SAT0610 THE DELPHI METHOD IN RHEUMATOLOGY RESEARCH: ARE WE DOING WELL?

Abstract

Background: Delphi method is an iterative process, designed to combine the opinion of a group of experts within a consensus. It is a structured methodology to systematically collect expert judgments about a problem, process the information and finally build a general group agreement1. It has 4 defining characteristics: iterative, anonymous process, generates feedback and generates a consensus2. Objectives: To evaluate the methodology and application of the Delphi method in rheumatology research. Methods: Search of the literature was performed in the MEDLINE, EMBASE, Clinical key and Scielo databases. MESH terms “Delphi Technique”, “Rheumatology” and “Consensus” were used, finding 404 articles. A total of the abstracts of these studies was read, discarding duplicates, articles of consensus methodology different from the Delphi technique and articles from studies of other specialties. The consultation was held on 30-10-18. Results: 109 articles were found. Journal with highest number of publications was Clinical Rheumatology (30 articles), followed by Journal of Rheumatology (11 articles). Rheumatoid arthritis was the first rheumatic diseases studied in 21.1% (n=23), followed by psoriatic arthritis in 11% (n=12). Only 16.5% (n=18) of the studies met the 4 characteristics of the Delphi method, 31.2% (n=34) met 3 characteristics, 18.3% (n=20) met 2 characteristics and 33.9% (n=37) meets only one of the defining characteristics of the method. Feedback was made in 43.1% (n=47) of the studies. Process was iterative in 64.2% (n=70) of papers. The coordinating group of the exercise was only reported in 27.5% (n=30), with an average of 8 (± 3.14) coordinators for each study. The group of experts was reported in 93.6% (n=102) of the studies, with a median of 28 (interquartile range: 54) experts per study. In 30.4% (n = 45) of the studies, the way in which communication with the group of experts was established was not reported. The modification of the Delphi technique was declared in 14.9% (n = 22) of the studies, however, in 18 of these studies it is not explained which was the modification of the technique; in 4 studies, the modification consisted of holding a face-to-face meeting of the group of experts after the consultation rounds; one of the studies clarifies having made a “RAND/UCLA” method without explaining in more detail what this method consists of. To refer to the modified versions of the method, terms such as “informal Delphi” or “Delphi like study” are coined, without further considerations or clarifications to what these mean Conclusion: Use of Delphi technique in rheumatology has not been carried out following the original methodology in most of the evaluated works, which puts at risk the validity of the results of these studies. Propening for the correct use of the technique, will improve the validity of the results obtained with this type of qualitative research. It is necessary to establish and validate minimum compliance criteria, so that an expert consensus exercise through the Delphi method achieves its purpose in a valid way. This context allows to open a line of methodological research in evaluation of the application of the Delphi methodology in the health area.