Two-round Delphi Questionnaire Research Articles

Defining well-being in psoriasis: A Delphi consensus among healthcare professionals and patients

Psoriasis is a chronic skin disease that negatively impacts on patient’s life. A holistic approach integrating well-being assessment could improve disease management. Since a consensus definition of well-being in psoriasis is not available, we aim to achieve a multidisciplinary consensus on well-being definition and its components. A literature review and consultation with psoriasis patients facilitated the design of a two-round Delphi questionnaire targeting healthcare professionals and psoriasis patients. A total of 261 panellists (65.1% patients with psoriasis, 34.9% healthcare professionals) agreed on the dimensions and components that should integrate the concept of well-being: emotional dimension (78.9%) [stress (83.9%), mood disturbance (85.1%), body image (83.9%), stigma/shame (75.1%), self-esteem (77.4%) and coping/resilience (81.2%)], physical dimension (82.0%) [sleep quality (81.6%), pain/discomfort (80.8%), itching (83.5%), extracutaneous manifestations (82.8%), lesions in visible areas (84.3%), lesions in functional areas (85.8%), and sex life (78.2%)], social dimension (79.5%) [social relationships (80.8%), leisure/recreational activities (80.3%), support from family/friends (76.6%) and work/academic life (76.5%)], and satisfaction with disease management (78.5%) [treatment (78.2%), information received (75.6%) and medical care provided by the dermatologist (80.1%)]. This well-being definition reflects patients’ needs and concerns. Therefore, addressing them in psoriasis will optimise management, contributing to better outcomes and restoring normalcy to the patient’s life.

The evaluation system of outstanding craftsmen of traditional building construction skills based on the Delphi method

In recent years, with the deepening of the work on the protection of intangible cultural heritage, artisans and traditional craftsmen have gained public attention. Various levels of government have also introduced relevant policy documents to select outstanding craftsmen, aiming to revitalize the traditional cultural industry. This study utilizes Rost-CM6 to analyze the content of government selection texts, extract high-frequency words, summarize the evaluation requirements for traditional craftsmen, and use a two-round Delphi questionnaire survey to construct an evaluation index system and weights. The research concludes that the inheritance of skills and reputation are the most fundamental and important criteria in the selection of outstanding craftsmen; similar weights for indicators indicate that these nine selection criteria are the core requirements for outstanding craftsmen

Analytic hierarchy process (AHP) assessment of Kuwait mega construction projects' complexity

PurposeMegaproject's construction is essential for the development and economic growth of any country, especially in the developing world. In Kuwait, megaprojects are facing many restrictions that discourage their execution causing a significant delay in bidding, design, construction and operation phases with the execution quality being affected. The objective of this study is to develop a complexity measurement model using analytic hierarchy process (AHP) for megaprojects in Kuwait, with a focus on the New Kuwait University multi-billion campus Shadadiyah (College of Social Science, Sharia and Law (CSSL)) as a case study.Design/methodology/approachThe study applies a hybrid fuzzy analytic hierarchy process (FAHP) method to compare the results with those obtained using the conventional AHP method. This can facilitate the project management activities during the different stages of construction. Data were collected based on the results of a two-round Delphi questionnaire completed by seniors and experts of the selected project.FindingsIt was found that project modeling methodology was responsible for complexity. It was grouped under several categories that include technological, goal, organizational, environmental and cultural complexities. The study compares complexity degrees assessed by AHP and FAHP methods. “Technological Complexity” scores highest in both methods, with FAHP reaching 7.46. “Goal Complexity” follows closely behind, with FAHP. “Cultural Complexity” ranks third, differing between methods, while “Organizational” and “Environmental Complexity” consistently score lower, with FAHP values slightly higher. These results show varying complexity levels across dimensions. Assessing and understanding such complexities were essential toward the completion of such megaprojects.Originality/valueThe contribution of this study is on providing the empirical evidential knowledge for the priority over construction complexities in a developing country (Kuwait) in the Middle East.

Modelling critical success factors (CSFs) for Ghanaian public–private partnership (PPP) power projects using fuzzy synthetic evaluation (FSE)

Purpose The purpose of this paper was to first identify and then model the impact of critical success factors (CSFs) of public–private partnership (PPP) power projects. Design/methodology/approach Review of empirical literature came out with 20 CSFs which were ranked by experts and industry practitioners through a two-round Delphi questionnaire survey. Findings These CSFs were grouped into CSF groups (CSFGs) using component analysis, and they served as the input variables for fuzzy analysis. The six components were collaboration and transparency, guarantee and permits, socio-political support, expected profitability, technical feasibility and risk allocation (RA). Overall success index of PPP power projects in Ghana was 5.966 and showed there is high impact of CSFGs on project success. Fuzzy analysis also confirmed RA as the most significant CSFG. Originality/value The model developed can serve as a multi-dimension CSF framework that can be used as a success attainment tool for PPP power projects. For policy developers and stakeholders, the model serves as a pointer to issues which the government/public sector must focus on to attract huge investments from the private sector in the power sector.

Contextualizing evidence-based nurse-led interventions for reducing 30-day hospital readmissions using GRADE evidence to decision framework: A Delphi study.

High 30-day readmission rates increase hospital costs and negatively impact patient outcomes in many healthcare systems, including Hong Kong. Evidence-based and local adaptable nurse-led interventions have not been established for reducing 30-day hospital readmissions among general medical patients in Hong Kong's public healthcare system. The aim of this study was to select and refine evidence-based nurse-led interventions for reducing 30-day hospital readmissions among general medical patients in Hong Kong's public healthcare system using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) framework. Eighteen local healthcare stakeholders were recruited to carry out a two-step process. In step 1, stakeholders were invited to prioritize nurse-led interventions which were supported by existing evidence and suggest important combinations of different interventions. For all interventions prioritized in step 1, step 2 involved stakeholders performing a two-round Delphi questionnaire aiming to generate consensus-based interventions appropriate to the local context. GRADE EtD framework was applied to guide the decision-making process, taking into account certainty of evidence, benefits and harms, resource use, equity, acceptability, and feasibility. Four out of eight nurse-led interventions reached a positive consensus with percentage agreement ranging from 70.6% to 82.4%. GRADE EtD criteria ratings showed that over 70% of stakeholders agreed these four interventions were probably acceptable and feasible, though the certainty of evidence was low or moderate. Half of stakeholders believed their desirable effects compared to undesirable effects were large. However, the resources required and how these nurse-led interventions might affect health inequities when implemented were uncertain. Preliminary implementation issues included high complexity of delivering multiple nurse-led intervention components, and challenges of coordinating different involved parties in delivering the interventions. Appropriate resource allocation and training should be provided to address these potential problems, as suggested by stakeholders. Using the GRADE EtD framework, four nurse-led interventions were recommended by healthcare stakeholders as possible strategies for reducing 30-day hospital readmissions among general medical patients in Hong Kong. To address preliminary implementation issues, nurses' role as care coordinators should also be strengthened to ensure smooth delivery of nurse-led intervention components, and to facilitate multidisciplinary collaboration during service delivery.

Defining and quantifying fatigue in the rugby codes.

The rugby codes (i.e., rugby union, rugby league, rugby sevens [termed 'rugby']) are team-sports that impose multiple complex physical, perceptual, and technical demands on players which leads to substantial player fatigue post-match. In the post-match period, fatigue manifests through multiple domains and negatively influences recovery. There is, however, currently no definition of fatigue contextualised to the unique characteristics of rugby (e.g., locomotor and collision loads). Similarly, the methods and metrics which practitioners consider when quantifying the components of post-match fatigue and subsequent recovery are not known. The aims of this study were to develop a definition of fatigue in rugby, to determine agreement with this common definition of fatigue, and to outline which methods and metrics are considered important and feasible to implement to quantify post-match fatigue. Subject matter experts (SME) undertook a two-round online Delphi questionnaire (round one; n = 42, round two; n = 23). SME responses in round one were analysed to derive a definition of fatigue, which after discussion and agreement by the investigators, obtained 96% agreement in round two. The SME agreed that fatigue in rugby refers to a reduction in performance-related task ability which is underpinned by time-dependent negative changes within and between cognitive, neuromuscular, perceptual, physiological, emotional, and technical/tactical domains. Further, there were 33 items in the neuromuscular performance, cardio-autonomic, or self-report domains achieved consensus for importance and/or feasibility to implement. Highly rated methods and metrics included countermovement jump force/power (neuromuscular performance), heart rate variability (cardio-autonomic measures), and soreness, mood, stress, and sleep quality (self-reported assessments). A monitoring system including highly-rated fatigue monitoring objective and subjective methods and metrics in rugby is presented. Practical recommendations of objective and subjective measures, and broader considerations for testing and analysing the resulting data in relation to monitoring fatigue are provided.

Integration of BIM in Steel Building Projects (BIM-DFE): A Delphi Survey

This study aims to design a BIM integration model for steel building projects (BIM-DFE). It was developed in the following three phases: (i) theoretical phase, (ii) validation phase, and (iii) statistical analysis for the theoretical phase. A literature review was conducted to study the applications of BIM in steel building projects and to develop an integrated BIM process map for the construction lifecycle of steel buildings. Subsequently, in the validation phase, 32 participants were invited to complete a two-round Delphi questionnaire to validate the BIM-DFE proposal. The participants were classified according to their knowledge level (skilled or expert). Based on the literature review, a process map that integrates BIM in different phases of a steel building project was created. In the first round of the Delphi questionnaire for the validation phase, the various groups studied (skilled vs. expert) were in moderate agreement with the BIM-DFE proposal; however, after the second round, this agreement became better. Therefore, this study contributes to the current body of knowledge by providing a BIM integration model to improve the management of steel building projects as defined by critical stakeholders in the steel industry. In addition, a real-time case is presented to elucidate a part of the research contribution.

Current controversies in trichology: a European expert consensus statement.

Hair disorders are one of the most common conditions within dermatology practice but, although new diagnostic tools and therapeutic options have arisen, the management of these patients still represents a major clinical challenge. This study aimed at gathering information and achieving consensus on relevant recommendations on the latest advances in alopecia, trichoscopy and hair dermocosmetics. Experts of the steering committee consulted the available evidence on trichology-related areas from the past 5years and formulated recommendations based on the evidence and their experience. A modified two-round Delphi procedure was performed among 45 European dermatologists experts in trichology to consult their degree of agreement on twenty recommendations, using a 4-point Likert scale. Consensus was defined as >80% of participants scoring either 1 (totally agree) or 2 (agree). In the first round of the Delphi questionnaire, 75% of the recommendations reached consensus. Those that were not agreed upon were reformulated by the steering committee and voted again after an online meeting, where consensus was achieved in all recommendations. All recommendations reached consensus after the two-round Delphi questionnaire and may be useful in clinical practice for dermatologists. The participants agreed that besides this consensus, further clinical studies are needed to assess the benefits of the emerging tools and treatments and to clarify the controversies that still exist in the field, aiming at improving patients' quality of life.

Roadmap to Early Implementation of Passenger Air Mobility: Findings from a Delphi Study

Urban air mobility (UAM) has recently increased in popularity as an emerging mode of transportation, covering a wide range of applications, for on-demand or scheduled operations of smaller aircraft, in and around metropolitan areas. Due to its novelty and as it has not yet been implemented, UAM research still faces uncertainties. In particular, there is a need to develop a roadmap for the early implementation of passenger air mobility, aiming to identify the most prominent challenges, opportunities, hazards, and risks, but also to highlight the most promising use cases, or on the contrary, the ones associated with the least benefits compared to the risks or complexity they entail. To answer the previous questions, and therefore address this research gap, this study used a two-round Delphi questionnaire, targeting various stakeholder groups (product owners, policymakers, researchers, consultants, investors), leading to a total of 51 experts, out of which 34 also participated in the second round. In the first round, the main challenges, opportunities, and hazards facing the implementation of passenger UAM were identified. Findings on challenges and opportunities that were dependent on use cases only (as opposed to being dependent on technology or external factors) were then fed back into the second round, which helped evaluate the use cases based both on their complexities, as well as the associated benefits. Accordingly, medical/emergency was identified as the best use case and intracity transport as the worst (in terms of complexity vs. benefits). Similarly, a risk analysis evaluated the potential hazards associated with the implementation of UAM and their impacts on the system viability. Community backlash was found to be the most hazardous one, while malicious passenger behavior and improperly designed infrastructure as the least. Findings from this study can help better understand stakeholders’ opinions, highlighting promising use cases, but also risks to be aware of, constituting therefore a roadmap for future implementation.

Critical success factors for adopting building information modelling (BIM) and lean construction practices on construction mega-projects: a Delphi survey

PurposeThe purpose of this paper is to investigate critical success factors (CSFs) that enhance integration between building information modelling (BIM) and lean construction (LC) practices on construction mega-projects. BIM and LC have gained momentum in the past decade.Design/methodology/approachThe Delphi survey technique was used to gauge opinions of a panel of 16 experts through a two-round Delphi questionnaire survey. Panel responses were scrutinised using inferential and descriptive statistical techniques.FindingsIn total, 30 CSFs were identified in the literature. The top ranked factor out of 30 that supports LeanBIM synergy was “collaboration in design, construction works and engineering management”. Other top rated CSFs were centric on people, data and technology elements. The research findings are important for project stakeholders, organisations, contractors, engineers and local authorities who implement LC and BIM synergies in construction mega-projects.Originality/valueThe research findings are important for project stakeholders, organisations, contractors, engineers and local authorities who implement LC and BIM synergies in construction mega-projects. The research recommends further hands-on training to increase the integration of BIM and LC practices in the architecture, engineering and construction industry and to enrich the extant body of knowledge in construction of mega-projects.

Proposal of competencies for engineering education to develop water infrastructure based on “Nature-Based Solutions” in the urban context

The aim of this work was to determine the competencies that need to be included in engineering programs to develop water infrastructure based on Nature-Based Solutions (NBS) in the urban context, focused on its application in developing countries. Thus, the work was developed in three phases: i) a theoretical phase, ii) a validation phase and iii) a statistical analysis. For the theoretical phase, a literature review was conducted to determine a set of competencies for developing these type of projects. Next, in the validation phase, fifty participants were invited to complete a two-round Delphi questionnaire to rank the competencies detected in the literature review. The participants were classified according to their level of knowledge (skilled or expert) and place of work (countries with upper-middle-income or high-income). The results showed that twenty-one competencies were identified. In the validation phase, for the first Delphi round, the different groups studied (skilled vs expert; high-income vs upper-middle-income) did not agree about the most important competencies. However, after the second Delphi round, an agreement was achieved. Therefore, competencies related to water quality and process design for improving its quality were defined as “extremely important” competencies. In addition, the entire panel of experts also highlighted competencies related to legislation, circular economy, equipment, climate, and construction materials. Thus, for the first time, a set of competencies that needs to be included in educational programs for engineers with a special focus on developing water infrastructure based on NBS in the urban context of developing countries has been proposed in this work.

Networks for studies on reproductive and perinatal health: Searching for a consensus.

To address the essential characteristics of a network and aspects related to network sustainability. A descriptive study based on a two-round Delphi survey was conducted from 2016 to 2018. Researchers participating in maternal and perinatal health networks were identified by searching PubMed for network-based publications and invited to complete a two-round Delphi questionnaire by email. Among 529 eligible researchers identified, 54 (10.2%) and 46 (8.7%) responses were received in the first and second rounds, respectively. A consensus on 13 of 21 [OK] questions, and 5 of 10 questions was achieved in the first and second rounds, respectively. The results indicated that a responsible leader is required, and both coordinators and members have a role in decision-making within the network. Good communication and periodic face-to-face meetings are key factors in sustainability and motivation. Rules for secure access to the network database and definition of authorship of scientific papers are essential. Mentioning the name of the network in publications is important for strengthening its activities and the obtainment of funds. Although operational characteristics of the network may differ according to setting and collaborators, homogeneous and essential network characteristics were identified.

SI model of measuring the success of strategies and decisions in construction projects using system dynamics

This paper uses system dynamics (SD) approach to predict and measure construction projects strategies and decisions success. SD model captures construction projects design phase processes using VENSIM software to simulate policies used. The model is validated by comparing results for the base case of Love, Edwards et al. 2008 model. Two scenarios are proposed to overcome owner changes. These changes are minimizing project schedule from 45 to 25 weeks. Polices used to overcome these changes are: 1- assign overtime to the available designers to increase the work output (one designer work more than one shift); 2- assign more experienced designers to work without assigning overtime to these designers (increase the available designers but the designer work only one shift). The SI model is developed to compare between these two scenarios. Two-round Delphi questionnaire are used for data gathering to build structure index (SI) model that represent measure of project success. Four success parameters; time, cost, quality, and Client’s Satisfaction; are used to formulate a success measure index for construction projects. This helps in indexing the success of finished projects in order to compare with each other. Also, using the proposed SI model with SD helps in measuring organization strategy success. And, help decision makers to assess their decisions. The results show that more designers assigned to finish the work in time (i.e. scenario two) is better than scenario one (i.e. better than working overtime that leads to more rework and increases the cost).

What patient assessment skills are required by pharmacists prescribing systemic anti-cancer therapy? A consensus study.

In the UK, pharmacist independent prescribers can prescribe for any condition within their clinical competence including systemic anti-cancer therapy. Competency frameworks have been developed but contain little detail on the patient assessment skills pharmacist independent prescribers require to prescribe systemic anti-cancer therapy with concern in the literature over current training on these skills. To gain consensus on the patient assessment skills required by pharmacist independent prescribers prescribing systemic anti-cancer therapy for genitourinary cancer (prostate and renal) and lung cancer across National Health Service Scotland. Two phases were performed to generate patient assessment skill consensus. Initially, the Nominal Group Technique was performed within a local cancer network by discussion and participant ranking within genitourinary and lung cancer multi-disciplinary teams. Where consensus was achieved, patient assessment skills were carried forward to try to achieve national (National Health Service Scotland) consensus using a two-round Delphi questionnaire. Of the 27 patient assessment skills, consensus was gained for 21 and 23 patient assessment skills in the genitourinary and lung Nominal Group Technique groups, respectively. Within the genitourinary and lung national groups, 13/21 and 18/23 patient assessment skills were agreed as required for a pharmacist independent prescriber to prescribe systemic anti-cancer therapy in genitourinary and lung cancer, respectively. Eight common patient assessment skills were identified as core skills. Reasons for not reaching consensus included pharmacist independent prescriber competence, knowledge, skills and the roles and responsibilities of pharmacist independent prescribers within the multi-disciplinary team. We identified the core and specific patient assessment skills required to prescribe systemic anti-cancer therapy within two tumour groups. Further work is necessary to develop patient assessment skill competency frameworks, training and assessment methods and to redefine the roles of pharmacist independent prescribers within the multi-disciplinary team.

Defining a set of standardised outcome measures for newly diagnosed patients with multiple myeloma using the Delphi consensus method: the IMPORTA project

ObjectiveTo define a standard set of outcomes and the most appropriate instruments to measure them for managing newly diagnosed patients with multiple myeloma (MM).MethodsA literature review and five discussion groups...

Developing a risk assessment method for complex pipe jacking construction projects

Abstract Pipe jacking (PJ) construction is a highly complex and uncertain process so that performing an accurate risk assessment is essential to the success of a project. This study presents an innovative risk assessment model which combines fuzzy inference with failure mode and effect analysis (FMEA) to improve the effectiveness of existing risk assessment methods for pipe jacking construction. The proposed model maps the relationship between occurrence (O), severity(S), and detection (D) with the level of criticality of risk events in three steps: fuzzification, fuzzy rule-based inference, and defuzzification. A case study of a PJ construction project for water transmission in Shanghai, China is presented to demonstrate and validate the proposed method. A total of 31 potential risks was identified according to the PJ construction procedure and two-round Delphi questionnaire surveys. By using the proposed fuzzy-FMEA approach, the most critical risks in the PJ construction process can be identified, in particular, the shaft structure construction, jacking operation, and steel pipe segments welding. The proposed method overcomes the inherent weaknesses of traditional FMEA method and provides a reliable and distinguishable risk ranking system by properly reflecting the complexity of PJ construction environment. The study also provides a comprehensive risk identification and evaluation tool for industrial practitioners who manage or involve with PJ construction projects.

Physiotherapy Research Priorities in Switzerland: Views of the Various Stakeholders.

Research priorities, defined by multiple stakeholders, can proximally facilitate the coordination of research projects and national and international cooperation and distally further improve the quality of physiotherapy practice. The aim of this study was therefore to establish physiotherapy research priorities in Switzerland considering multiple stakeholders' opinions. A mixed methods design was chosen. For a qualitative identification of physiotherapy research topics, 18 focus group discussions and 23 semi-structured interviews/written commentaries were conducted. For the quantitative analysis, 420 participants prioritized research topics using a two-round Delphi questionnaire survey. The following stakeholder groups were surveyed in the German-speaking, French-speaking and Italian-speaking regions of Switzerland: physiotherapy researchers, practitioners and educators, representatives of patient organizations, public health organizations, health insurers, physicians, nurses, occupational therapists and other health professionals, as well as physical educators. The top five overall physiotherapy research priorities identified were as follows: physiotherapy treatment, physiotherapy assessment and diagnosis, prevention, physiotherapist-patient interaction and physiotherapy professional education at the bachelor level. With regard to diagnostic groups, the highest priorities were placed on musculoskeletal disorders, neurology, orthopaedics, geriatrics and ergonomics/occupational health. Consensus was moderate to high, and only few differences between stakeholder groups were revealed. Research directly related to physiotherapy treatment is of highest priority. It should focus on diagnostic groups related to chronicity in anticipation of demographic changes. Multidisciplinary networks for research and practice, alongside sound coordination of research projects, should increase the impact of physiotherapy research. An accurate dissemination of research priorities, defined and supported by multiple stakeholder groups, might strengthen their impact on research and practice. Copyright © 2015 John Wiley & Sons, Ltd.

Construction Project Success ranking through the Data Envelopment Analysis

The purpose of this paper is to rank construction projects' success in a post delivery phase. To attain this objective, a data envelopment analysis (DEA) approach is used. The model's output is a project success index which is calculated based on five project success criteria. These criteria which are determined by a two-round Delphi questionnaire survey are time performance, cost performance, quality, HSE, and customer satisfaction. The input factors which have effects on the output measures are Organizational Sponsorship, Project Manager Competency, Customer Organization, Project Operational Environment and Organizational Experience. The tool adopted to determine these factors is questionnaire. This model is applied for 9 projects with different importance of output and input factors and the reasonable result is achieved for ranking these projects.

Surgical Referral Criteria for Degenerative Rotator Cuff Tears: A Delphi Questionnaire Study

Selecting the most appropriate patients to refer for surgery is crucial for high-quality and efficient clinical care. However, there are no specific referral criteria to guide the referral of appropriate patients for rotator cuff repair surgery. The aim of the present study was to design robust surgical referral criteria for patients with degenerative rotator cuff tears using consensus methodology. A two-round Delphi questionnaire was undertaken with a nationally representative sample of 41 specialist shoulder surgeons experienced in rotator cuff repair. Surgical referral criteria for degenerative rotator cuff tear were developed where consensus of at least 70% agreement was achieved. The initial questionnaire consisted of 24 items. Consensus was reached on 14 items, including: severity of pain, functional limitation, the identification of fat atrophy, agreement that a course of physiotherapy should be attempted before surgical referral, and exclusion for those with an active frozen shoulder. However, there was no consensus with regard to the dimensions of the tear. The surgical referral criteria developed were novel and promising for patients with degenerative rotator cuff tears, and further research is required to examine their efficacy.

Establishment of assessment system for comprehensive clinical competency of general practice residents

Objective To establish a assessment system for comprehensive clinical competency of general practice residents. Methods An assessment system for comprehensive clinical competency of general practice residents was developed with modified Delphi expert consultation during November 2010 to October 2011. Thirty three experts in clinical practice, education and administration of general practice were invited for two-round Delphi questionnaire consultation. Results In two-round consultation, the expert activity coefficient was 100%, the authority coefficient was 0.852 and 0.855, and the coordination coefficient for the importance of the indicators was 0.228 and 0.245 respectively (P=0.000). The opinions among the experts became consistent from round 1 to round 2. An assessment system was established, which consisted of 5 first-level (professionalism, communicate skills, clinical competency and professional development ability) and 36 second-level indicators. Conclusion The index system established in this study may be used as references for evaluating comprehensive clinical abilities of general practitioners systematically and objectively. Key words: Educational measurement; Delphi technique; General practitioners