Delphi Expert Panel Research Articles

Insights from an international clinic survey on CIED patient management practices and perceptions

Abstract Background Remote monitoring (RM) is recommended as standard of care to manage patients with cardiac implantable electronic devices (CIEDs). However, implementation within overall follow-up (FU) practice is challenging with many organizational aspects to consider. While the 2023 HRS/EHRA/APHRS/LAHRS consensus on management of remote device clinics provided guidance, data on current patient management practice is lacking to understand existing gaps. Purpose This survey of device clinic staff characterized the state and perceptions of CIED patient management. Methods A Delphi panel of US and EU clinical experts guided the research objectives, structure, and content of the survey. Once consensus was reached, the online survey (Qualtrics) was deployed in partnership with HRS. An available case analysis was performed to handle missing data. Results A total of 471 responses were received between September 2023-January 2024 (66% US, 19% Europe, 15% other). Overall, performing a combination of in-office visits and RM was the most frequent FU practice for all devices. Remote-only management was only commonly reported for insertable cardiac monitors (ICM). Adoption of RM was lower in EU compared to US for therapeutic devices, especially pacemakers for which in-person only FU remained high (Figure 1). Frequency of routine visits and transmissions is reported in Figure 2. While the majority of respondents (48-67%, depending on device type) expressed that less than 20% routine visits are actionable, adopting a practice of FU visits scheduled every 2 years as suggested in the 2023 consensus was rarely reported for therapeutic devices. However, alert-based RM seems to emerge for ICM without routine FU. In the US, frequency of scheduled transmissions appeared aligned with reimbursement rules (monthly for ICMs; quarterly for therapeutic devices), whereas there was more variability in EU where RM often lacks clear funding. Divided opinion was observed regarding staff sufficiency as 43% found staffing levels somewhat/very sufficient, while 42% rated it as somewhat/very insufficient. Managing disconnected patients, initial transmission review, and patient phone calls were identified as most burdensome tasks and were the ones for which there was most willingness to outsource. Although 60% respondents rated their practice as somewhat/very efficient, the majority (45%) did not report monitoring performance. The minority (29%) assessing patient management performance primarily tracked workload volume rather than quality-related metrics. Conclusion This large international survey characterized contemporary CIED patient management practices. While the 2023 HRS/EHRA/APHRS/LAHRS consensus highlighted the potential for alert-based RM, reducing in-person visits, and third-party resources to streamline patient FU, these practices have yet to be fully implemented. As such, there is opportunity to standardize and optimize workflows to drive efficiency and quality of care.Follow-up paradigm by regionFrequency of routine follow-up

COVID-19 Vaccination Recommendations for Immunocompromised Patient Populations: Delphi Panel and Consensus Statement Generation in the United States.

The United States Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) recommend COVID-19 vaccines for all immunocompromised individuals. Certain disease groups are at increased risk of comorbidity and death for which disease-specific recommendations should be considered. The objective of the Delphi panel of experts was to summarize expert consensus on COVID-19 vaccinations for patients with rheumatologic disease, renal disease, hematologic malignancy and solid organ transplant (SOT) in the US. A two-stage Delphi panel method was employed, starting with qualitative interviews with key opinion leaders (KOLs) in the four disease areas (n = 4 KOLs, n = 16 total) followed by three rounds of iterative revision of disease-specific COVID-19 vaccine recommendations. Final consensus was rated after the third round. Statements addressed primary and booster dosing (e.g., number and frequency) and other considerations such as vaccine type or heterologous messenger ribonucleic acid (mRNA) vaccination. Following the Delphi Panel, an online survey was conducted to assess physician agreement within the disease areas (n = 50 each, n = 200 total) with the consensus statements. Moderate to strong consensus was achieved for all primary series vaccination statements across disease groups, except one in hematology. Similarly, moderate to strong consensus was achieved for all booster series statements in all disease areas. However, statements on antibody titer measurements for re-vaccination considerations and higher dosages for immunocompromised patients did not reach agreement. Overall, approximately 62%-96% of physicians strongly agreed with the primary and booster vaccine recommendations. However, low agreement (29%-69%) was found among physicians for time interval between disease-specific treatment and vaccination, recommendations for mRNA vaccines, heterologous mRNA vaccination, antibody titer measurement and higher vaccine dosage for immunocompromised groups. Consensus was achieved for disease-specific COVID-19 vaccine recommendations concerning primary and booster series vaccines and was generally well accepted by practicing physicians.

Development and psychometric testing of the nurses' core competencies for public health emergencies scale: A multicenter cross-sectional study

BackgroundThe significance of addressing public health emergencies (PHEs) emphasizes the pivotal role of a skilled nursing workforce in effective preparedness and response. However, there's a lack of comprehensive assessments tailored to nurses' core competencies, serving as a standard for ongoing education in preparedness. ObjectiveThis study aimed to develop a psychometrically sound scale for identifying and measuring essential core competencies crucial for nurses during public health emergencies. DesignA multicenter cross-sectional study was conducted. SettingsTwelve tertiary hospitals in Shanghai. ParticipantsAffiliated nurses with prior experience and significant exposure to public health emergencies were recruited. MethodsThe study underwent development and validation in two stages, utilizing qualitative data analysis, a Delphi expert panel, and an empirical quantitative cross-sectional survey. The Nurses' Core Competencies for Public Health Emergencies (NCC-PHEs) scale and a demographic questionnaire were distributed between January 2023 and March 2023. Exploratory factor analysis, confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were employed to identify theoretical constructs, assess scale reliability, and establish validity. ResultsAnalysis was conducted on valid data collected from 1481 nurses. Factor analysis identified 47 professional nursing competencies arranged within a four-factor high-order model: prevention competencies (9 items), preparation competencies (7 items), response competencies (comprising basic and advanced levels) (26 items), and recovery competencies (5 items). Structural equation modelling confirmed satisfactory factor loadings and a good model fit, validating construct integrity. The reliability of the total scale was confirmed. ConclusionThis study presents a valid scale that empirically measures nurses' core competencies crucial for preparedness and response during public health emergencies. The findings offer instrumental support for guiding the development of future courses and training programs in nursing research and practice.

Creating a postgraduate syllabus for a team care diploma examination: a Delphi study

ObjectivesThere is no agreed standard assessment of the minimum knowledge and skills that are required to provide healthcare to participants in individual or team sports. This study aims to develop...

Check of APpropriaTeness of Antimicrobial therapy In Nursing homes (CAPTAIN):a point prevalence study in Belgium.

The overall prevalence of antimicrobial therapy (AMT) in nursing homes is well described. However, less is known about the appropriateness of AMT in nursing home residents. Therefore, the Check of APpropriaTeness of antimicrobial therapy in nursing homes (CAPTAIN) study aimed to assess both prevalence and appropriateness of AMT in Belgian nursing homes. In a prospective, observational, point prevalence study, researchers documented prevalence and identified potentially inappropriate prescriptions (PIPs) by evaluating accordance of AMT with national guidelines. The severity of inappropriateness was assessed by a modified Delphi expert panel. Eleven nursing homes, including 1178 residents, participated in this study. On the survey day, 8.0% of residents took systemic AMT, primarily for urinary tract infections (54.2%), respiratory tract infections (36.5%), and skin and skin-structure infections (6.3%). About half of these prescriptions were used in prophylaxis (52.1%). Registration of indication and stop date was missing in 58.3% and 56.3% of AMTs, respectively. In 89.6% of the systemic AMTs, at least one discordance with national guidelines was identified, resulting in a total of 171 PIPs, with 49 unique PIPs. Of all unique PIPs, 26.5% were assessed with a high severity score (≥4). According to the expert panel, most inappropriate practice was starting AMT for cough without other symptoms. Inappropriate timing of time-dependent AMTs was common, but assessed as 'moderately severe'. One-third of systemic AMT exceeded the recommended duration. AMT in nursing homes is often not prescribed according to national guidelines, highlighting the need for future interventions to promote the rational use of AMT in this setting.

Psychometric validation of the Chinese versions of the quality of communication questionnaires for cancer patients and their family caregivers

BackgroundGiven the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties.MethodsThe QOC-P and QOC-F were translated following an adapted version of Brislin’s translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined.ResultsThrough exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach’s coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P (r = -0.233 & -0.241, p < 0.001) and QOC-F (r = -0.464 & -0.420, p<0.001). The QOC-P showed a negative correlation with decision regret (r = -0.445, p<0.001) and a positive correlation with shared decision-making (r = 0.525, p<0.001), as hypothesized.ConclusionThe QOC-P and QOC-F show acceptable psychometric properties for evaluating the quality of communication between physicians and cancer patients and their family caregivers in both clinical and research contexts. Future studies should use more diverse and inclusive samples to test the structure of the Chinese version of the QOC-P and QOC-F with confirmatory factor analysis.

A systematic review and expert Delphi Consensus recommendation on the use of vaccines in patients receiving dupilumab: A position paper of the American College of Allergy, Asthma and Immunology

BackgroundDupilumab is a monoclonal antibody that targets the interleukin (IL)-4 receptor alpha subunit, thus blocking the effects of IL-4 and IL-13, and has shown efficacy in treating various conditions including asthma, atopic dermatitis, eosinophilic esophagitis, and others. Because of its immune modulatory effects, clinical trials that studied dupilumab did not allow patients to receive live vaccines during the clinical trials because of an abundance of caution, and thus package inserts recommend that patients who are being treated with dupilumab should avoid live vaccines. Because dupilumab is now approved for use in patients from 6 months of age for the treatment of atopic dermatitis, this reported contraindication is now posing a clinical dilemma for patients and clinicians. ObjectiveTo perform a systematic review of literature on the safety and efficacy of vaccinations in patients who are receiving dupilumab and to provide expert guidance on the use of vaccines in patients who are receiving dupilumab. MethodsA systematic review of the literature was performed, and an expert Delphi Panel was assembled. ResultsThe available literature on patients who received vaccinations while using dupilumab overall suggests that live vaccines are safe and that the vaccine efficacy, in general, is not affected by dupilumab. The expert Delphi panel agreed that the use of vaccines in patients receiving dupilumab was likely safe and effective. ConclusionVaccines (including live vaccines) can be administered to patients receiving dupilumab in a shared decision-making capacity.

Disaster management with cloud-based geographic information systems: site selection of landfill areas after Kahramanmaraş, Türkiye earthquake sequence

On February 6, 2023, the earthquakes centered on Kahramanmaraş-Pazarcık and Kahramanmaraş-Elbistan affected several provinces in the region and generated a vast amount of demolition waste. This study aims to develop a site selection model for the most suitable landfill areas after the earthquake using open-source Geographic Information Systems (GIS) software and the Best-Worst Method (BWM). First, the study identifies decision criteria with a Delphi expert panel. Next, it determines the weights using the BWM based on pairwise comparison. Spatial data of the determinants were obtained from open data portals, and proximity, overlay, and slope analyses were carried out for the disaster region. Combining the output data layer of each criterion, a suitability map of the landfills was produced. As a result, 36,2% (29,826 kms square) of the study area was classified as suitable and very suitable. In this study, a cloud GIS-based decision support platform was developed to act quickly and initiate recovery processes within the scope of disaster management of the destructive earthquake. The suitability map and potential sites were shared with the responsible teams in the disaster area so that the potential sites could be displayed on the map and the suitable areas could be navigated on appropriate routes. The findings of the study revealed that the use of open data and cloud GIS framework in the disaster management process enables quick, reliable, and cost-effective actions in the immediate aftermath of disasters.

Research priorities in tranexamic acid after trauma: Secondary analysis of the National Trauma Research Action Plan.

Tranexamic acid (TXA) is an antifibrinolytic drug that is used in traumatic hemorrhage and traumatic brain injury. Although TXA is considered relatively safe and inexpensive and is widely available, data regarding its mechanisms, optimal dosing, and timing, as well as relative risks and benefits for different patient populations, are inconsistent. In this study, we aim to identify and summarize consensus research questions related to TXA across all National Trauma Research Action Plan (NTRAP) Delphi expert panels to identify priorities for future research on TXA in trauma. A secondary analysis was performed using consensus-based research priorities collected by 11 NTRAP topic panels using a Delphi methodology. The database of questions was queried for the keywords "tranexamic" and "TXA." The identified questions were sorted by subject matter and summarized. Seven panels included a total of 73 TXA-related questions. Forty-six questions reached consensus. The most addressed topic was outcomes (discussed in 64% of questions) followed by indications (49%) and specific patient populations (38%). Because of overlap across panels, questions were summarized and sorted by topic resulting in 21 priority research questions. Seventy-three total questions and 46 questions reaching consensus were identified by NTRAP panelists. The key topics identified in these questions should be prioritized in future funded research on TXA in trauma. Prognostic and Epidemiological; Level V.

Development of the Parental Experience with Care for Children with Serious Illnesses (PRECIOUS) quality of care measure

BackgroundParent-reported experience measures are part of pediatric Quality of Care (QoC) assessments. However, existing measures were not developed for use across multiple healthcare settings or throughout the illness trajectory of seriously ill children. Formative work involving in-depth interviews with parents of children with serious illnesses generated 66 draft items describing key QoC processes. Our present aim is to develop a comprehensive parent-reported experience measure of QoC for children with serious illnesses and evaluate its content validity and feasibility.MethodsFor evaluating content validity, we conducted a three-round Delphi expert panel review with 24 multi-disciplinary experts. Next, we pre-tested the items and instructions with 12 parents via cognitive interviews to refine clarity and understandability. Finally, we pilot-tested the full measure with 30 parents using self-administered online surveys to finalize the structure and content.ResultsThe Delphi expert panel review reached consensus on 68 items. Pre-testing with parents of seriously ill children led to consolidation of some items. Pilot-testing supported feasibility of the measure, resulting in a comprehensive measure comprising 56 process assessment items, categorized under ten subthemes and four themes: (1) Professional qualities of healthcare workers, (2) Supporting parent-caregivers, (3) Collaborative and holistic care, and (4) Efficient healthcare structures and standards. We named this measure the PaRental Experience with care for Children with serIOUS illnesses (PRECIOUS).ConclusionsPRECIOUS is the first comprehensive measure and has the potential to standardize assessment of QoC for seriously ill children from parental perspectives. PRECIOUS allows for QoC process evaluation across contexts (such as geographic location or care setting), different healthcare workers, and over the illness trajectory for children suffering from a range of serious illnesses.

A comprehensive interventional program to improve the sexual function of women with endometriosis: a mixed-methods protocol study

BackgroundEndometriosis is a chronic disease affecting 6–10% of women worldwide. Sexual dysfunction has been reported in a significant percentage of these patients. Thus, the present study will be conducted to design, implement, and determine the effectiveness of an interventional program to improve the sexual function of women with endometriosis.Materials and methodsThis mixed-methods study will be carried out in three phases with a sequential exploratory approach. In the first phase (qualitative study) participants will be selected by purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. The interventional program will be designed in the second phase based on the results of the qualitative study and literature review and using the Delphi method and panel of experts. The interventional program will be implemented at the individual level in the third phase to investigate its effect on improving women’s sexual function. This phase includes quasi-experimental research, in which the pre- and post-intervention data will be collected from the intervention and control groups using the FSFI questionnaire and analyzed by descriptive and inferential statistical methods. Ultimately, a suitable interventional program will be presented by combining the data obtained in the qualitative and quantitative phases of the research.ConclusionConducting the present study, along with the design and implementation of an appropriate, native, and culturally sensitive interventional program, can contribute to improving the sexual function of women with endometriosis and enhancing the quality of sexual relations between couples.

Recommendations for optimal interdisciplinary management and healthcare settings for patients with rare neurological diseases

BackgroundIn 2017, the German Academy for Rare Neurological Diseases (Deutsche Akademie für Seltene Neurologische Erkrankungen; DASNE) was founded to pave the way for an optimized personalized management of patients with rare neurological diseases (RND) in all age groups. Since then a dynamic national network for rare neurological disorders has been established comprising renowned experts in neurology, pediatric neurology, (neuro-) genetics and neuroradiology. DASNE has successfully implemented case presentations and multidisciplinary discussions both at yearly symposia and monthly virtual case conferences, as well as further educational activities covering a broad spectrum of interdisciplinary expertise associated with RND. Here, we present recommendation statements for optimized personalized management of patients with RND, which have been developed and reviewed in a structured Delphi process by a group of experts.MethodsAn interdisciplinary group of 37 RND experts comprising DASNE experts, patient representatives, as well as healthcare professionals and managers was involved in the Delphi process. First, an online collection was performed of topics considered relevant for optimal patient care by the expert group. Second, a two-step Delphi process was carried out to rank the importance of the selected topics. Small interdisciplinary working groups then drafted recommendations. In two consensus meetings and one online review round these recommendations were finally consented.Results38 statements were consented and grouped into 11 topics: health care structure, core neurological expertise and core mission, interdisciplinary team composition, diagnostics, continuous care and therapy development, case conferences, exchange / cooperation between Centers for Rare Diseases and other healthcare partners, patient advocacy group, databases, translation and health policy.ConclusionsThis German interdisciplinary Delphi expert panel developed consented recommendations for optimal care of patients with RND in a structured Delphi process. These represent a basis for further developments and adjustments in the health care system to improve care for patients with RND and their families.

AGE-INCLUSIVE STRATEGIES TO ENHANCE LEARNING AND WORKPLACE ENVIRONMENTS IN U.S. HIGHER EDUCATION

Abstract This symposium reports on recent research to develop informed strategies to expand age-friendly campus practices related to institutional functions our previous study identified as areas of high-need and broad-impact within an age-friendly campus environment: Teaching and Learning, Personnel, and Student Affairs. The current research aimed to identify barriers and opportunities for age inclusivity as experienced by older campus members (faculty, staff, and students); identify challenges and strategies for implementing age-friendly campus practices; and recommend practical strategies to expand and enhance age-friendly practices. To this end, we drew on data collected from several sources: open-ended responses to the Age-Friendly Inventory and Campus Climate Survey (ICCS) administered to a sample of 23 U.S. members of the Age-Friendly University (AFU) network; responses from 16 focus groups of faculty, administrators/staff, and students; and 18 experts on a nationally selected Delphi panel of experts in higher education. Based on the focus group data, we generated over 50 strategy recommendations within the academic functions that were then evaluated by the Delphi panelists to assess their efficacy, feasibility, likelihood of implementation, and perceived impact. Silverstein will provide an overview of the research objectives, Bowen will discuss what the open-ended responses revealed about perceptions of campus age-inclusivity, Lin and Xu will describe the study samples, Whitbourne will describe the results of the focus group analyses, and Montepare will discuss the final set of recommendations based on the Delphi panel analyses. Berg-Weger will serve as Discussant.

Building bridges of excellence: a comprehensive competence framework for nurses in hospice and palliative care—a mixed method study

BackgroundHospice and Palliative Care (HPC) is in high demand in China; however, the country is facing the shortage of qualified HPC nurses. A well-suited competence framework is needed to promote HPC human resource development. Nevertheless, existing unstandardized single-structured frameworks may not be sufficient to meet this need. This study aimed at constructing a comprehensive multi-structured HPC competence framework for nurses.MethodsThis study employed a mixed-method approach, including a systematic review and qualitative interview for HPC competence profile extraction, a two-round Delphi survey to determine the competences for the framework, and a cross-sectional study for framework structure exploration. The competence profiles were extracted from publications from academic databases and interviews recruiting nurses working in the HPC field. The research team synthesized profiles and transferred them to competences utilizing existing competence dictionaries. These synthesized competences were then subjected to Delphi expert panels to determine the framework elements. The study analyzed theoretical structure of the framework through exploratory factor analysis (EFA) based on a cross-sectional study receiving 491 valid questionnaires.ResultsThe systematic review involved 30 publications from 10 countries between 1995 and 2021, while 13 nurses from three hospitals were interviewed. In total, 87 and 48 competence profiles were respectively extracted from systematic review and interview and later synthesized into 32 competences. After the Delphi survey, 25 competences were incorporated into the HPC competence framework for nurses. The EFA found a two-factor structure, with factor 1 comprising 18 competences namely Basic Competences; factor 2 concluding 7 competences namely Developmental Competences.ConclusionsThe two-factor HPC competence framework provided valuable insights into the need and directions of Chinese HPC nurses’ development.

New Research in Forecasting

All institutions in Georgia are changing. Decision-makers in Government agencies and private organizations need the best available data and analyses to meet the challenges of changing times. Evidence-based forecasting can help officials to predict the likely outcomes of their decisions. This paper reports on work being done by THE GEORGIA FORECASTTM and The University of Georgia Forecasting Center to identify and apply modern methods to Georgia’s most pressing issues. These methods include statistical techniques, such as time series and regression, and judgmental adjustments, such as Delphi, surveys of consumers and producers, and scenario scripting. One recent application studied in this research project, forecasting tourism in Georgia, is an example of how modern methods may improve decision-making by those who make public policy, allocate resources, and make business decisions.Statistical forecasting techniques assume that the near future will look substantially like the recent past. We can, therefore, use data from recent history to make predictions about the near future. The longer the horizon, the weaker the assumption. Two general classes of statistical forecasts are (1) Causal and (2) Non-Causal. The most common causal model is regression: the variable to be determined (Y) is related to one or more predictor variables (Xi). For example, the quantity demanded of a good (Qd) may be estimated from the price of that good (P) and other factors, such as income, relative prices of substitute and complementary goods, weather, etc. Time series models are non-causal. We may not know why a variable of interest rises or falls, but we can detect patterns from the recent past, such as trend, seasonality, and cycles. Judgmental methods assume some degree of knowledge that may not bereflected in the statistics. These may include, among others, a Delphi panel of experts, survey of consumers and producers, game theory, and scenario scripting. Because of the high degree of uncertainty in the Georgian economic, political, and social environment, the use of one model is unlikely to yield reliable forecasts. Therefore, THE GEORGIA FORECASTTM and The University of GeorgiaForecasting Center use a combination of methods and continually evaluate the performance of their forecasts. This paper uses the case of forecasting tourism to demonstrate these techniques.

Charting the course for student success: harnessing the potential of an accreditation-focused hospitality student-exit survey

PurposeThe purpose of this research is two-fold: first, the researchers will create a reliable and valid hospitality senior exit survey by conducting a Delphi panel of experts and second, the researchers will pilot-test the instrument with students from a four-year university. The data will be (a) assessed to determine the retention of knowledge by four-year students, (b) used by academicians to make changes to course material and (c) used to help with the accreditation assessment process.Design/methodology/approachA Delphi panel of hospitality educators was used to validate the items, and graduating hospitality students were used to calculate reliability.FindingsBy embracing the hospitality exit survey (HES), institutions can effectively evaluate and enhance their programs. With its ability to gauge students' knowledge retention, the study findings serve as a powerful tool for shaping the future of hospitality education.Research limitations/implicationsThe study's findings might be somewhat limited in representing a broader range of perspectives within hospitality programs. Another limitation stems from the structure of the survey itself. The survey included numerous items requiring two inputs for each item. This format has the potential to introduce certain biases among participants.Practical implicationsIn a positive statement, organizations can use this information to discover why employees stay and then continue to develop goals/strategies to ensure this process stays up to date. Academia is no different. Academia also wants to produce the best product, and since the students are to become the next set of leaders, these programs need to know what is successful and what needs to be adjusted.Social implicationsA strategic exit interview program should 1)Uncover issues relating to human resources/students; 2) understand employees'/students' perception of the work; 3) managers'/directors' leadership style and effectiveness; 4) human resource/college/departments benchmarks and 5) improve the organization.Originality/valueThis research holds significant importance as it focuses on developing the senior HES and its potential utilization within hospitality programs. The HES serves as a valuable tool for these programs to evaluate the knowledge levels of their graduating students and collect data necessary for assessment and accreditation purposes.

Developing “Eventful” Mega-Event Hosting Legacy Indicators

It is touted that mega-event host cities can strategically use the skills, knowledge, and networks developed from hosting as a catalyst to bid for and host subsequent events. There is currently scant research to support this claim. This study set out to develop and refine a set of indicators that can be used to assess an event hosting legacy. Based on the concepts of “eventful cities” and “event portfolios,” a review of secondary data sources was conducted to compile a list of draft indicators that could evaluate an event hosting legacy in respect of assessing the skills, knowledge, and networks required to host future events. These measures were refined by an expert Delphi panel over three rounds to arrive at a final set of 12 indicators. An agenda for future research to confirm the reliability and validity of these indicators is discussed.

Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO)-The First Disease-Specific Self-Report Questionnaire after Traumatic Brain Injury.

The subjective impact of the consequences of pediatric traumatic brain injury (pTBI) on different life dimensions should be assessed multidimensionally and as sensitively as possible using a disease-specific health-related quality of life (HRQoL) instrument. The development and psychometrics of the first such self-report questionnaire for children and adolescents after TBI are reported here. Focus group interviews with children, adolescents, and their parents, cognitive debriefing, item pool generation and reduction using Delphi expert panels were performed. The resulting version was psychometrically tested on 300 individuals aged 8-17 years. After item reduction based on factor analyses, differential item functioning, reliability, and validity were investigated. The final 35 items were associated with six scales (Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, Physical Problems). Internal consistency and construct validity were satisfactory. Health-related Quality of life (HRQoL) was significantly lower in older and in female participants, as well as those with cognitive disabilities, anxiety, depression and post-concussion symptoms, than in comparative groups. The new QOLIBRI-KID/ADO is a comprehensive, multidimensional, reliable, and valid instrument, comparable in content and items to the QOLIBRI adult version. Therefore, disease-specific HRQoL can now be measured across the lifespan and may support the amelioration of treatment, care, rehabilitation, and daily life of children and adolescents after TBI.

Management of pain in Fabry disease in the UK clinical setting: consensus findings from an expert Delphi panel

BackgroundFabry disease is a rare, X-linked inherited lysosomal storage disorder, that manifests as a heterogeneous disease with renal, cardiac and nervous system involvement. The most common pain experienced by people with Fabry disease are episodes of neuropathic pain reported in up to 80% of classical hemizygous male patients and up to 65% of heterozygous female patients. No clear consensus exists within UK clinical practice for the assessment and management of pain in Fabry disease based on agreed clinical practice and clinical experience. Here we describe a modified Delphi initiative to establish expert consensus on management of pain in Fabry disease in the UK clinical setting.MethodsDelphi panel members were identified based on their demonstrated expertise in managing adult or paediatric patients with Fabry disease in the UK and recruited by an independent third-party administrator. Ten expert panellists agreed to participate in two survey rounds, during which they remained anonymous to each other. Circulation of the questionnaires, and collection and processing of the panel’s responses were conducted between September 2021 and December 2021. All questions required an answer.ResultsThe Delphi panel reached a consensus on 21 out of 41 aspects of pain assessment and management of pain in Fabry disease. These encompassed steps in the care pathway from the goals of therapy through to holistic support, including the use of gabapentin and carbamazepine as first-line analgesic medications for the treatment of neuropathic pain in Fabry disease, as well as the proactive management of symptoms of anxiety and/or depression associated with Fabry pain.ConclusionsThe consensus panel outcomes reported here have highlighted strengths in current UK clinical practice, along with unmet needs for further research and agreement. This consensus is intended to prompt the next steps towards developing clinical guidelines.

Research Priorities in Venous Thromboembolism after Trauma: Secondary Analysis of the National Trauma Research Action Plan (NTRAP).

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality during recovery from injury and can result in significant healthcare costs. Despite advances in the past several decades in our approach to VTE prophylaxis after injury, opportunities exist to improve the delivery and implementation of optimal VTE prophylaxis. Here, we aim to identify consensus research questions related to VTE across all NTRAP Delphi expert panels to further guide the research agenda aimed at preventing VTE after injury. This is a secondary analysis of consensus-based research priorities that were collected using a Delphi methodology by 11 unique NTRAP panels that were charged with unique topic areas across the spectrum of injury care. The database of questions was queried for the keywords "VTE", "venous thromboembo", and "DVT", then grouped into relevant topic areas. There were 86 VTE-related research questions identified across 9 NTRAP panels. 85 questions reached consensus with 24 rated high priority, 60 medium priority and 1 low priority. Questions related to the timing of VTE prophylaxis (n = 17) were most common, followed by questions related to risk factors for the development of VTE (n = 16), the effects of tranexamic acid on VTE (n = 11), the approach to dosing of pharmacologic prophylaxis (n = 8), as well as the pharmacologic prophylactic medication choice for optimal VTE prophylaxis (n = 6). NTRAP panelists identified 85 consensus-based research questions that should drive dedicated extramural research funding opportunities to support quality studies aimed at optimizing VTE prophylaxis after injury. Original Research, IV.