Rounds Of Delphi Questionnaires Research Articles

Selection of outcome measurement instruments for a core outcome set for trials aimed at improving appropriate polypharmacy in older people in primary care: a Delphi consensus study

BackgroundDespite developing a polypharmacy core outcome set (COS) in primary care, it is not clear how these outcomes should be measured.AimTo select outcome measurement instruments (OMIs) for a COS targeting appropriate polypharmacy in older patients in primary care.MethodFollowing the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guideline, OMIs were identified from a Cochrane review focusing on appropriate polypharmacy. The quality of OMIs was assessed using a published checklist. Subsequently, two rounds of Delphi questionnaires were conducted via the SoGoSurvey® platform, engaging stakeholders (researchers, clinicians and journal editors specialising in geriatric primary care) to achieve consensus on OMIs using a scale encompassing “agree”, “disagree”, or “unsure”. Consensus was achieved if 70% or more participants chose “agree” and 15% or fewer chose “disagree.”ResultsThe quality of 20 OMIs identified from the Cochrane review was evaluated. Seven OMIs were selected based on meeting the COSMIN guideline’s minimum requirements. Out of 188 potential participants, 57 (30.3%) consented to participate. Rounds 1 and 2 of Delphi exercises were completed by 50 respondents, achieving agreement on three OMIs: ‘number of serious adverse drug reactions (ADRs)’ (98%), ‘number of deaths’ (76%), and ‘number of patients who fell’ (70%) for measuring ‘serious ADRs,’ ‘mortality,’ and ‘falls,’ respectively. No agreement was reached for ‘medication appropriateness,’ ‘medication side-effects,’ ‘quality of life,’ and ‘medication regimen complexity.’ConclusionOMIs were selected for a limited number of outcomes in the polypharmacy COS. Future research should identify suitable OMIs for the remaining four outcomes.

K-12 students' higher-order thinking skills: Conceptualization, components, and evaluation indicators

Higher-order thinking skills are essential for future citizens. Therefore, it is important to understand its conceptualization, components, and evaluation indicators. The aim of this study was to construct and validate a framework of indicators for evaluating higher-order thinking skills. We used a three-step mixed-method research design and collected expert opinions through a questionnaire. First, a literature review found that higher-order thinking skills include problem-solving, metacognitive, critical thinking, teamwork, and innovation development skills. Then, there was a general consensus among 11 evaluators regarding the conceptualization, components, and evaluation framework of higher-order thinking skills through two rounds of Delphi questionnaires. The framework for evaluating K-12 students' higher-order thinking skills includes five first-level indicators, 17 second-level indicators, and 55 third-level indicators. The results show that the indicator framework is scientific and reliable. In conclusion, this study not only proposes a compilation for evaluation indicators of K-12 students' higher-order thinking skills, but also provides support for the measurement and development of higher-order thinking skills.

Extending the Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement for reporting Chinese patent medicine guidelines: a protocol

Background: Based on the main document of the Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement, this study will aim to develop the reporting checklist applicable to the guidelines of Chinese patent medicine (CPM). Methods: According to the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network, three well-defined working groups were established, namely the coordination team, the advisory group, and the Delphi panel. The coordination team conducted a literature analysis of the already published CPM guidelines, the extensions of the RIGHT statement, and CPM related reporting specifications to initially form an initial item pool. The Delphi panel of multidisciplinary backgrounds will conduct two rounds of Delphi questionnaires to identify an extension item for RIGHT for CPM. These questionnaires will be sent to each Delphi panel member via email, and each member will independently fill out and provide comments within 10 working days of receiving the questionnaire. Finally, feedback will be provided to the coordination team and the post efficacy assessment of the already published clinical practice guidelines for CPM to determine the final items for RIGHT for CPM checklist. Dissemination: The extended version of the RIGHT for CPM checklist will be published in a peer reviewed journal. Conclusion: We hope that the upcoming RIGHT for CPM checklist provides detailed guidance for developers and users of CPM guidelines, further improving the quality of reports, and promoting the effective dissemination and implementation of CPM guidelines.

American Society of Metabolic and Bariatric Surgery consensus statement on laparoscopic adjustable gastric band management.

Laparoscopic adjustable gastric band (LAGB) management continues to be an important part of many metabolic and bariatric surgery practices. To replace the existing American Society for Metabolic and Bariatric Surgery (ASMBS) LAGB adjustment credentialing guidelines for physician extenders with consensus statements that reflect the current state of LAGB management. ASMBS Integrated Health Clinical Issues Committee. A modified Delphi process using a 2-stage consensus approach was conducted on LAGB management. Thirty-four consensus statements were developed following a literature search on a wide range of LAGB topics. A 5-point Likert scale was implemented to measure consensus agreement with a Delphi panel of 39 expert participants who were invited and agreed to participate in 2 rounds of Delphi questionnaires. Consensus was set a priori at 75% agreement, defined as the proportion of participants responding with agreement (i.e., 4 or 5) or disagreement (i.e., 1 or 2) on the Likert scale. Consensus was reached on 74% (25 of 34) of the LAGB management statements. In Delphi round 1, 95% (37 of 39) of the participants responded to 34 consensus statements; 21 of the statements (62%) met the 75% criteria for consensus. Thirty-one participants (80%) responded in round 2, shifting the agreement on 4 more statements to the 75% threshold. The ASMBS consensus statement on LAGB management is intended to guide practice with current evidence-based knowledge and professional experience. The ASMBS is not a credentialing body and does not seek to guide credentialing with this document.

Evidence-Based Aquatic Therapy Guidelines for Parkinson's Disease: An International Consensus Study.

Aquatic therapy is one therapy option for people living with Parkinson's disease (PD). However, the optimal prescription, dosage, and delivery remain unclear. i) To generate consensus statements, ii) to establish evidence-based clinical practice aquatic therapy guidelines for PD. Seventy-three international experts were invited to participate in a 3-step modified Delphi study. Gaps in the aquatic therapy evidence, patient preferences, and stakeholder engagement were considered when developing the initial list of 43-statements identified by the research development group. Practice experts rated each statement on an 11-point Likert scale. Consensus for inclusion was set at a priori of ≥70% of respondents scoring an item ≥7. Two rounds of Delphi questionnaires were completed online, and the expert comments were analyzed using content analysis. An online consensus meeting with an expert subgroup (n = 10) then advised on the guideline's acceptability and debated items until consensus for inclusion was reached. Fifty experts participated in the Delphi round one (83% response rate) and 45 in round two (90% response rate), representing 15 countries. In round one, 35 statements met the criteria for consensus. Content analysis informed the revised statements in round two, where 12 of the remaining 16 statements met consensus. The final agreed aquatic therapy guidelines include key information about dosage, content, safety, contraindications, and the optimal aquatic therapy delivery throughout the disease course. Stakeholders, including international practice experts, informed a rigorous evidence-based approach to integrate the best available evidence, patient preferences, and practice expertise to inform these guidelines.

Deciphering the link between procurement systems and sustainable building success in Hong Kong

Sustainable buildings are regarded as one of the most effective approaches to saving resources, reducing greenhouse gas emissions and supporting sustainable development. In the absence of prior research, Delphi as a group model-building approach for building a system dynamics model is appropriate for capturing the knowledge of construction professionals to identify the relationship between procurement systems and sustainable building success by facilitating efficient group communication. The concepts of the Delphi method were reviewed. Two rounds of Delphi questionnaires were carried out to identify the causal relationships between procurement system variables, critical success factors and success criteria. A causal-loop diagram was built based on the results of the two rounds of Delphi study; this will serve as a basis for building a system dynamics model of sustainable building success in a future study. The results show that some critical success factors related to sustainable building in Hong Kong include ‘market planning/business case for sustainability as sustainable objectives’; ‘top management commitment and support’; ‘sustainable strategic planning’; ‘green timing: early evaluation and adoption of sustainability considerations’; and ‘training and education’.

Delphi-based prioritization of economic criteria for development of wave and tidal energy technologies

Harness of wave and tidal energies can play an important role in the future energy portfolios to ensure the energy security and to reach the low-carbon energy development plans. However, despite the existence of adequate resources of these energies through the world, they have not been well exploited yet. This study has focused on the assessment of the economic criteria and their relative importance for the development of the wave and tidal energy technologies based on the experts' judgment. To this end, the expert elicitation process was performed using the Delphi methodology. 5 main criteria and 29 sub-criteria were initially identified through a comprehensive literature review. During two rounds of Delphi questionnaires, the degree of importance and the degree of consensus values were identified for each individual parameter. According to the results achieved, selling the energy produced and tax incentives were rated as the most important factors with the highest degrees of consensus. While quotas and tenders were not identified by the experts participated in the survey with high importance on the development of wave and tidal energies although with low degrees of consensus.

Art therapy for patients with depression: expert opinions on its main aspects for clinical practice

Background: Art therapy is based mainly on clinical experience and is rarely described and evaluated scientifically. There is a need for further exploration of its use in patients with depression.Aim: The aim of this study was to explore what experts consider to be the main aspects of art therapy in clinical practice for patients with depression.Method: Eighteen occupational therapists experienced and educated in art therapy participated. The experts answered three rounds of Delphi questionnaires and ranked their agreement with 74 assertions. Consensus was defined as 70% or higher.Results: The experts agreed more on assertions about theoretical frames of reference than about clinical practice. The main aspects of art therapy were agreed to be the patients’ opportunity to express themselves verbally and through making art. It was equally important that art tasks provided an opportunity to address depressive thoughts, feelings, life experiences, and physical symptoms.Conclusions: Experts in the field of art therapy considered that the main aspect of clinical practice in art therapy for patients with depression is that art themes should promote expression related to both to depression and personal history.

A value tree for identification of evaluation criteria for solar thermal power technologies in developing countries

The diversification of electricity generation is necessary for the sustainable development of developing countries and to reduce greenhouse emissions. Solar thermal power technologies are advancing and expected to play a significant role in energy portfolios in the future. Accordingly, it is essential to identify comprehensive combination of criteria for assessing these technologies. Various researchers used different parameter combinations for multiple criteria evaluation in renewable energy portfolio planning. The novelty of the proposed approach lies in the structured deliberation and the following analysis to formulate a combination of assessment parameters for solar thermal power technologies based on data providers’ judgment. A generic value tree of evaluation parameters is therefore obtained for solar thermal power technologies in developing countries. Expert elicitation was conducted through the Delphi method, with a total of 140 data providers from multidisciplinary solar thermal power fields affiliated in educational institutes, research centers, governmental organizations, and industrial companies from 32 countries participating in the survey. Five impact categories and nineteen performance measures were combined following a comprehensive literature review to derive a preliminary value tree. Based on participants’ judgments, as expressed during two rounds of Delphi questionnaires, parameters with importance and consensus degrees>50% were incorporated into the final value tree. Each parameter had a variation coefficient of <29%. The output of the process is an aggregated value tree, consisting of 31 performance measures categorized under four main impact categories (technical, economic, environmental, and social). Technical and economic impact categories were rated as most important and achieved the highest degrees of consensus. At performance measures level, economic feasibility obtained the highest level of importance and consensus degrees, followed by reliability, capital cost, storage hours, and water consumption. The recommendations of this work can be utilized as a foundation for stakeholder assessment of regional solar thermal power utilities planning in developing countries.

Three nested RCTs of dual or single stakeholder feedback within Delphi surveys during core outcome and information set development

Methods Two rounds of Delphi questionnaires were completed by patients and health professionals during the development of three surgical core sets. Participants rated items 1 (not essential) to 9 (absolutely essential). For round 2, participants were randomized to receive feedback from their stakeholder group only (single) or both stakeholder groups separately (dual). Items to retain following each round were determined by pre-specified criteria.

Practitioner consensus on the determinants of capacity building practice in high-income countries.

To assess and develop consensus among experienced public health nutrition practitioners from high-income countries regarding conceptualisation of capacity building in practice, and to test the content validity of a previously published conceptual framework for capacity building in public health nutrition practice. A Delphi study involving three iterations of email-delivered questionnaires testing a range of capacity determinants derived from the literature. Consensus was set at >50% of panellists ranking items as 'very important' on a five-point Likert scale across three survey rounds. Public health nutrition practice in Australia, the UK, Canada and the USA. Public health nutrition practitioners and academics. Result A total of thirty expert panellists (68% of an initial panel of forty-four participants) completed all three rounds of Delphi questionnaires. Consensus identified determinants of capacity building in practice including partnerships, resourcing, community development, leadership, workforce development, intelligence and quality of project management. The findings from the study suggest there is broad agreement among public health nutritionists from high-income countries about how they conceptualise capacity building in public health nutrition practice. This agreement suggests considerable content validity for a capacity building conceptual framework proposed by Baillie et al. (Public Health Nutr 12, 1031-1038). More research is needed to apply the conceptual framework to the implementation and evaluation of strategies that enhance the practice of capacity building approaches by public health nutrition professionals.

Adopting European Network for Health Technology Assessments (EunetHTA) core model for diagnostic technologies for improving the accuracy and appropriateness of blood gas analyzers' assessment.

Point-of-care testing (POCT) is a successful methodology for meeting clinical expectations of rapid and accurate results. Scientific literature has moreover highlighted and confirmed the necessity of individuating the best technological solution, in accordance with clinical requirements and contextualized to the whole health organization, where it will be implemented. Health Technology Assessment (HTA) can assist in reaching an appropriate and contextualized decision on a health technology. The aim of this study is to adapt a HTA core model for improving the evaluation of a POCT technology: blood gas analyzers. The European Network for Health Technology Assessment (EUnetHTA) core model for diagnostic technologies was applied for evaluating globally marketed blood gas analyzers. Evaluation elements were defined according to available literature and validated using the Delphi method. A HTA model of 71 issues, subdivided into 26 topics and 10 domains, was obtained by interviewing 11 healthcare experts over two rounds of Delphi questionnaires. Ten context parameters were identified in order to define the initial scenario from which the technology assessment was to begin. The model presented offers a systematic and objective structure for the evaluation of blood gas analyzers, which may play a guidance role for healthcare operators approaching the evaluation of such technologies thus improving, in a contextualized fashion, the appropriateness of purchasing.

Using a Delphi consensus process to develop an acupuncture treatment protocol by consensus for women undergoing Assisted Reproductive Technology (ART) treatment

BackgroundAssisted reproductive technologies (ART) are increasingly utilised for resolving difficulties conceiving. These technologies are expensive to both the public purse and the individual consumers. Acupuncture is widely used as an adjunct to ART with indications that it may assist reducing the time to conception and increasing live birth rates. Heterogeneity is high between treatment protocols.The aim of this study was to examine what fertility acupuncturists consider key components of best practice acupuncture during an ART cycle, and to establish an acupuncture protocol by consensus.MethodsFifteen international acupuncturists with extensive experience treating women during ART interventions participated in 3 rounds of Delphi questionnaires. The first round focused on identifying the parameters of acupuncture treatment as adjunct to ART, the second round evaluated statements derived from the earlier round, and the third evaluated specific parameters for a proposed trial protocol. Consensus was defined as greater than 80% agreement.ResultsSignificant agreement was achieved on the parameters of best practice acupuncture, including an acupuncture protocol suitable for future research. Study participants confirmed the importance of needling aspects relating to the dose of acupuncture, the therapeutic relationship, tailoring treatment to the individual, and the role of co-interventions. From two rounds of the Delphi a consensus was achieved on seven treatment parameters for the design of the acupuncture treatment to be used in a clinical trial of acupuncture as an adjunct to ART. The treatment protocol includes the use of the traditional Chinese medicine acupuncture, use of manual acupuncture, a first treatment administered between day 6–8 of the stimulated ART cycle which is individualised to the participant, two treatments will be administered on the day of embryo transfer, and will include points SP8, SP10, LR3, ST29, CV4, and post transfer include: GV20, KD3, ST36, SP6, and PC6. Auricular points Shenmen and Zigong will be used. Practitioner intent or yi will be addressed in the treatment protocol.ConclusionsDespite a lack of homogeneity in the research and clinical literature on ART and acupuncture, a consensus amongst experts on key components of a best practice treatment protocol was possible. Such consensus offers guidance for further research.

DEVELOPMENT OF A CLINICAL EXAMINATION IN NON-SPECIFIC LOW BACK PAIN: A DELPHI TECHNIQUE

To establish the discriminatory items of the clinical examination of non-specific low back pain, important to physiotherapists. A focus group and Delphi technique with UK physiotherapists. A purposive sample of 30 physiotherapists attended a focus group and completed 3 rounds of Delphi questionnaires. Data were analysed using mixed qualitative and quantitative approaches. A frequency content analysis identified commonly identified tests and questions, whilst the Delphi consensus technique assumed consensus had been reached with greater than 80% agreement on item inclusion or exclusion. The focus group established the structure of the clinical examination with 15 domains of questioning or physical testing. Three rounds of Delphi questionnaires established the important items of the clinical examination. The list of tests and questions included items evaluating both the psychosocial and biomedical status of the patient as well as questions screening for red flags. This is the first work to establish discriminatory tests in the clinical examination of non-specific low back pain, important to physiotherapists. The clinical examination will subsequently be evaluated for item validity and data will undergo cluster analysis. The items of this clinical examination may provide evidence for the existence of homogenous sub-groups within the heterogeneous non-specific low back pain diagnosis.