Expert Panel Method Research Articles

Digital Accessibility Education in Context: Expert Perspectives on Building Capacity in Academia and the Workplace

The social model of disability, accessibility legislation, and the digital transformation spurred by COVID-19 expose a lack of accessibility capacity in the workforce, indicating persistent gaps in academic and professional education. We adopt a socio-cultural lens to examine how the context of education and training influences teaching and learning in university and workplace sectors, and how expert educators manage and negotiate these contextual factors to build accessibility capacity. This article reports qualitative research with 55 experienced educators using an expert panel method and focus groups. Analysis highlights the important disconnects and contextual challenges that educators must navigate and negotiate to affect and embed cultural change. We find that faculty and workplace cultures frequently perpetuate precarity in accessibility education, individualising the responsibility to ‘heroes’ or ‘champions’, while disciplinary and role-based silos limit the scope for raising awareness and developing widescale competency. Conversely, centres of excellence and communities of practise can cultivate and sustain links between education and research, engage expert users, and promote interdisciplinary and cross-role learning environments, where accessibility is increasingly recognised as a shared endeavour. We conclude that greater collaboration between academia and industry can enhance pedagogical understanding, to transform accessibility educational practices and build and sustain capacity for the future.

Key Indicators for Monitoring the Efficiency of Iranian Health System: A Synthesized Design Study.

A significant share of medical care, primary health care, and health-related education and research in Iran is provided by the Ministry of Health and its affiliated universities of medical sciences. We aimed to identify a set of key metrics for monitoring their efficiency in the four areas of medical care, primary health care, education and research. A combination of scoping review, expert panel and Delphi method was used. First, the relevant keywords were searched in the appropriate databases between 2000 and 2020. The final extracted indicators then reviewed, reduced and refined through the expert panel meetings. The last metrics were established following a three-stage Delphi study. Out of 2327 studies, 155 were selected following the different screening stages of scoping review. After summarizing and refining the indicators via several expert panel meetings and the Delphi method, a total of 36 key indicators were considered appropriate for measuring efficiency of the health system, 23 of which were for the sub-systems of public health (4 indicators), medical services (10 indicators), education (4 indicators) and research (5 indicators) and 13 indicators for the whole system efficiency. The set of indicators presented representing both the technical and allocative efficiency, might be a reliable basis for designing information systems and management dashboards for periodic monitoring of health system efficiency at national, regional and local levels.

Identification and Prioritization of Health Indexes in Nomadic Tribespeople by Fuzzy Delphi Method: An Ecological Study.

The migratory lifestyle of nomadic communities, combined with the lack of a suitable health-related organizational structure, has made it difficult to provide health care services that can improve their health status. To achieve the concept of justice in health and sustainable development, it is imperative to improve the health status of all citizens in Iran, which consists of the nomadic communities, and urban and rural populations. In this ecological study national health indexes in nomadic tribespeople was Identified and prioritized by expert panel and fuzzy Delphi method. In the first step, the national health indexes were extracted from the literature, and then indexes that can be measured, evaluated and representative of the nomadic communities were extracted and prioritized by using fuzzy Delphi and TOPSIS methods, Questionnaire options were analyzed according to 3 criteria of economic efficiency, measurability, and simplicity in the form of 13 components and their indicators. The analysis of the results of the fuzzy Delphi method shows that the mental health component has the lowest real score in the criteria of measurability, simplicity and economic efficiency. The child care component has the highest real score in terms of economic efficiency and the vaccination component has the highest real score based on the criteria of measurability and simplicity in nomadic communities. The results of the TOPSIS method show that the components of vaccination, maternal care and child care have the highest priority for attention and investigation of their indicators in this segment of the population. In general, by designing and implementing systems to record the information of priority indexes extracted from the present study, it is possible for responsible organizations to make effective decisions and plans for the improvement of the health status of nomadic communities.

Proposal for measuring the impact of the quality of work life on business competitiveness: expert panel method

Objetive. Validate an instrument for determining the quality of work life factors that affect business competitiveness, taking several companies in the industrial sector as a case study through the Content Expert Panel method. Methodology. The research approach is quantitative, the aim is to contrast the theory found with the empirical evidence in the field. As the research developed, 3 research techniques were used in order to comply with methodological rigor: 1) Documentary technique. Reference materials: books, database, techniques and studies. 2) Bibliographic technique. Those used as support were: bibliographic and electronic files. 3) Field Technique, structured interviews for the Expert Panel. Contribution. In the literary review, it was found that there is statistically significant evidence on how improving the quality of life of the members of the organization has a direct impact on its performance, which is why, the better the quality of life, the employees can become more competitive. For future research, other validation techniques of the proposed instrument could be implemented, as well as the analysis of other theories related to quality of life and competitiveness.

Development of a social cognitive career theory scale for measuring the intention to select surgery as a career

BackgroundSurgeon shortages have emerged as a prominent global issue. Although various studies have explored the factors that influence medical students in choosing surgery as a career, addressing the need for surgeons requires a multifaceted approach. However, there is currently a lack of a theoretically grounded scale to evaluate the effectiveness of surgical career development or policy promotion. Thus, this study aimed to develop a questionnaire for assessing the preference for a surgical career by adopting the Social Cognitive Career Theory (SCCT). Materials and methodsThe study aimed to develop the Social Cognitive Career Theory Scale toward Surgery (SCCTSS) by adopting the framework of SCCT. The questionnaire was created through expert consensus and the content validity index (CVI) calculation. Subsequently, a pilot version of the SCCTSS was administered to 222 medical students in their clinical clerkships, and the collected data underwent item analysis. Additionally, the validation of the SCCTSS by gender was performed. ResultsThe SCCTSS comprised 16 items that passed expert panel evaluation, with a CVI >0.8, mean ≥ 3.00, and an interquartile range ≤1. Item analysis demonstrated that the quality of the SCCTSS met the qualifying threshold. Furthermore, the SCCTSS questionnaire effectively validated gender differences in surgical career preference. ConclusionsWe developed an internally consistent and reliable scale and validated it through an expert panel method and feedback from medical students. Further research is required to evaluate the targeted interventions that may assist in recruiting medical students into the field of surgery through the application of the SCCTSS.

Workplace approaches to teaching digital accessibility: establishing a common foundation of awareness and understanding

Accessibility in the digital world is a shared responsibility, requiring a common foundation of awareness and understanding. However, little is known about how digital accessibility can be effectively taught, and research on workplace teaching and training in accessibility is highly scarce, despite its crucial role in building accessibility capacity in the workforce. This paper considers workplace accessibility pedagogy to focus on aspects of foundational education, characterized as a pedagogically informed set of teaching strategies, cultivated through organizational and workplace cultures and practices. It contributes an analysis and synthesis of pedagogic research with 55 experienced accessibility educators in higher education and the workplace, in the UK and internationally, drawing on insights from expert panel methods including interviews, forums and focus groups. We find that digital accessibility is identified as a necessary core competency for an inclusive digital world. We examine the prevalent approaches that experienced workplace educators use to establish foundational awareness and understanding of accessibility to enable learners to achieve core learning objectives. We report the challenges that workplace educators face, negotiating different contexts and working practices and adapting foundational learning experiences to meet the pedagogic demands of different roles, responsibilities, and specialist advancement. In doing so, we demonstrate that establishing a common foundation of awareness and understanding is the basis for a pedagogic framework for digital accessibility education, with relevance for both workplace and academic settings.

Developing a quantitative relationship towards apparel design transition in China

The design of China’s apparel has undergone tremendous changes in the past 70 years. In order to investigate the transition in the design of Chinese apparel over these years, progress with three phases of apparel design in the past 70 years have been described in terms of the silhouette, color, materials, and details of apparel design by employing the expert panel method. Further, a quantitative model of the random forest was proposed to link the transition of apparel design and its determinants, including economy, aesthetics, science and technology, and globalization. The importance weight for each of these determinants had also been determined. In doing so, this study offers insights for apparel designers regarding ways of strategically designing apparel under the transition dynamics in China to follow the mainstream of the transition, and meet consumers’ satisfaction towards apparel design.

Development of a comprehensive assessment tool to measure the quality of care for individuals with traumatic spinal cord injuries.

To develop a comprehensive assessment tool to evaluate the Quality of Care (QoC) in managing individuals with traumatic spinal cord injuries (TSCI). At first, the concepts of QoC for TSCI were identified by conducting a qualitative interview along with re-evaluation of the results of a published scoping review (conceptualization). After operationalization of indicators, they were valued by using the expert panel method. Afterward, the content validity index (CVI) and content validity ratio (CVR) were calculated and served as cut-offs for indicator selection. Then specific questions were developed for each indicator and classified into three categories: pre-hospital, in-hospital, and post-hospital. Data availability of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) was subsequently used to design questions that represent indicators in an assessment tool format. The comprehensiveness of the tool was evaluated using a 4-item Likert scale by the expert panel. Twelve experts participated in conceptualization and 11 experts participated in operationalization phase. Overall, 94 concepts for QoC were identified from published scoping review (87 items) and qualitative interviews (7 items). The process of operationalization and indicator selection led to the development of 27 indicators with acceptable content validity. Finally, the assessment tool contained three pre-hospital, twelve in-hospital, nine post-hospital, and three mixed indicators. Ninety-one percent of experts evaluated the entire tool as comprehensive. Our study presents a health-related QoC tool that contains a comprehensive set of indicators to assess the QoC for individuals with TSCI. However, this tool should be used in various situations to establish construct validity further.

Development of the well-being scale for urban elderly tourists who travel in the countryside for summer health

ABSTRACT Rural summer health tourism for the urban elderly (RSHTUE) is developing in China. RSHTUE tourists are predominantly urban elderly who stay in the countryside for a long time during the summer. This study first obtained the initial dimensions and item lists of the RSHTUE tourist well-being scale from the literature and interview data. Then, the expert panel method was applied to determine the initial scale. Exploratory factor analysis and confirmatory factor analysis were conducted to obtain an 8D 28-item RSHTUE tourist well-being scale. This scale can be used to support subsequent theoretical studies and guide the RSHTUE's development practice.

The mechanics of implementation strategies and measures: advancing the study of implementation mechanisms

BackgroundThere is a fundamental gap in understanding the causal mechanisms by which strategies for implementing evidence-based practices address local barriers to effective, appropriate service delivery. Until this gap is addressed, scientific knowledge and practical guidance about which implementation strategies to use in which contexts will remain elusive. This research project aims to identify plausible strategy-mechanism linkages, develop causal models for mechanism evaluation, produce measures needed to evaluate such linkages, and make these models, methods, and measures available in a user-friendly website. The specific aims are as follows: (1) build a database of strategy-mechanism linkages and associated causal pathway diagrams, (2) develop psychometrically strong, pragmatic measures of mechanisms, and (3) develop and disseminate a website of implementation mechanisms knowledge for use by diverse stakeholders.MethodsFor the first aim, a combination of qualitative inquiry, expert panel methods, and causal pathway diagramming will be used to identify and confirm plausible strategy-mechanism linkages and articulate moderators, preconditions, and proximal and distal outcomes associated with those linkages. For the second aim, rapid-cycle measure development and testing methods will be employed to create reliable, valid, pragmatic measures of six mechanisms of common strategies for which no high-quality measures exist. For the third aim, we will develop a user-friendly website and searchable database that incorporates user-centered design, disseminating the final product using social marketing principles.DiscussionOnce strategy-mechanism linkages are identified using this multi-method approach, implementation scientists can use the searchable database to develop tailored implementation strategies and generate more robust evidence about which strategies work best in which contexts. Moreover, practitioners will be better able to select implementation strategies to address their specific implementation problems. New horizons in implementation strategy development, optimization, evaluation, and deployment are expected to be more attainable as a result of this research, which will lead to enhanced implementation of evidence-based interventions for cancer control, and ultimately improvements in patient outcomes.

Biochemical Approach to the Hotness and Coldness of Mizaj in Persian Medicine: A Cross-Sectional Survey in the Healthy Population

An individualized viewpoint in Persian Medicine is introduced with the concept of Mizaj (temperament). Accordingly, every individual is placed in a unique point among a spectrum ranging from extreme hotness to extreme coldness. The whole-body Mizaj is mainly determined by three organs of heart, brain, and liver. This study investigates the relationship between whole-body and three main organ Mizajes with some hormonal and biochemical factors. In 324 healthy volunteers between the ages of 20 and 40, whole-body Mizaj and Mizajes of heart, brain, and liver were determined in two sessions with an expert panel method. Any disagreement between experts and the moderate diagnosis was excluded. Finally, 72 healthy volunteers (including 40 hot Mizaj individuals and 32 cold Mizaj) entered the second phase. In this phase, some hormonal and biochemical factors were evaluated. In whole-body Mizaj, FBS, Hgb, Hct, MCHC, WBC, and Monocytes, were higher in people with hot Mizaj than cold Mizaj. Besides, relating to the Mizaj of the liver, FBS, cortisol, TG, Hgb, Hct, MCH, MCHC in hot Mizaj were higher than cold Mizaj. Also, in the heart, MCV and MCH were higher in hot individuals and in the brain FBS, Hgb, Hct, MCV, MCH, lymphocytes were significantly higher in hot Mizaj. It seems that FBS and Hgb as the factors involved in metabolism have the most important role in the whole-body Mizaj. Also, the association between cortisol with the hotness of the liver can be suggested by increasing sympathetic activity as one of the hotness/coldness theories.

Toward an ontology of collaborative learning healthcare systems.

ObjectiveTo establish a basis for a domain ontology ‐ a formal, explicit specification of a shared conceptualization ‐ of collaborative learning healthcare systems (CLHSs) in order to facilitate measurement, explanation, and improvement.MethodsWe adapted the “Methontology” approach to begin building an ontology of CLHSs. We specified the purpose of an ontology, acquired domain knowledge via literature review, conceptualized a common framework of CLHSs using a grounded approach, refined these concepts based on expert panel input, and illustrated concept application via four cases.ResultsThe set of concepts identified as important to include in an ontology includes goals, values, structure, actors, environment, and products. To establish this set of concepts, we gathered input from content experts in two ways. First, expert panel methods were used to elicit feedback on these concepts and to test the elicitation of terms for the vocabulary of the Values concept. Second, from these discussions we developed a mapping exercise to test the intuitiveness of the concepts, requesting that network leaders from four CLHSs complete a mapping exercise to associate characteristics of their networks with the high‐level concepts, building the vocabulary for each concept in a grounded fashion. We also solicited feedback from these participants on the experience of completing the mapping exercise, finding that the exercise is acceptable and could aid in CLHS development and collaboration. Respondents identified opportunities to improve the operational definitions of each concept to ensure that corresponding vocabularies are distinct and non‐overlapping.DiscussionOur results provide a foundation for developing a formal, explicit shared conceptualization of CLHSs. Once developed, such a tool can be useful for measurement, explanation, and improvement. Further work, including alignment to a top‐level ontology, expanding the vocabulary, and defining relations between vocabulary is required to formally build out an ontology for these uses.

Nursing ethics for prevention and control of major infectious disease outbreaks: Chinese expert consensus

BackgroundMajor infectious disease has become a serious threat to people’s health worldwide. As the world’s largest healthcare workforce and the core forces fighting against the epidemic, nurses are on the frontline of this battle. A number of ethical issues have given rise to numerous concerns that have largely affected nurses in different ways as they respond to the epidemic. In addition, excessive expectations from people can exert undue pressure, which can easily lead to burnout in nurses. MethodsIn this consensus, the expert panel method was used to develop and reach a consensus. The members involved in the formation of the consensus included an expert discussion panel and a consensus writing expert group, a methodologist, and four secretaries. After 16 rounds of online expert consultation and two rounds of expert panel meetings, the writing team analyzed and reviewed the 78 amendments suggested by the experts to develop a consensus on nursing ethics for prevention and control of major infectious disease outbreaks based on the ethical vision of life care. ResultsThis expert consensus focuses on five essential domains: the responsibilities and rights of nurses, the nurse-patient relationship, the doctor-nurse relationship, and the relationship between society and nurses throughout the epidemic. ConclusionsWe hope this consensus can help nurses better understand and respond to the ethical issues and challenges in public health emergencies, and raise reasonable public expectations of the roles and responsibilities of nurses in these situations.

An ecohydraulic-based expert system for optimal management of environmental flow at the downstream of reservoirs

Abstract Linking ecohydraulic modeling and reservoir operation optimization is a requirement for robust management of the environmental degradations at the downstream of the reservoirs. The present study proposes and evaluates an ecohydraulic-based expert system to optimize environmental flow at the downstream of the reservoirs. Three fuzzy inference systems including physical habitat assessment, water quality assessment and combined suitability assessment were developed based on the expert panel method. Moreover, water temperature and dissolved oxygen were simulated by the coupled particle swarm optimization (PSO)–adaptive neuro-fuzzy inference system. Three evolutionary algorithms including PSO, differential evolution algorithm (DE) and biogeography-based optimization were applied to optimize the environmental flow regime. A fuzzy technique for order of preference by similarity to ideal solution was applied to select the best evolutionary algorithm to assess environmental flow. Based on the results in the case study, the proposed method provides a robust framework for simultaneous management of environmental flow and water supply. DE was selected as the best algorithm to optimize environmental flow. The optimization system was able to balance habitat losses, storage loss and water supply loss that might reduce negotiations between the stakeholders and environmental managers in the reservoir management.

A Future Study of an Environment Driving Force (EDR): The Impacts of Urmia Lake Water-Level Fluctuations on Human Settlements

Lake Urmia, one of the world’s largest salt lakes, is rapidly losing water and drying up. This environmental hazard has raised concerns about the consequences and impact on the surrounding communities. In this paper, we use a futuristic view (horizon of 10 years based on medium-term planning) to identify the main environmental drivers in the surrounding settlements of the Urmia Lake basin. A qualitative method, based on cross-impact analysis, was used as a means of future research. We also used a Delphi-based expert panel method to collect data and extract the environmental impacts of Urmia Lake. After the three rounds of the Delphi process, the expert panel reached a high level of agreement (100%) on the top 17 environmental consequences. Then, these consequences were classified by driving force and dependency using the MICMAC method. The results show that reducing pasture area, soil and water salinity, groundwater decline and depletion, and destruction of surrounding agricultural lands play a significant role in environmental change in Urmia Lake. Overall, any small change in these variables may lead to fundamental changes in the entire system.

Experiential examination of higher education partnerships in the UK: a knowledge management perspective

PurposeHigher education institutions possess a plethora of knowledge at the institutional, departmental and individual levels. Therefore, knowledge management plays a vital role in assisting partnerships to synergise knowledge and strengthen market competitiveness when working collaboratively. The purpose of this study is to identify and critically discuss the role of knowledge management concepts that support development of UK higher education partnerships. This knowledge management research was undertaken with the purpose of exploring components of behavioural constructs in assisting the development of successful partnerships between higher education institutions.Design/methodology/approachThis research embraces a qualitative methodology and makes use of an expert panel method to gather field data and assess the relevance, robustness and applicability of a conceptual model developed in the context of higher education partnerships. Guided by two research questions, the researchers elicited knowledge from eight experts, academics and practitioners, who had initiated and led partnership development between UK higher education institutions. The experts were invited and selected to attend the panel using the criteria of “Years of Experience in the Higher Education sector”, “Job Positions and Experiences” and the “Partnership Scope and Impact”.FindingsDepicting in a tree analogy, the conceptual model indicates that effective knowledge management will require higher education executives, managers and practitioners to centre on nurturing “tree roots” presented as behavioural knowledge management constructs and include institutional culture, trust, absorptive capacities and communication channels. The research findings elaborate on previous research and provide a categorisation of partnership outcomes between higher education institutions, explaining that partnership outcomes can be of an “Academic”, “Marketing and Finance” or “Managerial” nature. Importantly, practical use of the model could be implemented using audit methods or benchmarking methods, whereby the categorised elements of the model are used as a criterion of assessment for audit teams.Originality/valueThe conclusion extracted experiential insights to provide guidance as to how higher education executives, managers and practitioners can make use of knowledge management behavioural constructs and activities to assist collaborative undertakings in the higher education sector. This paper provided a new, modified, knowledge management higher education partnership tree, thus giving researchers and academic practitioners a holistic viewpoint of important partnership knowledge management factors.

Quality measures for end-of-life care for children with cancer: A modified Delphi approach.

The quality of adult end-of-life (EOL) cancer care has benefited from quality measures, but corresponding pediatric measures are lacking. Therefore, the authors used a validated expert panel method to recommend EOL quality measures for pediatric oncology. The authors used the modified Delphi method to assess potential quality measures. Panelists were selected on the basis of professional organization nominations and expert qualifications. Pediatric and adult oncology, pediatric palliative care, social work, nursing, and hospice were represented. The authors provided the panel with a literature review on 20 proposed measures derived from adult measures and bereaved family interviews. The panel first scored the importance of each measure on a 9-point scale and then discussed the measures via a conference call. The panel then rescored the measures. According to a priori standards, measures with median scores ≥ 7 with at least 7 of 9 experts ranking it as ≥4 were endorsed. The 16 endorsed measures included measures related to avoidance of medically intense care (eg, intensive care unit death and intubation in the last 14 days of life), death location (eg, death in the preferred location), hospital policies/programs (eg, the removal of visitor restrictions at EOL and the presence of a bereavement program), and supportive care services (eg, pediatric palliative care involvement and sibling needs assessment). Unendorsed measures included avoidance of chemotherapy at EOL and home death. Expert panel-endorsed quality measures have been developed for EOL care in pediatric oncology. The measures need validation with bereaved families and further refinement before they are ready for real-world application as a tool for standardizing EOL care in pediatric oncology. Quality measures for end-of-life care for children with cancer lag behind adult quality measures. Therefore, the authors have conducted an expert panel to develop an endorsed list of quality measures for end-of-life care for children with cancer. The 16 endorsed measures include measures related to avoidance of medically intense care (eg, intensive care unit death and intubation in the last 14 days of life), location of death (eg, death in the preferred location), hospital policies/programs (eg, the removal of visitor restrictions at the end of life and the presence of a bereavement program), and supportive care services (eg, pediatric palliative care involvement and sibling needs assessment).

Validation of a rapid wetland ecosystem services assessment technique using the Delphi method

Wetlands differ in their ability to provide ecosystem services, and thus there is a need to assess ecosystem service delivery in order to prioritize protection and restoration efforts. We used a Delphi-based expert-panel method to validate an ecosystem services assessment technique in a context where there is a paucity of field-level process-based research into the delivery of ecosystem services. The validation process entailed comparing scores from a panel of wetland experts to that derived by WET-EcoServices. Three wetlands were selected where detailed information relating to the supply of regulating services was available. At each site a selection of regulating services was assessed and then scored using the technique and independently by the panel of experts. The expert panel reached high levels of consensus (83%) on the scores for the three case studies used in the validation process. The consensus formed a useful basis for the validation of the technique. Statistical testing revealed no significant differences between expert and technique scores however, when considered practically, there were small differences in 53% of the scores, moderate differences in 23% and large in 20%. In most cases the technique over scored relative to the expert assessment. The results were useful for identifying specific refinements to the technique. The study demonstrates how a three-way “engagement” of a rapid-assessment technique, expert opinion and detailed research can be used to improve ecosystem services assessments in resource-limited situations. We reflected on the use of the Delphi method in a resource-constrained environment and advocate its careful application in similar contexts.

Методика відбору критичних технологій

An important condition for the stable development of the country is quality predictive research, in international practice better known as foresight. In this paper, authors analyze the most popular methods of technological foresight, which are used both in Ukraine and in other countries. The positive and negative traits of each of them are determined. This research showed that the most common methods of technological foresight are Delphi, SWOT analysis, expert panels, scenarios, modeling, bibliometric and patent analysis, etc. The analysis also indicated that methods, such as benchmarking, polling, brainstorming, roadmaps and scenarios, conferences, seminars and SWOT analysis cannot be applied to technological foresight in defense sphere. We also cannot talk about the use of exclusively methods of bibliometric and patent analysis, if the statistical data is not enough to predictive research. Therefore, we cannot forecast future technological directions without expert methods, but it should be borne in mind that expert estimates always have an error. The authors proposed a new method of technological foresight to determine the list of critical technologies in the defense sector of Ukraine - the method of critical technologies. It combines expert methods (Delphi and expert panel method) and statistical methods (patent and bibliometric analysis). The paper describes the complete algorithm of conducting predictive research regarding to determine the critical technologies list in the defense sector of Ukraine. In addition, the full decision-making structure the selection of technologies to the list of critical ones was demonstrated, with a description of the composition of the expert commission and generalized selection criteria. A new principle is proposed for cutting off non-priority technologies based on differentiation of the approximated function and determination of the point of equal increments of abscissa and ordinate. The algorithm involves carrying out two stages of the survey, the Delphi method and method of pairwise comparisons, bibliometric and patent analysis. As a result of the foresight by the method of critical technologies, we get an objective ranking of critical technologies.

Policy package for preventing overuse and underuse of health care services in the Iranian health care system: A study protocol.

Background: Overuse and underuse of health care services are progressively recognized in all health systems around the world. There is evidence of overuse and underuse of health care services in Iran. In this study, it was aimed to summarize the evidence of overuse and underuse of health care services in the Iranian health care system. Methods: This study will be conducted in 5 steps using a sequential explanatory multimethod design, literature review, systematic review, qualitative interview, expert panel, and policy Delphi method. This study was approved by Tabriz University of Medical Sciences (ethical confirmation number: IR.TBZMED.REC.1396.908). Conclusion: There is a strong evidence of worldwide overuse and underuse of health care services. Designing context-based prevention strategies by conducting comprehensive and systematic studies will improve the appropriate use of routine services and help patients, physicians, and providers make evidence-based decisions.