Delphi Survey Research Articles

Definition of diaphragmatic sleep disordered breathing and clinical meaning in Duchenne muscular dystrophy

BackgroundDiaphragmatic sleep disordered breathing (dSDB) has been recently identified as sleep dysfunction secondary to diaphragmatic weakness in Duchenne muscular dystrophy (DMD). However, scoring criteria for the identification of dSDB are...

International Expert Consensus on Semantics of Multimodal Esophageal Cancer Treatment: Delphi Study

BackgroundRecent developments in esophageal cancer treatment, including studies exploring active surveillance following chemoradiotherapy, have led to a need for clear terminology and definitions regarding different multimodal treatment options.ObjectiveThe aim of this study was to reach worldwide consensus on the definitions and semantics of multimodal esophageal cancer treatment.MethodsIn total, 72 experts working in the field of multimodal esophageal cancer treatment were invited to participate in this Delphi study. The study comprised three Delphi surveys sent out by email and one online meeting. Input for the Delphi survey consisted of terminology obtained from a systematic literature search. Participants were asked to respond to open questions and to indicate whether they agreed or disagreed with different statements. Consensus was reached when there was ≥75% agreement among respondents.ResultsForty-nine of 72 invited experts (68.1%) participated in the first online Delphi survey, 45 (62.5%) in the second survey, 21 (46.7%) of 45 in the online meeting, and 39 (86.7%) of 45 in the final survey. Consensus on neoadjuvant and definitive chemoradiotherapy with or without surgery was reached for 27 of 31 items (87%). No consensus was reached on follow-up after treatment with definitive chemoradiotherapy.Conclusion(s)Consensus was reached on most statements regarding terminology and definitions of multimodal esophageal cancer treatment. Implementing uniform criteria facilitates comparison of studies and promotes international research collaborations.

Identifying core mental health services required for adult justice-involved populations in Australia: a Delphi study

This study aimed to define required forensic mental health service types in Australia. A staged Delphi process was used, including: (1) reference group consultation to establish a set of core forensic mental health service types; (2) Delphi survey to seek consensus on identified service types and definitions among forensic mental health stakeholders in Australia; and (3) amendment of service definitions in response to survey feedback. Nine forensic mental health service types were identified. Consensus (>80% agreement) was achieved among Delphi respondents that all services were core components of an ideal forensic mental health system. These included forensic bed-based (acute, sub-acute, non-acute, non-acute community), forensic community, outreach, prison and court liaison services. The high levels of agreement on service types are notable considering legislative differences impacting on design and operation of services across jurisdictions. The findings could contribute to the evidence base required for needs-based planning of forensic mental health services.

Consensus and controversies on the diagnosis of GH-deficiency in children and adults - A Delphi survey by the GH research society

Consensus and controversies on the diagnosis of GH-deficiency in children and adults - A Delphi survey by the GH research society

Exploring a definition of healthy longevity in Chinese population based on Delphi method

Objective: To explore a definition of healthy longevity in the Chinese population based on the Delphi method. Methods: Through a comprehensive literature review and expert consultation, the dimensions in the definition of healthy longevity were identified, and a preliminary list of questions was created. Experts in clinical medicine, public health, basic research, and the elderly care service industry, who had been working in the field of geriatric health for at least 5 years, were invited to participate in the Delphi survey from August to December 2022. The survey questionnaires were administered via email in two rounds, and experts were asked to select the optimal options from the provided questions. The active coefficients were expressed by the response rate, and a consensus was reached when the largest number of experts agreed for single-choice questions and more than 70% agreed for multiple-choice questions. Results: In the two rounds, the active coefficients were 96.00% (24/25) and 79.17% (19/24), respectively, and a consensus was finally reached on nine items, including age, physical health, common metabolic indicators, mental health, cognitive function, functional ability, social activity, self-rated health, and subjective well-being. Following discussions among the research team and experts, a final definition of healthy longevity was determined. Healthy longevity could refer to a state of good physical, psychological, cognitive function and social adaptation, as well as subjective well-being, in individuals aged 90 and above. Specifically, individuals with healthy longevity should be free from diseases associated with high disability rates and mortality, such as stroke, cancer, and Parkinson's disease. They should also maintain reasonable levels of common non-communicable disease indicators, such as blood pressure and blood glucose, and exhibit favorable mental health and cognitive function using validated measurement tools. In addition, individuals with healthy longevity should engage in social interactions with friends and relatives, care for family members, and go out to do things. Meanwhile, with the ability to complete the visual and hearing functions of daily life and communication, and the ability to complete basic activities such as walking, eating, bathing, toileting, dressing, continence of urination, and bowel movement independently, they could rate themselves to be in good health and experience a relatively high level of life satisfaction. Conclusion: A definition of healthy longevity in the Chinese population is established through the two-round Delphi consultation.

Indication and Contraindication of Video-Based Psychotherapy: A Qualitative Delphi Survey to Capture Psychotherapists' Reflection and Deliberation Processes

The Corona pandemic forced many psychotherapists to make a rapid transition to video setting. Even after the acute phase of the pandemic, video-based treatments can be determined to a certain extent in practice. Thus, indication and contraindication recommendations are essential to ensure treatment quality. However, empirical studies are almost completely lacking in this regard. In the context of this work, the decision-making and consideration processes of psychotherapists regarding video-based treatments are to be recorded and those factors that can have an effect on the indication are to be identified. Two-stage, qualitative Delphi survey with psychodynamically oriented psychotherapists (n=9) and behavioural therapists (n=7) who can be assigned to the fields of research and practice. The quality of the therapeutic alliance guides the participants' choice of setting. An indication for video setting results from the feasibility of therapeutic interventions and the respective treatment goal. The therapists weighed the costs and benefits of video setting for various disorders. The changed feeling of control on both sides and the possibility of improving health care are decisive factors. Based on the results, a decision tree for psychotherapists was created, which includes the identified indication criteria.

Development of antibiotic metrics for hospitalists via multi-institutional modified Delphi survey.

Closing the gap between evidence-supported antibiotic use and real-world prescribing among clinicians is vital for curbing excessive antibiotic use, which fosters antimicrobial resistance and exposes patients to antimicrobial side effects. Providing prescribing information via scorecard improves clinician adherence to quality metrics. We aimed to delineate actionable, relevant antimicrobial prescribing metrics extractable from the electronic health record in an automated way. We used a modified Delphi consensus-building approach. Our study entailed two iterations of an electronic surveydisseminated to hospital medicine physicians at 10 academic medical centers nationwide. Main outcomes comprised consensus metrics describing the quality of antibiotic prescribing to hospital medicine physicians. Twenty-eight participants from 10 United States institutions completed the first survey version containing 38 measures. Sixteen respondents completed the second survey, which contained 37 metrics. Sixteen metrics, which were modified based on qualitative survey feedback, met criteria for inclusion in the final scorecard. Metrics considered most relevant by hospitalists focused on the appropriate de-escalation of antimicrobial therapy, selection of guideline-concordant antibiotics, and appropriate duration of treatment for common infectious syndromes. Next steps involve prioritization and implementation of these metrics based on quality gaps at our institution, focus groups exploring impressions of clinicians who receive a scorecard,and analysis of antibiotic prescribing patterns before and after metric implementation. Other institutions may be able to implement metrics from this scorecard based on their own quality gaps to provide hospitalists with automated feedback related to antibiotic prescribing.

Development of family resource indicators for people with schizophrenic disorder in community by modified Delphi method in Beijing, China

IntroductionMost people with schizophrenia in China are supported by their family members in community. The patient’s family is confronted with severe care burden and pressure, which directly affects the caregiver’s...

Identifying factors that can be used to assess a country’s readiness to deploy a new vaccine or improve uptake of an underutilised vaccine: a scoping review

ObjectivesIdentifying whether a country is ready to deploy a new vaccine or improve uptake of an existing vaccine requires knowledge of a diverse range of interdependent, context-specific factors. This scoping...

Delphi Method Analysis and Consensus of Prevalent Distinctive Practices for Biliary Atresia Management after Kasai Portoenterostomy.

Extrahepatic biliary atresia (BA) is seen in infants, with an incidence of 1 in 15,000 live births. The presentation is progressive jaundice, dark-colored urine, and clay-colored stools. Kasai portoenterostomy (KPE) is the commonly performed surgical procedure in these patients. Postoperatively, phenobarbitone, ursodeoxycholic acid (UDCA), steroids, and other drugs are given to improve bile drainage and prevent inflammation and fibrosis. However, a definitive protocol regarding the need for different drugs, dosage, and duration varies across individual surgeons and centers. No universally accepted protocol exists for postoperative management after KPE. The aim of this study was to know the prevailing postoperative management of BA by subject experts and use the Delphi process to know if the experts want to change their practice based on the results from the survey. A questionnaire was made after discussing with two experts in the field of BA. The questionnaire was mailed to 25 subject experts. The first survey data were analyzed and shared with all responders. In the second survey, change in the management based on the results from the first survey was assessed. The Delphi questionnaire was answered by 17 experts. Postoperatively, prophylactic antibiotics are prescribed for 6-12 weeks by around 40% and >12 weeks by 30% of respondents. Phenobarbitone is prescribed for <3 months by nearly 50%. UDCA is prescribed for <3 months, ≤6 months, and 6 months-1 year by 47.1%, 23.5%, and 23.5% responders, respectively. Nearly 50% prescribe steroids (mostly prednisolone), and among them, two-thirds prescribe it for 6-12 weeks. Approximately 60% give antiviral drugs to children who are cytomegalovirus immunoglobulin M positive. In our survey, 50% of experts perform 5-10 KPE per year, and 25% each perform 10-15 and >15 KPE per year. The second survey noted that a significant percentage of responders want to change their practice according to consensus. From our Delphi survey, an overview of the postoperative management of BA could be made. However, multicentric studies are required for uniform protocol on the postoperative management of BA.

Defining practices suitable for care via teleconsultation in gynaecological and obstetrical care: a French Delphi survey

ObjectiveDelineate the scope of teleconsultation services that can be effectively performed to provide women with comprehensive gynaecological and obstetrical care.DesignBased on the literature and experts’ insights, we identified a list...

Development and Validation of a Discharge Assessment Scale for Outpatients Undergoing Sedative Anesthesia in the Ambulatory Postanesthesia Care Unit: A Comprehensive Delphi Study

PurposeThe purpose of this study was to develop a discharge assessment scale tailored for outpatients undergoing sedative anesthesia treatment in the ambulatory postanesthesia care unit and validate its agreement with the Post-Anesthetic Discharge Scoring System. DesignThe Delphi method. MethodsA Delphi survey was conducted with 30 experts focusing on the evaluation of outpatient discharges following treatment under ambulatory anesthesia. Subsequently, a cross-sectional observational study employing convenience sampling selected 2,579 outpatients who had undergone painless ambulatory gastrointestinal endoscopy at a tertiary hospital to analyze the level of agreement with the Post-Anesthesia Discharge Scoring System. FindingsThe study conducted three rounds of expert consultations to create the ambulatory discharge assessment scale. Twenty-five experts from 12 provinces and municipalities in our country were interviewed. The discharge assessment form encompassed five aspects: consciousness level, vital signs, directional stability, mobility, and adverse reactions. According to the scale, if the total score exceeded 9 points, with none of the items scoring 0 points, the ambulatory patient could be discharged from the hospital with the accompaniment of family members. Patients assessed using this newly constructed scale were able to leave the hospital earlier compared to those assessed using the comparative scale. No significant differences were observed in vital signs at the time of discharge or the occurrence of adverse events within 24 hours after the procedure. ConclusionsThis assessment tool for discharging ambulatory patients after the ambulatory anesthesia from the postanesthesia outpatient care unit can be considered a valuable addition to formalize the discharge process in outpatient services.

Quality Indicators for the Perinatal Care of Women with Disabilities: A Scoping Review and Modified Delphi Survey

Quality Indicators for the Perinatal Care of Women with Disabilities: A Scoping Review and Modified Delphi Survey

사회복지학과 전공역량 진단도구 개발 및 타당화에 대한 탐색적 연구: U대학 사례를 중심으로

The purpose of this study is to define the concept of major competencies in the Department of Social Welfare and to develop and validate a major competency measurement model. Literature analysis, department consumer satisfaction survey, major curriculum committee, and FGI were conducted to define the four competencies and the concept of the lower eight competencies. A Delphi survey (1st) was conducted on social welfare professors and field experts to validate major and sub competencies. Based on the four major competencies and the eight sub competencies of the social welfare department, a new preliminary question was developed, and a preliminary content validity test was conducted through the Delphi survey (2nd) targeting the expert panel group. In the second Delphi survey, two questions with low content validity were deleted, and a preliminary test was conducted for college students in the Department of Social Welfare to analyze the reliability and validity of the diagnostic tool. The items with the highest factor loading value were selected in order to reduce them to the final 66 questions, and a diagnostic tool to measure major competency was completed. This makes it possible to diagnose and analyze the level of major competency of students in the Department of Social Welfare. In addition, the results of this study are expected to be usefully used by the Department of Social Welfare to manage the quality of major education, such as improving the curriculum based on quantitative data.

델파이를 활용한 고등학생 세계시민성 측정 도구 개발

Objectives This study, we intend to develop a tool item for measuring global citizenship that can grasp the relationship between world geography classes and cultivation of global citizenship through a Delphi survey. Methods To this end, areas, items, and questions for global citizenship measurement tools were extracted by analyzing the 2022 revised curriculum high school “World Citizens and Geography” textbook and the social studies curriculum (Ministry of Education Notice No. 2022-33). In addition, a group of 10 experts was formed into a panel to conduct a Delphi survey. Results As a result of the Delphi survey, the area of the global citizenship measurement tool was divided into cognitive, social and emotional, and skill areas, and a total of 15 category and 30 items were developed in 4 category in the cognitive domain, 7 category in the social and emotional domain, and 4 category in the skill domain. Conclusions The areas, items, and questions of the developed global citizenship measurement tool will serve as a guide and guide for studying the close connection between learning high school world geography (2022 revised world citizenship and geography) and cultivating global citizenship.

Developing a pediatric nursing simulation scenario template in South Korea: applying real-time Delphi methods.

This study aimed to describe the process of developing a validated pediatric nursing simulation scenario template using the real-time Delphi method. A panel of 13 pediatric nursing experts participated in a real-time Delphi survey conducted over two rounds. Initially, 83 items were included in the questionnaire focusing on the structure and content of the simulation scenario template. Data analysis involved calculating the content validity ratio (CVR) and the coefficient of variation to assess item validity and stability. Through iterative rounds of the Delphi survey, a consensus was reached among the experts, resulting in the development of a pediatric nursing simulation scenario template comprising 41 items across nine parts. The CVR values ranged from 0.85 to 1.0, indicating a high consensus among experts regarding the inclusion of all items in the template. This study presents a novel approach for developing a pediatric nursing simulation scenario template using real-time Delphi methods. The real-time Delphi method facilitated the development of a comprehensive and scientifically grounded pediatric nursing simulation scenario template. Our template aligns with the International Nursing Association for Clinical Simulation and Learning standards, and provides valuable guidance for educators in designing effective simulation scenarios, contributing to enhanced learning outcomes and better preparation for pediatric clinical practice. However, consideration of cultural and contextual adaptations is necessary, and further research should explore alternative consensus criteria.

2022 개정 기술과 교육과정 개발과 주요 특징

The purpose of this study was to develop the 2022 revised technology and curriculum. The study was divided into primary and secondary research according to the government's curriculum development process. The research methods used in this study included literature research, expert consultation, Delphi survey, and policy consultation. One of the most important features of the 2022 revised technology subject curriculum development is that the participation of professors at technology teacher training institutions and current technology teachers increased compared to the previous curriculum. As a result of this participation and discussion, the results of the 2022 revised technology subject curriculum development study were derived. The results of this study are summarized as follows. First, the middle school technology curriculum was developed into two major areas: technological problem solving and innovation, and sustainable technology and convergence. Second, the high school technology curriculum was composed and developed with technology and home economics as general electives, robots and the world of engineering as career electives, and creative engineering design and general intellectual property as convergence electives. Third, all curriculum were developed by dividing them into changed content elements: knowledge/understanding, process/skill, value/attitude, and achievement standards were developed through combination of content elements. Fourth, the high school technology curriculum strengthened the nature of the engineering field and attempted to preserve the purpose of the high school credit system. The development process and main features of the 2022 revised technology subject curriculum can be used as explanatory material for future curriculum implementation, monitoring of future curriculum, and basic data for the next curriculum.

Challenges to energy retrofitting of existing office buildings in high-rise high-density cities: The case of Hong Kong

Achieving carbon neutrality by 2050 has become a global goal, sparking concerns regarding energy consumption and carbon emissions in building operations. Office buildings in high-rise high-density cities serve as central business districts, contributing significantly to the city’s economic activity and consuming a lot of energy. The process of retrofitting existing office buildings for energy efficiency in high-rise high-density cities tends to be challenging. However, there is a lack of comprehensive understanding of the challenges involved in office buildings’ energy retrofitting, as they have not been thoroughly explored. This study aims to investigate the challenges to the existing office building energy retrofitting (EOBER) in high-rise high-density cities with real cases in Hong Kong. Initially, a systematic literature review was undertaken to identify 49 potential EOBER challenges and categorized into seven groups: technical, financial, institutional, social, environmental, regulatory, and other categories. Afterward, 23 EOBER challenges were identified through 24 semi-structured interviews with 36 real office building energy retrofitting cases in Hong Kong. Moreover, these challenges were quantified by the Z-numbers-based Delphi survey and analysis. Results show that regulatory challenges are the primary challenges, followed by financial challenges. The lack of government incentives, policies, legislation and regulations significantly hinders practitioners’ ability to engage in energy retrofitting initiatives. The long payback period of building energy retrofitting poses a critical financial concern for practitioners embracing such initiatives. In the end, this research proposed integrated strategies to tackle these challenges and increase building energy efficiency, including launching financial and regulatory incentives, shortening the interval for mandatory energy audits, disseminating knowledge, and diversifying finance channels of building energy retrofitting. The findings contribute to the body of knowledge by employing systems thinking to identify and evaluate EOBER challenges in high-rise high-density cities through empirical methodologies. Moreover, this study provides valuable references for practitioners in navigating these challenges and minimizing risks associated with the retrofitting process.

일반계 고등학생 진로분별력 개념모형 개발

Objectives The purposes of this study were to investigate the definition of career savvy that fits general high school students and its components and variables for the conceptual model. Methods For the purpose of this study, a conceptual model draft of career savvy was derived based on a comprehensive review of literature in business administration and pedagogy as well as two main theories which are trait-factor theory and cognitive information processing theory. With a conceptual model draft, Delphi surveys were conducted three times on eight career education experts. Results As a result of the Delphi survey, a conceptual model of career savvy was made and it was agreed upon by the expert panel and its validity was secured. Carrer savvy is the concept that consists of 3 components (career information collecting competence, career strategic formulation ability, and career meta-cognition ability). Specifically, career information collecting competence has 3 factors(technological ability, Networking ability, and critical acceptance ability). Career strategic formulation ability includes 4 factors(finding the gaps, analysis, synthesis, and executing). Career meta-cognition ability forms 2 factors(knowledge meta-cognition, process meta-cognition). Conclusions Career savvy consists of three components which are the ability to collect career information, the ability to formulate career strategies, and the ability of career meta-cognition and these components also contain more specific variables. The Career savvy conceptual model of this study can be used as a foundation for customized career education to improve the future career competency of general high school students.

기업 HRD 관점에서 본 마이크로러닝의 실천적 정의 및 활용 특징 탐색

Objectives This study was conducted to identify the definition of microlearning, misconceptions and corrections, differences from traditional e-learning, and characteristics of microlearning as recognized by the corporate HRD. Methods To identify and analyze the reality of microlearning, 16 microlearning experts from companies and universities were nominated and conducted a Delphi Survey in three rounds. Results We were able to define microlearning from three perspectives: purpose of utilization, learning method, and learning form. Second, we provided corrective opinions on the misconceptions of microlearning (“It's just a short lecture,” “Learning time should not exceed 15 minutes,” “It only includes videos,” etc. Third, we compared the characteristics of microlearning with traditional e-learning and explored our own characteristics. These features were presented in terms of learning goals, learning content, learning activities, and learning time. Conclusions Through this study, we have prepared basic data to promote the proper understanding and practice of microlearning and to activate microlearning as a digital learning solution in the corporate HRD.