Rounds Of Delphi Survey Research Articles

Perceived barriers to implementing building information modeling in Iranian Small and Medium-Sized Enterprises (SMEs): a Delphi survey of construction experts

ABSTRACT Building information modeling (BIM) is a disruptive information technology tool in the construction sector. Although this technology had a significant impact on the manufacturing industries, it, like any other technology, encountered several challenges when applied to the construction sector. Conversely, small and medium-sized enterprises (SMEs) in developing economies often face significant impediments when using innovative technologies. Thus, this paper seeks to determine and investigate the perceived barriers to applying BIM in construction SMEs based in Iran. Three rounds of Delphi surveys were carried out with 15 BIM experts engaged in construction SMEs to identify the key barriers to BIM implementation in SMEs. An empirical survey questionnaire comprising these identified barriers was subsequently designed and disseminated to the invited experts. Altogether, 56 valid survey responses were received and analyzed. The study’s findings revealed SMEs management’s hesitancy to adopt BIM, stakeholders’ reluctance to change their established methods, and a lack of technical understanding as the critical impediments to BIM adoption in construction SMEs. Also, the study identified four barrier dimensions – technology, legal, management, and financial. These BIM implementation barrier dimensions can be employed to better allocate resources and financing for BIM deployment and construction innovation in SMEs. The study will assist major project stakeholders and SMEs make better-informed BIM adoption decisions, particularly in developing nations like Iran.

ICF Core-Set Autism Brief 기반 자폐성장애 영유아 언어 행동 평가 도구 개발에 대한 델파이 조사*

The purpose of this study is to develop a verbal behavior assessment tool for asd children using ICF Core Set-Autism Children Brief and verify the validity. Two rounds of Delphi survey on validity of items from IICF Core Set-Autism Children Brief was undertaken by 9 panels who are professionals in applied behavior analysis. As a result, 22 items were identified to be suitable among 48 items. For developmental level suitability, pre-talking and watching were the most suitable items for pre-listener level and listener level and speaker level were found to share common items such as memory function, intellectual function, pay attention, overall psychosocial functions. We discussed about implications that verbal behavior assessment tool for asd children should consider based on the results.

Development of a core outcome set for treatment studies for provoked vestibulodynia.

There is an inconsistency in treatment outcomes used in clinical trials for provoked vestibulodynia (PVD), which makes it impossible to compare the effects of different interventions. In this study, we completed the first step in creating a core outcome set (COS), defining what outcomes should be measured in clinical trials for PVD. Identification of outcomes used in studies was done by extracting data from clinical trials in a recently published systematic review and via review of clinical trials for PVD registered on ClinicalTrials.gov. The COS process consisted of 2 rounds of Delphi surveys and a consensus meeting, during which the final COS was decided through a modified nominal group technique. Consensus on what outcomes to include in a COS for PVD. Forty scientific articles and 92 study protocols were reviewed for outcomes. Of those, 36 articles and 25 protocols were eligible, resulting in 402 outcomes, which were then categorized into 63 unique outcomes. Participants consisted of patients, relatives/partners of patients, health care professionals, and researchers. Out of 463 who registered for participation, 319 and 213 responded to the first and second surveys, respectively. The consensus meeting consisted of 18 members and resulted in 6 outcomes for the COS to be measured in all treatment trials regardless of intervention: insertional pain (nonsexual), insertional pain (sexual), provoked vulvar pain by pressure/contact, pain-related interference on one's life, pain interference on sexual life, and sexual function. Critical outcomes to be measured in clinical trials will allow for accurate comparison of outcomes across treatment interventions and provide solid treatment recommendations. The major strengths of the study are the adherence to methodological recommendations and the intentional focus on aspects of diversity of participating stakeholders (eg, status such as patients with lived experience and researchers, inclusiveness with respect to sexual identity), the latter of which will allow for broader application and relevance of the COS. Among the limitations of the study are the low rate of participants outside North America and Europe and the lower response rate (about 50%) for the second Delphi survey. In this international project, patients, health care professionals, and researchers have decided what critical outcomes are to be used in future clinical trials for PVD. Before the COS can be fully implemented, there is also a need to decide on how and preferably when the outcomes should be measured.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method

Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine.Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert.Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed.Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

Reaching consensus on the definition of person-centred handover practices in emergency departments: A modified online Delphi.

To reach consensus on the definition and attributes of 'person-centred handover practices' in emergency departments. Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. A three-round online Delphi survey. Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. Improve handover practices and patient care. Improve person-centred care in emergency departments. Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.

Development of a Content Framework of Artificial Intelligence Integrated Education Considering Ethical Factors

The rapid advancement of Artificial Intelligence (AI) technology has brought about significant positive changes across society. However, it has also introduced challenges like privacy breaches, data bias, and spreading fake news. In response, several countries, including South Korea, have provided ethical guidelines and policies for AI. Yet, these measures often fall short of keeping pace with the speed and diversity of AI development. To address these issues, this study developed a comprehensive approach by integrating ethical considerations into AI education, covering the entire AI technology development and application process. It involved analyzing previous research on AI and AI ethics education and creating a draft of an integrated AI education program focused on problem-solving based on computational thinking and ethical practicality. The draft was refined and supplemented through two rounds of expert Delphi surveys, ultimately leading to an “Integrated AI Education Program.” This proposed program emphasizes that the knowledge content of AI technology and ethical considerations should not be treated separately but addressed together. It aims to enhance moral and social capacities alongside the experience of thinking like a computer scientist when solving real-life problems. Through this, the program supports the ultimate goal of AI education: to foster computational thinking while providing an educational experience that considers both technology and ethics. This study is expected to advance the discussion on integrating AI ethics into AI education curricula and contribute to developing socially responsible AI developers and users.

Patient reported outcomes in brachial plexus birth injury: results from the iPLUTO world‐wide consensus survey

Purpose Brachial plexus birth injuries (BPBI) can have lifelong effects on the development and functional use of the upper extremity. Currently there is no agreement with regards to what patient-reported outcome (PRO) measures should be used. Therefore, the ability to compare the effects of treatment between individuals and institutions is challenging. This study aimed to achieve consensus among clinicians on the use of PRO measures within this patient group to allow for improved comparison of treatments and outcomes in the future. Materials and Methods Online, a 3 round Delphi survey was completed by 35 international multi-disciplinary specialist centers. Results All respondents (100%) agreed that PRO measures are useful for clinical evaluation and patient treatment. None of the outcome measures scored >75% agreement for ability to assess responsiveness and current state in children with BPBI as most outcome measures were judged as not specific for BPBI. Additionally, participant centers were asked their perspective on the best available PRO option for each of the 3 categories: functional use of the upper limb, quality of life and pain. This resulted in endorsement by the participant centers of the Brachial Plexus Outcome Measure – Self-Evaluation, the Pediatric Quality of Life Inventory, and Visual Analogue Scale/Brief Pain Inventory respectively. Conclusion International specialists in BPBI agree that PRO measures are important to use both clinically and in research in children aged 5 years and above.

Development of the "LAser Surgical skills Evaluation for Residents" (LASER) Scale Through a Modified Delphi Method.

The CO2 laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees. "LAser Surgical skills Evaluation for Residents" (LASER) Scale aims to facilitate the evaluation of residents' performance and promote constructive feedback. The initial evaluation grid was based on a literature review of CO2 laser laryngoscopy (with an emphasis on indications, technique, safety, and efficacy) using Covidence systematic review software (Veritas Health Innovation). The final version was produced after 4 rounds of Delphi surveys. This study was an international collaboration including 15 otolaryngologists with either laryngology or head and neck surgery subspecialties. Panelists were based in Canada (8), the United States (3), France (1), Spain (1), Belgium (1), and Lebanon (1). The process involved 4 rounds of Delphi surveys. Assessment categories included: anesthesia considerations, pre- and perioperative laser safety measures, and surgical technique. Consensus was reached on final survey completion. Through a modified Delphi method, a novel scale was developed through an international collaborative effort that evaluates resident skillset in CO2 laser MLS. Future studies are warranted to validate this assessment tool.

Exploring decision indicators for selecting elite players in youth male singles badminton: based on anthropometric indicators

Exploring decision indicators for selecting elite players in youth male singles badminton: based on anthropometric indicators

Core values and competencies of public health nurses: A Delphi survey

Objectives This study aimed to clarify the core values and competencies of public health nurses (PHNs) who contribute to improve health issues in transitioning societies, based on a consensus among PHN-related organizations, including practitioners and education researchers.Methods A draft defining the core values and competencies of PHNs was developed through five consultation sessions with 20 executives and nominees of organizations in each area of PHN practice, education, and research to collect, categorize, and refine the items. The expert panel comprised 534 nominees from six PHN-related organizations, and three rounds of Delphi surveys were conducted. The consensus criteria were ≥70% for agreement and ≥80% for firm agreement.Results In the first round, 272 expert panel nominees (50.9%) responded, and 217 responded in all rounds. The draft was revised based on the feedback from each round. By round 3, >90% agreed on the core value and competency frameworks and definitions.Conclusion The Delphi survey revealed the three core value frameworks and definitions of "social justice in health," "human rights and autonomy," and "health and safety" and eight core competencies of "professional autonomy and responsibility," "scientific research and use of information science and technology," "population-based assessment and analysis," "practices for health enhancement and prevention," "building systems to improve public health," "management of healthy community development," "person/community-centered collaboration and cooperation," and "communication for consensus and solutions," with a firm agreement. Eventually, these frameworks would be the bases for creating national standards of practice, education, and research to satisfy the consensus levels of PHNs and PHN-related organizations.

Development of quality assessment tool for systematic reviews and meta-analyses of real-world studies: a Delphi consensus survey

The increasing adoption of real-world studies in healthcare for decision making and planning has further necessitated the need for a specific quality assessment tool for evidence synthesis. This study aimed to develop a quality assessment tool for systematic reviews (SR) and meta-analysis (MA) involving real-world studies (QATSM-RWS) using a formal consensus method. Based on scoping review, the authors identified a list of items for possible inclusion in the quality assessment tool. A Delphi survey was formulated based on the identified items. A total of 89 experts, purposively recruited, with research experience in real-world data were invited to participate in the first round of Delphi survey. The participants who responded in the first Delphi round were invited to participate (n = 15) in the phrasing of the items. Strong level of agreement was found on the proposed list of items after the first round of Delphi. A rate of agreement ≥ 0.70 was used to define which items to keep in the tool. A list of 14 items emerged as suitable for QATSM-RWS. The items were structured under five domains: introduction, methods, results, discussions, and others. All participants agreed with the proposed phrasing of the items. This is the first study that has developed a specific tool that can be used to appraise the quality of SR and MA involving real-world studies. QATSM-RWS may be used by policymakers, clinicians, and practitioners when evaluating and generating real-world evidence. This tool is now undergoing validation process.

유아교사의 디지털 리터러시 역량 모형 개발

Objectives This study aims to develop a model of digital literacy competencies for teachers in early childhood.
 Methods To this end, literature review, 3 rounds of delphi surveys were conducted. The research team and an expert advisory committee executed mutual validation at the end of each delphi survey to ensure objectivity and validity.
 Results As a result of this study, a digital literacy competency model for teachers in early childhood was derived, consisting of four main competencies and nine sub-competencies. The main competencies include digital cit-izenship consciousness, digital thinking competency, digital utilization and creation competency, and digital teaching competency. The sub-competencies for digital citizenship consciousness include compliance with digi-tal norms and digital responsibility consciousness, while sub-competencies for digital thinking competency in-clude digital critical thinking and problem-solving abilities. The sub-competencies for digital utilization and crea-tion competency include digital technology utilization and digital creation abilities. Finally, the sub-competencies for digital teaching competency include digital teaching design ability, digital teaching execution ability, and digital teaching reflection ability.
 Conclusions Based on the results of this study, it is expected that an education and training system can be estab-lished to cultivate digital literacy competencies that teachers in early childhood must possess in the educational field of the digital era.

Delivering health promotion during school closures in public health emergencies: building consensus among Canadian experts

Abstract School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: ‘awareness of healthy lifestyle behaviours and mental wellness’, ‘virtual events’, ‘tangible supports’ and ‘school-student-family connectedness’. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated ‘awareness of healthy lifestyle behaviours and mental wellness’ and ‘virtual events’ as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. ‘Tangible supports’ (equipment, food) and ‘school-student-family connectedness’ were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.

The Aging Care 5Ms Competencies: A Modified Delphi Study to Revise Medical Student Competencies for the Care of Older Adults.

To revise the 2009 Canadian Geriatrics Society (CGS) Core Competencies in the Care of Older Persons for Canadian Medical Students by applying current frameworks and using a modified Delphi process. The working group chose the Geriatric 5Ms model and CanMEDS framework to develop and structure the competencies. National (i.e., Canadian) Delphi participants were recruited, and 3 Delphi survey rounds were conducted from 2019 to 2021. Each survey round collected quantitative data using a 7-point Likert scale (LS) and qualitative data using free-text comments. The purpose of the first round was to establish the importance of the components of the proposed competencies (categorized into 13 subsections) and identify additional themes. The second round assessed agreement with 31 proposed competencies organized into 7 themes: aging, caring for older adults, mind, mobility, medications, multicomplexity, and matters the most. The third survey-rated agreement levels after further revisions to the competencies were applied. The final 33 competencies were shared with survey participants for feedback and other stakeholders for external validation. Mean LSs for the importance of the 13 competency component subsections on the first survey varied from 5.11 to 6.54, with an agreement level of 73%-93%. New themes emerged from the qualitative comments. Mean LSs for the 31 competencies on the second survey ranged from 5.57 to 6.81, with an agreement level of 80%-97%. Mean LSs for the revised competencies on the third survey ranged from 5.83 to 6.65, with an agreement level of 83%-95%. The authors developed the 33 Aging Care 5Ms Competencies for Canadian medical students using a consensus process. The competencies fulfill an important need in medical education, and ultimately, society. The authors strongly believe that the competencies can be woven into existing undergraduate medical curricula through purposeful integration and collaboration, including with other specialties.

Nurses' perceived barriers and facilitators to the implementation of nurse prescribing: Delphi study and focus group.

To obtain consensus on barriers and facilitators to nurse prescribing following its recent introduction in Spain. A three round online Delphi survey and focus group. An exploratory method was used with three consecutive rounds of questionnaires based on anonymity and feedback, and a focus group. The study was carried out with primary care, specialized care, socio-health care and manager nurses. On the basis of the Delphi study that was conducted, a list of 15 barriers and 18 facilitators of nurse prescribing was obtained. However, no general consensus was found with respect to the prioritization of these barriers/facilitators. The analysis of the results of the focus group confirmed the information obtained from the Delphi study. The main barriers highlighted were dependence on the figure of the physician, insufficient training in pharmacology, a lack of institutional support and the limited list of products that could be prescribed. The key facilitators were academic knowledge and ongoing training and education, independence in the functions and responsibilities of the nursing profession, adaptation to new roles and autonomy in the case of chronic care processes. Nurses were generally positive about the introduction of nurse prescribing. The commitment of nurses to training and their accreditation as prescribers (internal forces) and health policy and nursing management (external forces) play a fundamental role in supporting the basis of nurse prescribing and ensuring that it is developed with the identified support resources, such as staff training and the provision of the materials necessary for its proper implementation, all with the aim of guaranteeing quality healthcare. Strong models of nurse prescribing are being considered globally to address population needs. The results can help the future implementation of non-medical independent prescribing and provide guidance to the government and society on the interventions that can be used to consolidate it. What problem did the study address? By 2027, the world's population will receive more than 4.5 trillion doses of medicine each year. However, the WHO estimates a projected shortfall of 10 million health workers by 2030. Inadequacies with traditional physician-led care systems mean that new approaches are imperative to maintain patient access to prescription medicines, with NP being a key element in this regard. In Catalonia (Spain), the accreditation process for nurses as prescribers was implemented in 2021. It is therefore of vital importance to question and consult the nurses themselves, the main promoters of the process, to find out their perceptions and thus be able to take them into consideration in the implementation process. What were the main findings? A total of 15 barriers and 17 facilitators were identified. The main perceived barriers are dependence on the figure of the physician, insufficient training in pharmacology during undergraduate studies and a lack of institutional support. The main perceived facilitators are academic knowledge and ongoing education and training, independence in nursing functions and responsibilities, and adaptation to new roles and tasks. Where and on whom will the research have an impact? These results can contribute to improving NP implementation in Spain and serve as a reference for other countries, especially where NP education and training have only recently been instigated or are in the planning process. Standards for reporting qualitative research: a synthesis of recommendations. SRQR. No patient or public contribution.

Development Competencies of Junior Middle School Physical Education Teachers in Dongguan City

Background and aim: Based on the importance that the party and the country attach to school work; Dongguan's junior middle school physical education teachers shoulder a key role in connecting the past and the next. It is necessary to improve the competencies of Dongguan's junior middle school physical education teachers. Methods and processes: This is application-oriented research. The number of participants in this study was 28 experts. The research process is as follows: (1) Collect relevant literature and materials and draft the "Indicator System for the Competency Development of Junior Middle School Physical Education Teachers in Dongguan City"; (2) Two rounds of Delphi surveys involving 19 experts; (3) 9 experts participate in the appreciation of the indicator system. Result: 1) The positive coefficient of expert participation in the research is close to 90%>70%, Cr ≥ 0.7, the average score of expert opinion exceeds 4 points and exceeds 90%, 0 < W < 1, P<0.05, indicating that experts assume reliability. 2) In the first round of the expert’s questionnaire, the Mean of B11, C26, C28, C33, and C40 is < 3.5, CV > 0.25, and these indicators are deleted. The Mean of the remaining indicators is> 3.5, CV < 0.25, so the remaining indicators are retained.3) In the second round of the expert’s questionnaire, The Mean of all indicators is> 3.5, CV < 0.25, so all the indicators are retained. Conclusion: The study constructed a competencies development index system for junior middle school physical education teachers in Dongguan City, including three dimensions: values, physical education ethics, and key competencies, with a total of 52 indicators.

Delphi-Based Survey for Surgical Indications in Biopsy Proven Active Adult Spinal Tuberculosis.

Delphi survey. To obtain an expert consensus on various dilemmas in the surgical treatment of adult spinal tuberculosis (TB) patients. Stage I included a literature review, stage II the identification of 40 Key Opinion leaders (KOLs) and a set of 46 questions, stage III included analysis of 3 rounds of the Delphi survey, and stage IV had final analysis and recommendations. For each question, the level of agreement needed to reach a consensus was set at greater than or equal to 70.0%. The first and second Delphi survey rounds received 62 and 58 responses, respectively, with 16 questions having more than 70% and two questions having 100% agreement in the first stage. The second stage saw a 70% agreement on six questions. Thus, a consensus was obtained on 22 questions. The recommendations that emerged were as follows: neurodeficit with corresponding radiology and neurological deficit appearing/deteriorating while on anti-tubercular chemotherapy(ATT) are absolute indications for surgery, duration of ATT before neurological deterioration need not be considered, epidural abscess does not need decompression unless concordant clinical neurological findings are present, pain not responding to medical management is not a surgical indication, active pulmonary TB, drug-resistant TB, and tubercular sacroiliitis are not considered as surgical indications, and hemoglobin and other health markers have little contribution to surgical indications. In order to resolve several conundrums in the surgical treatment of adult spinal TB, this Delphi survey is the first to achieve a national consensus from spine experts. The final recommendations cover the serological, radiographic, and clinical aspects of spinal TB.

Clinical comprehensive evaluation of direct oral anticoagulants for patients with atrial fibrillation in China.

Direct oral anticoagulants (DOACs) are increasingly recommended over warfarin in stroke prevention for patients with non-valvular atrial fibrillation (AF). However, there is an important evidence gap in choosing the most appropriate DOAC for Chinese patients in clinical practice. A multi-criteria decision analysis (MCDA) was adopted to build a scoring framework. Attributes and criteria were identified and determined by a scoping literature review, two rounds of Delphi surveys, and a consensus meeting. Weights of each attribute and criterion in the framework were determined using analytic hierarchy process (AHP). Evidence was collected based on the domestic or at least Asian data. Scoring methods for each criterion were developed depended on their characteristics and determined with an expert consensus meeting. Comprehensive scores of each DOAC were calculated based on the utility scores of each criterion and their corresponding weights. A total of 5 attributes, including safety, efficacy, costs/cost-effectiveness, suitability, and accessibility, were determined, and 16 criteria were under the 5 attributes. The safety and efficacy were ranked as the top two important attributes with the weights of 38.8% and 35.9%, respectively, while the suitability received the lowest weight of 7.9%. The comprehensive score for edoxaban was the highest (72.3), followed by dabigatran (49.7), rivaroxaban (37.9), and apixaban (35.8). This study provided a scoring framework developed for comprehensive evaluation of DOACs in China. The ranking of DOACs could help to support the decision-making in clinical practice. The framework could provide a reference for comprehensive evaluation of other drugs.

Construction of nursing-sensitive quality indicators for the care of patients with prone position ventilation using the Delphi method

BackgroundProne position ventilation (PPV) has gradually become an adjuvant treatment to improve oxygenation in patients with acute respiratory distress syndrome. Scientific and comprehensive evaluation of the quality of nursing care for patients with PPV is of great significance to ensure the effectiveness of treatment and patient safety. However, there are no established objective indicators for evaluating the quality of nursing care for patients with PPV. This study intended to identify a set of scientific, systematic and clinically applicable nursing-sensitive quality indicators for the care of patients with PPV.MethodsBased on the Donabedian structure-process-result theory model, the quality evaluation indicators of nursing care for patients with PPV were preliminarily constructed based on an evidence-based perspective, and two rounds of Delphi surveys were conducted with the purpose of collecting opinions from a panel of independent experts.ResultsThe questionnaire recovery rates of the two rounds of correspondence were 100.00% and 95.00%, the recovery rates of expert opinions were 80.00% and 26.32%, the expert authority coefficient values were 0.89, and the Kendall coordination coefficient W values were 0.110 and 0.133, respectively. The final nursing-sensitive quality indicators for the care of patients with PPV included 3 first-level indicators, 9 s-level indicators and 29 third-level indicators.ConclusionThe constructed nursing-sensitive quality indicators for the care of patients with PPV involve quality supervision during the whole process of PPV from three dimensions: structure, process and results. These indicators have strong operability, reliability, practicability and scientificity and can provide a reference for the quality evaluation and monitoring of nursing care for patients with PPV.Implications for nursing managementThe quality indicators of nursing care for patients with PPV constructed in this research are scientific and reliable, and the content of the quality indicators can better reflect the technical characteristics of special nursing. Nursing managers are encouraged to use these quality indicators to evaluate the quality of clinical nursing care and improve safety for patients with PPV.

O.2.3-4 A standardised core outcome set for measurement and reporting sedentary behaviour interventional research: the CROSBI consensus study

PurposeHeterogeneity of descriptors and outcomes measured and reported in sedentary behaviour (SB) research hinder the meta-analysis of data and accumulation of evidence. The objective of the Core Research Outcomes for Sedentary Behaviour Interventions (CROSBI) consensus study was to identify and validate, a core outcome set (COS) to report (what, how, when to measure) in interventional sedentary behaviour studies.MethodsOutcomes, extracted from a systematic literature review, were categorized into domains and data items (COS v0.0). International experts (n = 5) provided feedback and identified additional items, which were incorporated into COS v0.1. A two round online Delphi survey was conducted to seek consensus from a wider stakeholder group and outcomes that achieved consensus in the second round COS (v0.2), were ratified by the expert panel.ResultsThe final COS (v1.0) contains 53 data items across 12 domains, relating to demographics, device details, wear-time criteria, wear-time measures, posture-related measures, sedentary breaks, sedentary bouts and physical activity. Notably, results indicate that sedentary behaviour outcomes should be measured by devices that include an inclinometry or postural function.ConclusionsThe proposed standardised COS is available openly to enhance the accumulation of pooled evidence in future sedentary behaviour intervention research and practice.