Table 4 Individual statements (barriers) to antigen identification that were ranked
Theme | Statement | Groups that ranked the statement (n = 3) |
|---|---|---|
There are still many unknown and undiscovered antigens | Half of the time no antigen is identifiable | 1,2 |
Ubiquitous nature for potential exposures e.g., mold in a significant number of ILD patients | 3 | |
Unclear significance of identified exposures | Patients may have many potential exposures, difficult to know which are relevant or may be causing the disease | 1,2,3 |
There is a question of temporal relationship of the identified exposure | 1,2 | |
Unclear if identified exposure is significant or intense enough to cause disease | 2,3 | |
Difficulty in quantifying level or significance of exposure | 1 | |
No known test that confirms that an antigen identified is actually causing the disease | 1 | |
Gaps in clinical knowledge and testing capabilities | The commercially available hypersensitivity panel is neither sensitive no specific | 1,2,3 |
Problems with obtaining an accurate and comprehensive exposure history | There is no comprehensive user and time friendly evidence-based questionnaire to ask about exposures in the clinic | 2,3 |
Obtaining complete occupational and recreational exposure | 1 | |
Problems with environmental inspections and testing | Lack of professional resources to look for antigens in the home or workplace | 3 |
Cost and availability of environmental sampling and relevance to CHP | 2 |