Validation of an Educational Tool for Skin Abscess Incision and Drainage by Delphi and Angoff Methods.

Online CKD Education for Medical Students, Residents, and Fellows: Training in a New Era

Data collection and review are the building blocks of academic research regardless of the discipline. The gathered and reviewed data, however, need to be validated in order to obtain accurate information. The Delphi consensus is known as a method for validating the data. However, several studies have shown that this method is time-consuming and requires a number of rounds to complete. Until now, there has been no clear evidence that validating data by a Delphi consensus is more significant than by a general consensus. In this regard, if data validation between both methods are not significantly different, then just using a general consensus method is sufficient, easier, and less time-consuming. Hence, this study aims to find out whether or not data validation by a Delphi consensus method is more significant than by a general consensus method. This study firstly collected and reviewed the data of sustainable building criteria, secondly validated these data by applying each consensus method, and finally made a comparison between both consensus methods. The results showed that seventeen of the valid criteria obtained from the general consensus and reduced by the Delphi consensus were found to be inconsistent for sustainable building assessments in Cambodia. Therefore, this study concludes that using the Delphi consensus method is more significant in validating the gathered and reviewed data. This experiment contributes to the selection and application of consensus methods in validating data, information, or criteria, especially in engineering fields.

Our aim was to develop and assess the feasibility of an education tool to improve health outcomes of patients with thalassemia. Thirty-five patients attending a Canadian thalassemia clinic were enrolled. Acting in an expert role, they participated in a Delphi method to reach consensus as to what tools and information should be incorporated in the development of a self management Smartphone app. One- and 6-month usability and health impact feedback surveys were built-in. Sixty percent of responders were 18–34 years old, over 50.0% had a college degree. The Delphi method successfully generated a comprehensive list of features important to patients. The app has been downloaded 147 times globally. Between March 2015 and January 2016, 19 responses for the 1-month survey were collected and the trends described. Responders reported improved medication adherence. The personal adherence pledge feature supports gamification of health apps to individualize goals of therapy. The impact of tracking iron levels was highly favorable. The Delphi method was an effective way to introduce a patient education and empowerment tool to the thalassemia population. The long-term impact requires data maturation. Use of validated methodology is essential to ensure ehealth interventions are positively contributing to patient education and disease outcomes.

PurposeThe percent Angoff (PA) method has been recommended as a reliable method to set the cutoff score instead of a fixed cut point of 60% in the Korean Medical Licensing Examination (KMLE). The yes/no Angoff (YNA) method, which is easy for panelists to judge, can be considered as an alternative because the KMLE has many items to evaluate. This study aimed to compare the cutoff score and the reliability depending on whether the PA or the YNA standard-setting method was used in the KMLE.MethodsThe materials were the open-access PA data of the KMLE. The PA data were converted to YNA data in 5 categories, in which the probabilities for a “yes” decision by panelists were 50%, 60%, 70%, 80%, and 90%. SPSS for descriptive analysis and G-string for generalizability theory were used to present the results.ResultsThe PA method and the YNA method counting 60% as “yes,” estimated similar cutoff scores. Those cutoff scores were deemed acceptable based on the results of the Hofstee method. The highest reliability coefficients estimated by the generalizability test were from the PA method and the YNA method, with probabilities of 70%, 80%, 60%, and 50% for deciding “yes,” in descending order. The panelist’s specialty was the main cause of the error variance. The error size was similar regardless of the standard-setting method.ConclusionThe above results showed that the PA method was more reliable than the YNA method in estimating the cutoff score of the KMLE. However, the YNA method with a 60% probability for deciding “yes” also can be used as a substitute for the PA method in estimating the cutoff score of the KMLE.

Severity grading system for acute allergic reactions—time for validation and assessment of best practices

Cabazitaxel is a second line chemotherapy drug recently approved for the treatment of metastatic castration-resistant prostate cancer. A first panel of French experts and a second independent panel of European experts were convened to assess the conformity of prescription of cabazitaxel with a Delphi consensus method. A two-round modified Delphi consensus process was conducted. This methodology is based on experts’ opinion obtained in a systematic manner. The process was divided into five steps: (i) elaboration of the questionnaire, (ii) rating, (iii) analysis, (iv) discussion of the points with absence of consensus following rating of the questionnaire, and (v) final reporting. Consensus was defined according to RAND method and all analyses were conducted according to the same methodology. At the end of the two rounds of rating and a synthesis meeting, of the 26 items included in the Summary of Product Characteristics (SPC), 11 items were judged appropriate with strong consensus by the two independent panels of experts. These items can therefore be considered of prime importance to evaluate conformity of cabazitaxel prescription in the context of observatory studies as well as in further clinical trials using this new taxane. Our findings further provide important evidence about the value of the Delphi consensus and highlight a requirement for “conformity” standards to assist practitioners in a safe chemotherapy drug prescription.

BackgroundLung volume reduction (LVR) is an effective treatment option offered to patients with emphysema. There is no formalised LVR referral network in Ireland. A rigorous approach to agreeing and implementing a LVR referral framework in an Irish context is required. A Delphi process was used to provide a basis for a framework of multi-disciplinary teams (MDTs) which can provide LVR as a management option. A Delphi process offers a framework for understanding variations and developing a consensus from expert opinion.AimThe aim of this study was to develop consensus on recommendations for LVR referral guidelines in an Irish context and provide a national scope based on current practice and evidence.DesignIn accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building Delphi study was performed. Thirty-three statements informed from review of research literature were identified and presented to participants. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ≥ 70% agreement was defined as consensus and items with a consensus rating of < 70% were revised during the process. In total, Delphi questionnaires were distributed to 18 experts with a response rate of 78% (n = 14) and a follow-up response-rate of 50% (n = 7).Setting/participants.The expert panel in Ireland consisted of representatives from respiratory medicine, cardiothoracic surgery and allied-health professionals with expertise in COPD care.ResultsOf the initial 33 statements in five dimensions, there were consensus regarding 31 statements.ConclusionsThe 31 statements agreed through this Delphi study clarify a coherent direction for development of a LVR framework in Ireland. The Delphi study methodology described is a useful process to reach consensus among multi-disciplinary experts.

Delphi studies have established themselves in the health sciences as a means to systematically and, ideally, synthesize expert opinions into a consensus on concrete issues. As participatory health research increases in relevance, lifeworld experts (e.g., patients, caregiving relatives) are being included in Delphi surveys and their opinions placed alongside those of professional and scientific experts. Looking at the theory and methodology, we discuss the opportunities and challenges concerning result quality and derive practical implications for conducting Delphi studies involving lifeworld experts alongside scientific and/or professional experts. Delphi techniques are understood here to be social interaction processes whose outcomes are a result of the participating experts' conscious, cognitive judgment processes, and also shaped by individual, situational and cultural factors. The more heterogeneous the expert panel, in particular when lifeworld experts are participating, the more these influences vary. Expert panel composition and how diversity is handled prove significant to Delphi study results. Our argument is based on an in-depth analysis of a systematic review of Delphi studies with lifeworld experts. We found that the inclusion of lifeworld experts in Delphi studies usually occurs relatively unsystematically and, furthermore, that results are not analysed separately according to expert group, although there would be good reasons for this. We have oriented the reporting here on PRISMA. To enhance the outcomes of Delphi studies that incorporate lifeworld experts alongside scientific and/or professional experts, we put forward specific recommendations that address potential biases arising from the participation of lifeworld experts.

Distribution transformer maintenance plays a critical role in ensuring the continuity and reliability of PLN’s electricity supply. Currently, PLN employs a Condition-Based Maintenance (CBM) approach, relying on a Health Index (HI) derived from Tier 1 and Tier 2 inspection outcomes. However, in practice, determining maintenance priorities remains largely dependent on the intuition and technical experience of decision-makers, leading to potential inconsistencies in decision-making. Additionally, the absence of a structured weighting mechanism among HI parameters and unclear relevance of indicators used further hampers valid and reliable decision-making aligned with current operational conditions. This research aims to propose a structured and adaptive Health Index evaluation method through the integration of the Delphi and Analytical Hierarchy Process (AHP) methods. The Delphi method was employed to identify the most relevant parameters based on expert consensus, while the AHP method provided logical and consistent weighting among these parameters. Although AHP does not entirely eliminate subjectivity, as it still depends on expert judgments, it offers a systematic and transparent way to manage conflicting criteria effectively. The Delphi application yielded seven sub-criteria parameters grouped into three main criteria: oil leakage, transformer body temperature, load percentage, grounding value, physical condition, transformer age, and neutral current percentage. Based on AHP analysis, the oil leakage parameter was identified as having the highest weighting (0.23), indicating its significant impact on transformer performance. Applying this methodology to 253 distribution transformers resulted in prioritizing maintenance into three categories: Priority I (4 transformers), Priority II (54 transformers), and Priority III (195 transformers). The findings and validation from this study demonstrate that a structured, weighting-based approach significantly enhances the accuracy and transparency of decision-making processes in asset maintenance management.

Evaluation of surgical competency has important implications for training new surgeons, accreditation, and improving patient outcomes. A method to specifically evaluate dissection performance does not yet exist. This project aimed to design a tool to assess surgical dissection quality. Delphi method was used to validate structure and content of the dissection evaluation. A multi-institutional and multi-disciplinary panel of 14 expert surgeons systematically evaluated each element of the dissection tool. Ten blinded reviewers evaluated 46 de-identified videos of pelvic lymph node and seminal vesicle dissections during the robot-assisted radical prostatectomy. Inter-rater variability was calculated using prevalence-adjusted and bias-adjusted kappa. The area under the curve from receiver operating characteristic curve was used to assess discrimination power for overall DART scores as well as domains in discriminating trainees (≤100 robotic cases) from experts (>100). Four rounds of Delphi method achieved language and content validity in 27/28 elements. Use of 3- or 5-point scale remained contested; thus, both scales were evaluated during validation. The 3-point scale showed improved kappa for each domain. Experts demonstrated significantly greater total scores on both scales (3-point, p< 0.001; 5-point, p< 0.001). The ability to distinguish experience was equivalent for total score on both scales (3-point AUC= 0.92, CI 0.82-1.00, 5-point AUC= 0.92, CI 0.83-1.00). We present the development and validation of Dissection Assessment for Robotic Technique (DART), an objective and reproducible 3-point surgical assessment to evaluate tissue dissection. DART can effectively differentiate levels of surgeon experience and can be used in multiple surgical steps.

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ObjectiveTo establish an expert consensus on which criteria are the most appropriate in clinical practice to refer patients with systemic sclerosis (SSc) for right heart catheterisation (RHC) when pulmonary hypertension...

Purpose: This study explored the reliability and credibility of a standardized patient (SP)-based performance exam in physician assistant (PA) education with passing standards set using the Angoff method. Methods: PA faculty were asked to serve as judges, using the Angoff method to set a passing cut-off score for a four-case SP exam. Fifty-eight clinical-year PA students were evaluated using the exam. Passing cut-off levels and passing rates were reported for the Angoff method, for a fixed percentage cut-off score of 70%, and for a norm-referenced standard. Reliability of test items was assessed using Cronbach's alpha. Judge agreement was evaluated using kappa statistics. Credibility of judge's ratings was assessed using Pearson correlation, comparing student performance on test items with item difficulty as defined by the Angoff method. Results: The passing score was 62% (100% pass rate) for the Angoff method, 70% (88% pass rate) for the fixed percentage, and 72% (81% pass rate) for the relative standard. Cronbach's alpha for the test items was 0.75. Judge agreement was substantial (kappa coefficient = 0.71). Pearson correlation between actual item difficulty and difficulty as predicted by the Angoff method showed significant positive correlations (+0.44, p < 0.05). Conclusions: The Angoff method proved to be a reliable and credible method for setting a passing cut-off score for the exam. This study demonstrates that different standard-setting methods yield different results and care should be taken to engage in a defensible process when making grading decisions for SP examinations.

Background There is a need for an accurate assessment of the patterns and determinants of sexual and reproductive health in South Asia owing to high fertility rates and high incidence of unplanned pregnancy among adolescents. Health indicator sets, with a wide range of health dimensions, also support in formulating evidence-based policies. For attaining this, indicators should be developed and prioritized based on consensus and relevance. Objective This study aimed to develop a comprehensive list of adolescent sexual and reproductive health (ASRH) key indicators for South Asia through systematic participatory expert consultation exercise using the Delphi technique. Methods Experts were invited to two rounds of an indicator rating exercise and a third round to discuss the results in a broader regional perspective. A list of nine indicator categories, including 41 adolescent health indicators, was rated by the expert panel. Prioritization was based on mean Likert scores while consensus was established using Kendall’s W. Results 24, 16 and six experts participated in the first, second and third round, respectively. Out of the nine indicator categories, demographics, reproductive health, violence, and nutrition were ranked high in relevance by the expert panel. Experts had a strong consensus on the relevance of parental control and connection, and behavioral indicators while there was moderate consensus on the relevance of nutrition, infectious disease, and mortality indicators. Conclusion As far as we know, this is the first study that employs the Delphi technique for prioritizing ASRH indicators for South Asia. Engaging a diverse group of experts, using an online platform, we developed a comprehensive list of key indicators for appraising ASRH relevant to South Asia based on expert panel consensus and recommendations. Our results also highlight that there is a need for developing a region-specific prioritized list of indicators which might assist in identifying regional health needs.