoidosis patients concurrently. Multidisciplinary sarcoidosis clinics appeared to be located where hospitalization rates for sarcoidosis are higher.
Conclusions: A minority of academic medical centers has a dedicated sarcoidosis clinic, and the minority of dedicated sarcoidosis clinics used a concurrent multidisciplinary model. Additional research comparing patient populations, clinic organization and processes, as well as patient outcomes is needed to determine the optimal clinic structure for sarcoidosis. We assert that the sarcoidosis community should create a standard multidisciplinary model for evaluation, diagnosis, and treatment which could lead to more reliable conclusions and progress in treatment of sarcoidosis.
Keywords: Pulmonary sarcoidosis; Surrogate; Idiopathic pulmonary fibrosis; Bronchiolar epithelial cells; Cystic fibrosis
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