Improving the care of older persons in Australian prisons using the Policy Delphi method.

PubMed

Patterson, Karen; Newman, Claire; Doona, Katherine

2016-09-01

There are currently no internationally recognised and approved processes relating to the care of older persons with dementia in prison. This research aimed to develop tools and procedures related to managing the care of, including the identification and assessment of, older persons with dementia who are imprisoned in New South Wales, Australia. A modified approach to the Policy Delphi method, using both surveys and facilitated discussion groups, enabled experts to come together to discuss improving the quality of care provision for older persons with dementia in prison and achieve research aims. © The Author(s) 2014.

Legislative priorities for transportation safety in Virginia : a pilot application of a modified delphi technique : final report.

DOT National Transportation Integrated Search

1985-01-01

Using a modified version of the Delphi technique, a panel of transportation safety experts developed the following list of legislative priorities for submission to the Department of Motor Vehicles (DMV) Legislative Package for the 1986 session of the...

Developing a Canadian Curriculum for Simulation-Based Education in Obstetrics and Gynaecology: A Delphi Study.

PubMed

Craig, Catherine; Posner, Glenn D

2017-09-01

As obstetrics and gynaecology (Ob/Gyn) residency training programs move towards a competence-based approach to training and assessment, the development of a national standardized simulation curriculum is essential. The primary goal of this study was to define the fundamental content for the Canadian Obstetrics and Gynecology Simulation curriculum. A modified Delphi technique was used to achieve consensus in three rounds by surveying residency program directors or their local simulation educator delegates in 16 accredited Canadian Ob/Gyn residency programs. A consensus rate of 80% was agreed upon. Survey results were collected over 11 months in 2016. Response rates for the Delphi were 50% for the first round, 81% for the second round, and 94% for the third round. The first survey resulted in 84 suggested topics. These were organized into four categories: obstetrics high acuity low frequency events, obstetrics common events, gynaecology high acuity low frequency events, and gynaecology common events. Using the modified Delphi method, consensus was reached on 6 scenarios. This study identified the content for a national simulation-based curriculum for Ob/Gyn residency training programs and is the first step in the development of this curriculum. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Development of criteria for evaluating clinical response in thyroid eye disease using a modified Delphi technique.

PubMed

Douglas, Raymond S; Tsirbas, Angelo; Gordon, Mark; Lee, Diana; Khadavi, Nicole; Garneau, Helene Chokron; Goldberg, Robert A; Cahill, Kenneth; Dolman, Peter J; Elner, Victor; Feldon, Steve; Lucarelli, Mark; Uddin, Jimmy; Kazim, Michael; Smith, Terry J; Khanna, Dinesh

2009-09-01

To identify components of a provisional clinical response index for thyroid eye disease using a modified Delphi technique. The International Thyroid Eye Disease Society conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical trials in thyroid eye disease. The steering committee discussed the results in a face-to-face meeting (nominal group technique) and evaluated each criterion with respect to its feasibility, reliability, redundancy, and validity. Redundant measures were consolidated or excluded. Criteria were parsed into 11 domains for the Delphi surveys. Eighty-four respondents participated in the Delphi 1 survey, providing 220 unique items. Ninety-two members (100% of the respondents from Delphi 1 plus 8 new participants) responded in Delphi 2 and rated the same 220 items. Sixty-four members (76% of participants) rated 153 criteria in Delphi 3 (67 criteria were excluded because of redundancy). Criteria with a mean greater than 6 (1 = least appropriate to 9 = most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. Using a Delphi exercise, we developed provisional core measures for assessing disease activity and severity in clinical trials of therapies for thyroid eye disease. These measures will be iteratively refined for use in multicenter clinical trials.

Development of criteria for evaluating clinical response in thyroid eye disease (CRI-TED) using a modified Delphi technique

PubMed Central

Douglas, Raymond S.; Tsirbas, Angelo; Gordon, Mark; Lee, Diana; Khadavi, Nicole; Garneau, Helene Chokron; Goldberg, Robert A.; Cahill, Kenneth; Dolman, Peter J.; Elner, Victor; Feldon, Steve; Lucarelli, Mark; Uddin, Jimmy; Kazim, Michael; Smith, Terry J.; Khanna, Dinesh

2014-01-01

To identify components of a provisional clinical response index for thyroid eye disease (CRI-TED) using a modified Delphi technique. The International Thyroid Eye Disease Society (ITEDS) conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical trials in TED. The steering committee discussed the results in a face-to-face meeting (nominal group technique) and evaluated each criterion with respect to its feasibility, reliability, redundancy, and validity. Redundant measures were consolidated or excluded. Criteria were parsed into 11 domains for the Delphi surveys. Eighty four respondents participated in the Delphi-1 survey, providing 220 unique items. Ninety- two members (100% of the respondents from Delphi 1 plus eight new participants) responded in Delphi-2 and rated the same 220 items. Sixty-four members (76% of participants) rated 153 criteria in Delphi-3 (67 criteria were excluded due to redundancy). Criteria with a mean greater than 6 (1 least appropriate to 9 most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. Using a Delphi exercise, we developed provisional core measures for assessing disease activity and severity in clinical trials of therapies for TED. These measures will be iteratively refined for use in multicenter clinical trials. PMID:19752424

Ascertaining top evidence in emergency medicine: A modified Delphi study.

PubMed

Bazak, Stephanie J; Sherbino, Jonathan; Upadhye, Suneel; Chan, Teresa

2018-06-21

CLINICIAN'S CAPSULE What is known about the topic? EM is a specialty with a broad knowledge base making it daunting for a junior resident to know where to begin the acquisition of evidence-based knowledge. What did the study ask? What list of "top papers" was formulated in the field of EM using a national Canadian Delphi approach to achieve an expert consensus? What did the study find? A list was produced of top studies relevant for Canadian EM physicians in training. Why does this study matter to clinicians? The list produced can be used as an educational resource for junior residents.

Development of an Electronic Pediatric All-Cause Harm Measurement Tool Using a Modified Delphi Method.

PubMed

Stockwell, David Christopher; Bisarya, Hema; Classen, David C; Kirkendall, Eric S; Lachman, Peter I; Matlow, Anne G; Tham, Eric; Hyman, Dan; Lehman, Samuel M; Searles, Elizabeth; Muething, Stephen E; Sharek, Paul J

2016-12-01

To have impact on reducing harm in pediatric inpatients, an efficient and reliable process for harm detection is needed. This work describes the first step toward the development of a pediatric all-cause harm measurement tool by recognized experts in the field. An international group of leaders in pediatric patient safety and informatics were charged with developing a comprehensive pediatric inpatient all-cause harm measurement tool using a modified Delphi technique. The process was conducted in 5 distinct steps: (1) literature review of triggers (elements from a medical record that assist in identifying patient harm) for inclusion; (2) translation of triggers to likely associated harm, improving the ability for expert prioritization; (3) 2 applications of a modified Delphi selection approach with consensus criteria using severity and frequency of harm as well as detectability of the associated trigger as criteria to rate each trigger and associated harm; (4) developing specific trigger logic and relevant values when applicable; and (5) final vetting of the entire trigger list for pilot testing. Literature and expert panel review identified 108 triggers and associated harms suitable for consideration (steps 1 and 2). This list was pared to 64 triggers and their associated harms after the first of the 2 independent expert reviews. The second independent expert review led to further refinement of the trigger package, resulting in 46 items for inclusion (step 3). Adding in specific trigger logic expanded the list. Final review and voting resulted in a list of 51 triggers (steps 4 and 5). Application of a modified Delphi method on an expert-constructed list of 108 triggers, focusing on severity and frequency of harms as well as detectability of triggers in an electronic medical record, resulted in a final list of 51 pediatric triggers. Pilot testing this list of pediatric triggers to identify all-cause harm for pediatric inpatients is the next step to establish the appropriateness of each trigger for inclusion in a global pediatric safety measurement tool.

Development of clinical pharmacy key performance indicators for hospital pharmacists using a modified Delphi approach.

PubMed

Fernandes, Olavo; Gorman, Sean K; Slavik, Richard S; Semchuk, William M; Shalansky, Steve; Bussières, Jean-François; Doucette, Douglas; Bannerman, Heather; Lo, Jennifer; Shukla, Simone; Chan, Winnie W Y; Benninger, Natalie; MacKinnon, Neil J; Bell, Chaim M; Slobodan, Jeremy; Lyder, Catherine; Zed, Peter J; Toombs, Kent

2015-06-01

Key performance indicators (KPIs) are quantifiable measures of quality. There are no published, systematically derived clinical pharmacy KPIs (cpKPIs). A group of hospital pharmacists aimed to develop national cpKPIs to advance clinical pharmacy practice and improve patient care. A cpKPI working group established a cpKPI definition, 8 evidence-derived cpKPI critical activity areas, 26 candidate cpKPIs, and 11 cpKPI ideal attributes in addition to 1 overall consensus criterion. Twenty-six clinical pharmacists and hospital pharmacy leaders participated in an internet-based 3-round modified Delphi survey. Panelists rated 26 candidate cpKPIs using 11 cpKPI ideal attributes and 1 overall consensus criterion on a 9-point Likert scale. A meeting was facilitated between rounds 2 and 3 to debate the merits and wording of candidate cpKPIs. Consensus was reached if 75% or more of panelists assigned a score of 7 to 9 on the consensus criterion during the third Delphi round. All panelists completed the 3 Delphi rounds, and 25/26 (96%) attended the meeting. Eight candidate cpKPIs met the consensus definition: (1) performing admission medication reconciliation (including best-possible medication history), (2) participating in interprofessional patient care rounds, (3) completing pharmaceutical care plans, (4) resolving drug therapy problems, (5) providing in-person disease and medication education to patients, (6) providing discharge patient medication education, (7) performing discharge medication reconciliation, and (8) providing bundled, proactive direct patient care activities. A Delphi panel of hospital pharmacists was successful in determining 8 consensus cpKPIs. Measurement and assessment of these cpKPIs will serve to advance clinical pharmacy practice and improve patient care. © The Author(s) 2015.

Business Education University Supervisors' Perspectives of Mentor Teachers' Competencies

ERIC Educational Resources Information Center

Fletcher, Edward C., Jr.

2012-01-01

This study examined the perspectives of an expert panel of 31 business education university supervisors from the U.S. and Canada using a modified Delphi approach regarding the areas in which mentor teachers are typically most and least prepared. Findings indicated business education mentor teachers are most prepared in the areas of classroom…

The Semiconductor Industry and Emerging Technologies: A Study Using a Modified Delphi Method

ERIC Educational Resources Information Center

Jordan, Edgar A.

2010-01-01

The purpose of this qualitative descriptive study was to determine what leaders in the semiconductor industry thought the future of computing would look like and what emerging materials showed the most promise to overcome the current theoretical limit of 10 nanometers for silicon dioxide. The researcher used a modified Delphi technique in two…

Personal Learning Environments and University Teacher Roles Explored Using Delphi

ERIC Educational Resources Information Center

Shaikh, Zaffar Ahmed; Khoja, Shakeel Ahmed

2014-01-01

This paper presents the results of research using an online Delphi method, which aimed to explore university teacher roles and readiness for learner-centred pedagogy, driven by personal learning environments (PLEs). Using a modified Policy Delphi technique, a group of researchers worked with 34 international experts who are university teachers by…

Identification of Response Options to Artisanal and Small-Scale Gold Mining (ASGM) in Ghana via the Delphi Process.

PubMed

Basu, Avik; Phipps, Sean; Long, Rachel; Essegbey, George; Basu, Niladri

2015-09-10

The Delphi technique is a means of facilitating discussion among experts in order to develop consensus, and can be used for policy formulation. This article describes a modified Delphi approach in which 27 multi-disciplinary academics and 22 stakeholders from Ghana and North America were polled about ways to address negative effects of small-scale gold mining (ASGM) in Ghana. In early 2014, the academics, working in disciplinary groups, synthesized 17 response options based on data aggregated during an Integrated Assessment of ASGM in Ghana. The researchers participated in two rounds of Delphi polling in March and April 2014, during which 17 options were condensed into 12. Response options were rated via a 4-point Likert scale in terms of benefit (economic, environmental, and benefit to people) and feasibility (economic, social/cultural, political, and implementation). The six highest-scoring options populated a third Delphi poll, which 22 stakeholders from diverse sectors completed in April 2015. The academics and stakeholders also prioritized the response options using ranking exercises. The technique successfully gauged expert opinion on ASGM, and helped identify potential responses, policies and solutions for the sector. This is timely given that improvement to the ASGM sector is an important component within the UN Minamata Convention.

Identification of Response Options to Artisanal and Small-Scale Gold Mining (ASGM) in Ghana via the Delphi Process

PubMed Central

Basu, Avik; Phipps, Sean; Long, Rachel; Essegbey, George; Basu, Niladri

2015-01-01

The Delphi technique is a means of facilitating discussion among experts in order to develop consensus, and can be used for policy formulation. This article describes a modified Delphi approach in which 27 multi-disciplinary academics and 22 stakeholders from Ghana and North America were polled about ways to address negative effects of small-scale gold mining (ASGM) in Ghana. In early 2014, the academics, working in disciplinary groups, synthesized 17 response options based on data aggregated during an Integrated Assessment of ASGM in Ghana. The researchers participated in two rounds of Delphi polling in March and April 2014, during which 17 options were condensed into 12. Response options were rated via a 4-point Likert scale in terms of benefit (economic, environmental, and benefit to people) and feasibility (economic, social/cultural, political, and implementation). The six highest-scoring options populated a third Delphi poll, which 22 stakeholders from diverse sectors completed in April 2015. The academics and stakeholders also prioritized the response options using ranking exercises. The technique successfully gauged expert opinion on ASGM, and helped identify potential responses, policies and solutions for the sector. This is timely given that improvement to the ASGM sector is an important component within the UN Minamata Convention. PMID:26378557

Creation and Delphi-method refinement of pediatric disaster triage simulations.

PubMed

Cicero, Mark X; Brown, Linda; Overly, Frank; Yarzebski, Jorge; Meckler, Garth; Fuchs, Susan; Tomassoni, Anthony; Aghababian, Richard; Chung, Sarita; Garrett, Andrew; Fagbuyi, Daniel; Adelgais, Kathleen; Goldman, Ran; Parker, James; Auerbach, Marc; Riera, Antonio; Cone, David; Baum, Carl R

2014-01-01

There is a need for rigorously designed pediatric disaster triage (PDT) training simulations for paramedics. First, we sought to design three multiple patient incidents for EMS provider training simulations. Our second objective was to determine the appropriate interventions and triage level for each victim in each of the simulations and develop evaluation instruments for each simulation. The final objective was to ensure that each simulation and evaluation tool was free of bias toward any specific PDT strategy. We created mixed-methods disaster simulation scenarios with pediatric victims: a school shooting, a school bus crash, and a multiple-victim house fire. Standardized patients, high-fidelity manikins, and low-fidelity manikins were used to portray the victims. Each simulation had similar acuity of injuries and 10 victims. Examples include children with special health-care needs, gunshot wounds, and smoke inhalation. Checklist-based evaluation tools and behaviorally anchored global assessments of function were created for each simulation. Eight physicians and paramedics from areas with differing PDT strategies were recruited as Subject Matter Experts (SMEs) for a modified Delphi iterative critique of the simulations and evaluation tools. The modified Delphi was managed with an online survey tool. The SMEs provided an expected triage category for each patient. The target for modified Delphi consensus was ≥85%. Using Likert scales and free text, the SMEs assessed the validity of the simulations, including instances of bias toward a specific PDT strategy, clarity of learning objectives, and the correlation of the evaluation tools to the learning objectives and scenarios. After two rounds of the modified Delphi, consensus for expected triage level was >85% for 28 of 30 victims, with the remaining two achieving >85% consensus after three Delphi iterations. To achieve consensus, we amended 11 instances of bias toward a specific PDT strategy and corrected 10 instances of noncorrelation between evaluations and simulation. The modified Delphi process, used to derive novel PDT simulation and evaluation tools, yielded a high degree of consensus among the SMEs, and eliminated biases toward specific PDT strategies in the evaluations. The simulations and evaluation tools may now be tested for reliability and validity as part of a prehospital PDT curriculum.

Use of a Computer-Mediated Delphi Process to Validate a Mass Casualty Conceptual Model

PubMed Central

CULLEY, JOAN M.

2012-01-01

Since the original work on the Delphi technique, multiple versions have been developed and used in research and industry; however, very little empirical research has been conducted that evaluates the efficacy of using online computer, Internet, and e-mail applications to facilitate a Delphi method that can be used to validate theoretical models. The purpose of this research was to develop computer, Internet, and e-mail applications to facilitate a modified Delphi technique through which experts provide validation for a proposed conceptual model that describes the information needs for a mass-casualty continuum of care. Extant literature and existing theoretical models provided the basis for model development. Two rounds of the Delphi process were needed to satisfy the criteria for consensus and/or stability related to the constructs, relationships, and indicators in the model. The majority of experts rated the online processes favorably (mean of 6.1 on a seven-point scale). Using online Internet and computer applications to facilitate a modified Delphi process offers much promise for future research involving model building or validation. The online Delphi process provided an effective methodology for identifying and describing the complex series of events and contextual factors that influence the way we respond to disasters. PMID:21076283

Use of a computer-mediated Delphi process to validate a mass casualty conceptual model.

PubMed

Culley, Joan M

2011-05-01

Since the original work on the Delphi technique, multiple versions have been developed and used in research and industry; however, very little empirical research has been conducted that evaluates the efficacy of using online computer, Internet, and e-mail applications to facilitate a Delphi method that can be used to validate theoretical models. The purpose of this research was to develop computer, Internet, and e-mail applications to facilitate a modified Delphi technique through which experts provide validation for a proposed conceptual model that describes the information needs for a mass-casualty continuum of care. Extant literature and existing theoretical models provided the basis for model development. Two rounds of the Delphi process were needed to satisfy the criteria for consensus and/or stability related to the constructs, relationships, and indicators in the model. The majority of experts rated the online processes favorably (mean of 6.1 on a seven-point scale). Using online Internet and computer applications to facilitate a modified Delphi process offers much promise for future research involving model building or validation. The online Delphi process provided an effective methodology for identifying and describing the complex series of events and contextual factors that influence the way we respond to disasters.

Use of the Delphi process in paediatric cataract management.

PubMed

Serafino, Massimiliano; Trivedi, Rupal H; Levin, Alex V; Wilson, M Edward; Nucci, Paolo; Lambert, Scott R; Nischal, Ken K; Plager, David A; Bremond-Gignac, Dominique; Kekunnaya, Ramesh; Nishina, Sachiko; Tehrani, Nasrin N; Ventura, Marcelo C

2016-05-01

To identify areas of consensus and disagreement in the management of paediatric cataract using a modified Delphi approach among individuals recognised for publishing in this field. A modified Delphi method. International paediatric cataract experts with a publishing record in paediatric cataract management. The process consisted of three rounds of anonymous electronic questionnaires followed by a face-to-face meeting, followed by a fourth anonymous electronic questionnaire. The executive committee created questions to be used for the electronic questionnaires. Questions were designed to have unit-based, multiple choice or true-false answers. The questionnaire included issues related to the preoperative, intraoperative and postoperative management of paediatric cataract. Consensus based on 85% of panellists being in agreement for electronic questionnaires or 80% for the face-to-face meeting, and near consensus based on 70%. Sixteen of 22 invited paediatric cataract surgeons agreed to participate. We arrived at consensus or near consensus for 85/108 (78.7%) questions and non-consensus for the remaining 23 (21.3%) questions. Those questions where consensus was not reached highlight areas of either poor evidence or contradicting evidence, and may help investigators identify possible research questions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A Modified Delphi to Identify the Significant Works Pertaining to the Understanding of Reading Comprehension and Content Analysis of the Identified Works

ERIC Educational Resources Information Center

Zunker, Norma D.; Pearce, Daniel L.

2012-01-01

The first part of this study explored the significant works pertaining to the understanding of reading comprehension using a Modified Delphi Method. A panel of reading comprehension experts identified 19 works they considered to be significant to the understanding of reading comprehension. The panel of experts identified the reasons they…

Recommended Skill Requirements of Recent Management Information Systems Graduates for Employment: A Modified Delphi Study

ERIC Educational Resources Information Center

Strnad, Michael A., Sr.

2013-01-01

The purpose of this Modified Delphi study was to achieve a consensus and forecast a prediction from expert IT hiring managers on what skills are required of MIS graduates for employment. In doing so, guidance could be provided to academic leaders who design curricula for MIS students on the required skills for employment. This study was conducted…

Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study.

PubMed

Primdahl, Stine C; Todsen, Tobias; Clemmesen, Louise; Knudsen, Lars; Weile, Jesper

2016-09-21

Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed. We aimed to develop a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4 on the Likert scale. Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second Delphi round, the experts excluded one element from the scale. In the third Delphi round, consensus was obtained on the eight elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure. We developed an RS for assessment of UGVA competence based on opinions of ultrasound experts through a modified Delphi consensus study.

Patient safety priorities in mental healthcare in Switzerland: a modified Delphi study.

PubMed

Mascherek, Anna C; Schwappach, David L B

2016-08-05

Identifying patient safety priorities in mental healthcare is an emerging issue. A variety of aspects of patient safety in medical care apply for patient safety in mental care as well. However, specific aspects may be different as a consequence of special characteristics of patients, setting and treatment. The aim of the present study was to combine knowledge from the field and research and bundle existing initiatives and projects to define patient safety priorities in mental healthcare in Switzerland. The present study draws on national expert panels, namely, round-table discussion and modified Delphi consensus method. As preparation for the modified Delphi questionnaire, two round-table discussions and one semistructured questionnaire were conducted. Preparative work was conducted between May 2015 and October 2015. The modified Delphi was conducted to gauge experts' opinion on priorities in patient safety in mental healthcare in Switzerland. In two independent rating rounds, experts made private ratings. The modified Delphi was conducted in winter 2015. Nine topics were defined along the treatment pathway: diagnostic errors, non-drug treatment errors, medication errors, errors related to coercive measures, errors related to aggression management against self and others, errors in treatment of suicidal patients, communication errors, errors at interfaces of care and structural errors. Patient safety is considered as an important topic of quality in mental healthcare among experts, but it has been seriously neglected up until now. Activities in research and in practice are needed. Structural errors and diagnostics were given highest priority. From the topics identified, some are overlapping with important aspects of patient safety in medical care; however, some core aspects are unique. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Patient safety priorities in mental healthcare in Switzerland: a modified Delphi study

PubMed Central

Mascherek, Anna C

2016-01-01

Objective Identifying patient safety priorities in mental healthcare is an emerging issue. A variety of aspects of patient safety in medical care apply for patient safety in mental care as well. However, specific aspects may be different as a consequence of special characteristics of patients, setting and treatment. The aim of the present study was to combine knowledge from the field and research and bundle existing initiatives and projects to define patient safety priorities in mental healthcare in Switzerland. The present study draws on national expert panels, namely, round-table discussion and modified Delphi consensus method. Design As preparation for the modified Delphi questionnaire, two round-table discussions and one semistructured questionnaire were conducted. Preparative work was conducted between May 2015 and October 2015. The modified Delphi was conducted to gauge experts' opinion on priorities in patient safety in mental healthcare in Switzerland. In two independent rating rounds, experts made private ratings. The modified Delphi was conducted in winter 2015. Results Nine topics were defined along the treatment pathway: diagnostic errors, non-drug treatment errors, medication errors, errors related to coercive measures, errors related to aggression management against self and others, errors in treatment of suicidal patients, communication errors, errors at interfaces of care and structural errors. Conclusions Patient safety is considered as an important topic of quality in mental healthcare among experts, but it has been seriously neglected up until now. Activities in research and in practice are needed. Structural errors and diagnostics were given highest priority. From the topics identified, some are overlapping with important aspects of patient safety in medical care; however, some core aspects are unique. PMID:27496233

A consensus definition of running-related injury in recreational runners: a modified Delphi approach.

PubMed

Yamato, Tiê Parma; Saragiotto, Bruno Tirotti; Lopes, Alexandre Dias

2015-05-01

Delphi study. To reach a consensus definition of running-related injury in recreational runners through a modified Delphi approach. Many studies have suggested the need for a standardized definition of running-related injury to provide uniformity to injury surveillance in running. We invited 112 researchers from running-related injury studies identified in a previous systematic review to classify words and terms frequently used in definitions of running-related injury in an online form during 3 rounds of study. In the last round, participants were asked to approve or disapprove the consensus definition. We considered an agreement level of at least 75% to be a consensus. Thirty-eight participants agreed to participate in the study. The response rates were 94.7% (n = 36) for the first round, 83.3% (n = 30) for the second round, and 86.7% (n = 26) for the third round. A consensus definition of running-related injury was reached, with 80% of participants approving the following: "Running-related (training or competition) musculoskeletal pain in the lower limbs that causes a restriction on or stoppage of running (distance, speed, duration, or training) for at least 7 days or 3 consecutive scheduled training sessions, or that requires the runner to consult a physician or other health professional." The proposed standardized definition of running-related injury could assist in standardizing the definitions used in sport science research and facilitate between-study comparisons. Future studies testing the validity of the proposed consensus definition, as well as its accurate translation to other languages, are also needed.

Distribution network connection pricing framework and methodology: identification of areas of improvement for Sarawak Energy Berhad Connection Charges Guidelines through modified delphi method

NASA Astrophysics Data System (ADS)

Tan, J. K.; Abas, N.

2017-07-01

Complaints on issues and matters related to connection charges have been very common for electricity supply utility companies around the world including Sarawak Energy Berhad. In order to identify the areas that can be improved, a mixed method of exploratory research involving qualitative and quantitative methods have been designed and undertaken rather than a single method of survey. This will ensure a more comprehensive and detailed understanding of the issues from various target groups. The method is designed under three phases, employing Modified Delphi Technique for phase 1 through a series of stake holder engagements, online and offline survey questionnaires to be filled by internal wiring contractors for phase 2 whilst under phase 3, case studies shall be carried out on the issues identified from phase 1 and phase 2 of the study. This paper presented the findings from the Modified Delphi Technique. The findings revealed that there are areas of improvement for Sarawak Energy Berhad connection guidelines in term of differentiation of dedicated and shared assets which leads to unfairness to the connecting customers, inconsistency and non-transparent in charging. The findings of Modified Delphi Technique shall be used for implementation of phase 2 and phase 3 of the study.

Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing.

PubMed

Carter, Nancy; Lavis, John N; MacDonald-Rencz, Sandra

2014-01-01

Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Using a Delphi process to establish consensus on emergency medicine clerkship competencies.

PubMed

Penciner, Rick; Langhan, Trevor; Lee, Richard; McEwen, Jill; Woods, Robert A; Bandiera, Glen

2011-01-01

Currently, there is no consensus on the core competencies required for emergency medicine (EM) clerkships in Canada. Existing EM curricula have been developed through informal consensus or local efforts. The Delphi process has been used extensively as a means for establishing consensus. The purpose of this project was to define core competencies for EM clerkships in Canada, to validate a Delphi process in the context of national curriculum development, and to demonstrate the adoption of the CanMEDS physician competency paradigm in the undergraduate medical education realm. Using a modified Delphi process, we developed a consensus amongst a panel of expert emergency physicians from across Canada utilizing the CanMEDS 2005 Physician Competency Framework. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). This study demonstrated that a modified Delphi process can result in a strong consensus around a realistic number of core competencies for EM clerkships. We propose that such a method could be used by other medical specialties and health professions to develop rotation-specific core competencies.

Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives.

PubMed

Thellesen, Line; Hedegaard, Morten; Bergholt, Thomas; Colov, Nina P; Hoegh, Stinne; Sorensen, Jette L

2015-08-01

To define learning objectives for a national cardiotocography (CTG) education program based on expert consensus. A three-round Delphi survey. One midwife and one obstetrician from each maternity unit in Denmark were appointed based on CTG teaching experience and clinical obstetric experience. Following national and international guidelines, the research group determined six topics as important when using CTG: fetal physiology, equipment, indication, interpretation, clinical management, and communication/responsibility. In the first Delphi round, participants listed one to five learning objectives within the predefined topics. Responses were analyzed by a directed approach to content analysis. Phrasing was modified in accordance with Bloom's taxonomy. In the second and third Delphi rounds, participants rated each objective on a five-point relevance scale. Consensus was predefined as objectives with a mean rating value of ≥ 3. A prioritized list of CTG learning objectives. A total of 42 midwives and obstetricians from 21 maternity units were invited to participate, of whom 26 completed all three Delphi rounds, representing 18 maternity units. The final prioritized list included 40 objectives. The highest ranked objectives emphasized CTG interpretation and clinical management. The lowest ranked objectives emphasized fetal physiology. Mean ratings of relevance ranged from 3.15 to 5.00. National consensus on CTG learning objectives was achieved using the Delphi methodology. This was an initial step in developing a valid CTG education program. A prioritized list of objectives will clarify which topics to emphasize in a CTG education program. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Uterine Artery Embolization: A Systematic Review of the Literature and Proposal for Research.

DTIC Science & Technology

1999-01-01

examined the literature review. Using a modified Delphi process, the panelists rated a comprehensive list of outcomes with regard to their importance...accounts for the bulk of symptoms) is medical, and includes the use of hormonal agents such as progestins, combined oral contraceptives , and (less...leiomyomata. At the meeting, panelists used a modified Delphi process, to independently and anonymously rate the importance of measuring each of these

Seeking an oracle: using the Delphi process to develop practice guidelines for the treatment of endometriosis with Chinese herbal medicine.

PubMed

Flower, Andrew; Lewith, George T; Little, Paul

2007-11-01

For most complementary and alternative medicine interventions, the absence of a high-quality evidence base to define good practice presents a serious problem for clinicians, educators, and researchers. The Delphi process may offer a pragmatic way to establish good practice guidelines until more rigorous forms of assessment can be undertaken. To use a modified Delphi to develop good practice guidelines for a feasibility study exploring the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. To compare the outcomes from Delphi with data derived from a systematic review of the Chinese language database. An expert group was convened for a three-round Delphi that initially produced key statements relating to the CHM diagnosis and treatment of endometriosis (round 1) and then anonymously rated these on a 1-7 Likert scale (rounds 2 and 3). Statements with a median score of 5 and above were regarded as demonstrating positive group consensus. The differential diagnoses within Chinese Medicine and rating of the clinical value of individual herbs were then contrasted with comparable data from a review of Chinese language reports in the Chinese Biomedical Retrieval System (1978-2002), and China Academy of Traditional Chinese Medicine (1985-2002) databases and the Chinese TCM and magazine literature (1984-2004) databases. Consensus (good practice) guidelines for the CHM treatment of endometriosis relating to common diagnostic patterns, herb selection, dosage, and patient management were produced. The Delphi guidelines demonstrated a high degree of congruence with the information from the Chinese language databases. In the absence of rigorous evidence, Delphi offers a way to synthesize expert knowledge relating to diagnosis, patient management, and herbal selection in the treatment of endometriosis. The limitations of the expert group and the inability of Delphi to capture the subtle nuances of individualized clinical decision-making limit the usefulness of this approach.

Anatomical Society core regional anatomy syllabus for undergraduate medicine: the Delphi process.

PubMed

Smith, C F; Finn, G M; Stewart, J; McHanwell, S

2016-01-01

A modified Delphi method was employed to seek consensus when revising the UK and Ireland's core syllabus for regional anatomy in undergraduate medicine. A Delphi panel was constructed involving 'expert' (individuals with at least 5 years' experience in teaching medical students anatomy at the level required for graduation). The panel (n = 39) was selected and nominated by members of Council and/or the Education Committee of the Anatomical Society and included a range of specialists including surgeons, radiologists and anatomists. The experts were asked in two stages to 'accept', 'reject' or 'modify' (first stage only) each learning outcome. A third stage, which was not part of the Delphi method, then allowed the original authors of the syllabus to make changes either to correct any anatomical errors or to make minor syntax changes. From the original syllabus of 182 learning outcomes, removing the neuroanatomy component (163), 23 learning outcomes (15%) remained unchanged, seven learning outcomes were removed and two new learning outcomes added. The remaining 133 learning outcomes were modified. All learning outcomes on the new core syllabus achieved over 90% acceptance by the panel. © 2015 Anatomical Society.

Development of a competency framework for optometrists with a specialist interest in glaucoma.

PubMed

Myint, J; Edgar, D F; Kotecha, A; Crabb, D P; Lawrenson, J G

2010-09-01

To develop a competency framework, using a modified Delphi methodology, for optometrists with a specialist interest in glaucoma, which would provide a basis for training and accreditation. A modified iterative Delphi technique was used using a 16-member panel consisting almost exclusively of sub-specialist optometrists and ophthalmologists. The first round involved scoring the relevance of a draft series of competencies using a 9-point Likert scale with a free-text option to modify any competency or suggest additional competencies. The revised framework was subjected to a second round of scoring and free-text comment. The Delphi process was followed by a face-to-face structured workshop to debate and agree the final framework. The version of the framework agreed at the workshop was sent out for a 4-month period of external stakeholder validation. There was a 100% response to round 1 and an 94% response to round 2. All panel members attended the workshop. The final version of the competency framework was validated by a subsequent stakeholder consultation and contained 19 competencies for the diagnosis of glaucoma and 7 further competencies for monitoring and treatment. Application of a consensus methodology consisting of a modified Delphi technique allowed the development of a competency framework for glaucoma specialisation by optometrists. This will help to shape the development of a speciality curriculum and potentially could be adapted for other healthcare professionals.

Gaining consensus on family carer needs when caring for someone dying at home to develop the Carers' Alert Thermometer (CAT): a modified Delphi study.

PubMed

Knighting, Katherine; O'Brien, Mary R; Roe, Brenda; Gandy, Rob; Lloyd-Williams, Mari; Nolan, Mike; Jack, Barbara A

2016-01-01

To report a multi-phase modified Delphi study conducted with carers and professionals to identify the priority areas for inclusion in an alert screening tool for carers providing support to someone dying at home. Internationally, there is a growing emphasis on increasing choice for patients who wish to die at home which relies heavily on care provided by the unpaid family carers. Family carers can have high levels of unmet needs comprising their psychological and physical health and their ability to provide effective care and support. Development of an alert tool to identify carers' needs in everyday practice required identification and consensus of the priority areas of need for inclusion. Multi-phase modified Delphi study and instrument development. Qualitative and quantitative data collection took place between 2011-2013 with 111 carers and 93 professionals to identify carers' needs and gain consensus on the priority areas for inclusion in the alert tool. An expert panel stage and final evidence review post-Delphi were used. The Delphi panels had high levels of agreement and consensus. Ten areas of carer need across two themes of 'the current caring situation' and 'the carer's own health and well-being' were prioritized for inclusion in the alert tool. An optional end-of-life planning question was included following the final stages. The results provide evidence of carers' needs to be assessed, areas for consideration in the education of those who support carers and someone dying at home and targeting of services, while demonstrating the usefulness and adaptability of the Delphi method. © 2015 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Youth injury prevention in Canada: use of the Delphi method to develop recommendations.

PubMed

Pike, Ian; Piedt, Shannon; Davison, Colleen M; Russell, Kelly; Macpherson, Alison K; Pickett, William

2015-12-22

The Health Behaviour in School-aged Children Survey is one of very few cross-national health surveys that includes information on injury occurrence and prevention within adolescent populations. A collaboration to develop a Canadian youth injury report using these data resulted in, Injury among Young Canadians: A national study of contextual determinants. The objective of this study was to develop specific evidence-based, policy-oriented recommendations arising from the national report, using a modified-Delphi process with a panel of expert stakeholders. Eight injury prevention experts and a 3-person youth advisory team associated with a Canadian injury prevention organization (Parachute Canada) reviewed, edited and commented on report recommendations through a three-stage iterative modified-Delphi process. From an initial list of 27 draft recommendations, the modified-Delphi process resulted in a final list of 19 specific recommendations, worded to resonate with the group(s) responsible to lead or take the recommended action. Two recommendations were rated as "extremely important" or "very important" by 100 % of the expert panel, two were deleted, a further two recommendations were deleted but the content included as text in the report, and four were merged with other existing recommendations. The modified-Delphi process was an appropriate method to achieve agreement on 19 specific evidence-based, policy-oriented recommendations to complement the national youth injury report. In providing their input, it is noted that the injury stakeholders each acted as individual experts, unattached to any organizational position or policy. These recommendations will require multidisciplinary collaborations in order to support the proposed policy development, additional research, programming and clear decision-making for youth injury prevention.

A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery.

PubMed

van Vliet, Daphne C R; van der Meij, Eva; Bouwsma, Esther V A; Vonk Noordegraaf, Antonie; van den Heuvel, Baukje; Meijerink, Wilhelmus J H J; van Baal, W Marchien; Huirne, Judith A F; Anema, Johannes R

2016-12-01

Evidence-based information on the resumption of daily activities following uncomplicated abdominal surgery is scarce and not yet standardized in medical guidelines. As a consequence, convalescence recommendations are generally not provided after surgery, leading to patients' insecurity, needlessly delayed recovery and prolonged sick leave. The aim of this study was to generate consensus-based multidisciplinary convalescence recommendations, including advice on return to work, applicable for both patients and physicians. Using a modified Delphi method among a multidisciplinary panel of 13 experts consisting of surgeons, occupational physicians and general practitioners, detailed recommendations were developed for graded resumption of 34 activities after uncomplicated laparoscopic cholecystectomy, laparoscopic and open appendectomy, laparoscopic and open colectomy and laparoscopic and open inguinal hernia repair. A sample of occupational physicians, general practitioners and surgeons assessed the recommendations on feasibility in daily practice. The response of this group of care providers was discussed with the experts in the final Delphi questionnaire round. Out of initially 56 activities, the expert panel selected 34 relevant activities for which convalescence recommendations were developed. After four Delphi rounds, consensus was reached for all of the 34 activities for all the surgical procedures. A sample of occupational physicians, general practitioners and surgeons regarded the recommendations as feasible in daily practice. Multidisciplinary convalescence recommendations regarding uncomplicated laparoscopic cholecystectomy, appendectomy (laparoscopic, open), colectomy (laparoscopic, open) and inguinal hernia repair (laparoscopic, open) were developed by a modified Delphi procedure. Further research is required to evaluate whether these recommendations are realistic and effective in daily practice.

Core Outcomes in Ventilation Trials (COVenT): protocol for a core outcome set using a Delphi survey with a nested randomised trial and observational cohort study.

PubMed

Blackwood, Bronagh; Ringrow, Suzanne; Clarke, Mike; Marshall, John; Rose, Louise; Williamson, Paula; McAuley, Danny

2015-08-20

Among clinical trials of interventions that aim to modify time spent on mechanical ventilation for critically ill patients there is considerable inconsistency in chosen outcomes and how they are measured. The Core Outcomes in Ventilation Trials (COVenT) study aims to develop a set of core outcomes for use in future ventilation trials in mechanically ventilated adults and children. We will use a mixed methods approach that incorporates a randomised trial nested within a Delphi study and a consensus meeting. Additionally, we will conduct an observational cohort study to evaluate uptake of the core outcome set in published studies at 5 and 10 years following core outcome set publication. The three-round online Delphi study will use a list of outcomes that have been reported previously in a review of ventilation trials. The Delphi panel will include a range of stakeholder groups including patient support groups. The panel will be randomised to one of three feedback methods to assess the impact of the feedback mechanism on subsequent ranking of outcomes. A final consensus meeting will be held with stakeholder representatives to review outcomes. The COVenT study aims to develop a core outcome set for ventilation trials in critical care, explore the best Delphi feedback mechanism for achieving consensus and determine if participation increases use of the core outcome set in the long term.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi.

PubMed

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M

2017-02-09

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.

Testing an Adapted Modified Delphi Method: Synthesizing Multiple Stakeholder Ratings of Health Care Service Effectiveness.

PubMed

Escaron, Anne L; Chang Weir, Rosy; Stanton, Petra; Vangala, Sitaram; Grogan, Tristan R; Clarke, Robin M

2016-03-01

The Affordable Care Act incentivizes health systems for better meeting patient needs, but often guidance about patient preferences for particular health services is limited. All too often vulnerable patient populations are excluded from these decision-making settings. A community-based participatory approach harnesses the in-depth knowledge of those experiencing barriers to health care. We made three modifications to the RAND-UCLA appropriateness method, a modified Delphi approach, involving patients, adding an advisory council group to characterize existing knowledge in this little studied area, and using effectiveness rather than "appropriateness" as the basis for rating. As a proof of concept, we tested this method by examining the broadly delivered but understudied nonmedical services that community health centers provide. This method created discrete, new knowledge about these services by defining 6 categories and 112 unique services and by prioritizing among these services based on effectiveness using a 9-point scale. Consistent with the appropriateness method, we found statistical convergence of ratings among the panelists. Challenges include time commitment and adherence to a clear definition of effectiveness of services. This diverse stakeholder engagement method efficiently addresses gaps in knowledge about the effectiveness of health care services to inform population health management. © 2015 Society for Public Health Education.

Defining interdisciplinary competencies for audiological rehabilitation: findings from a modified Delphi study.

PubMed

Xue, Lina; Le Bot, Gaëlle; Van Petegem, Wim; van Wieringen, Astrid

2018-02-01

The aim of this study is to derive a consensus on an interdisciplinary competency framework regarding a holistic approach for audiological rehabilitation (AR), which includes disciplines from medicine, engineering, social sciences and humanities. We employed a modified Delphi method. In the first round survey, experts were asked to rate an initial list of 28 generic interdisciplinary competencies and to propose specific knowledge areas for AR. In the second round, experts were asked to reconsider their answers in light of the group answers of the first round. An international panel of 27 experts from different disciplines in AR completed the first round. Twenty-two of them completed the second round. We developed a competency framework consisting of 21 generic interdisciplinary competencies grouped in five domains and nine specific competencies (knowledge areas) in three clusters. Suggestions for the implementation of the generic competencies in interdisciplinary programmes were identified. This study reveals insights into the interdisciplinary competencies that are unique for AR. The framework will be useful for educators in developing interdisciplinary programmes as well as for professionals in considering their lifelong training needs in AR.

Development and pilot testing of an informed consent video for patients with limb trauma prior to debridement surgery using a modified Delphi technique.

PubMed

Lin, Yen-Ko; Chen, Chao-Wen; Lee, Wei-Che; Lin, Tsung-Ying; Kuo, Liang-Chi; Lin, Chia-Ju; Shi, Leiyu; Tien, Yin-Chun; Cheng, Yuan-Chia

2017-11-29

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients' knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department (ED) were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts' opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480 . The date of registration was April 18, 2011 (retrospectively registered).

Classification of drugs with different risk profiles.

PubMed

Saedder, Eva Aggerholm; Brock, Birgitte; Nielsen, Lars Peter; Bonnerup, Dorthe Krogsgaard; Lisby, Marianne

2015-08-01

A risk stratification approach is needed to identify patients at high risk of medication errors and a resulting high need of medication review. The aim of this study was to perform risk stratification (distinguishing between low-risk, medium-risk and high-risk drugs) for drugs found to cause serious adverse reactions due to medication errors. The study employed a modified Delphi technique. Drugs from a systematic literature search were included into two rounds of a Delphi process. A panel of experts was asked to evaluate each identified drug's potential for harm and for clinically relevant drug-drug interactions on a scale from 1 (low risk) to 9 (high risk). A total of 36 experts were appointed to serve on the panel. Consensus was reached for 29/57 (51%) drugs or drug classes that cause harm, and for 32/57 (56%) of the drugs or drug classes that cause interactions. For the remaining drugs, a decision was made based on the median score. Two lists, one stating the drugs' potential for causing harm and the other stating clinically relevant drug-drug interactions, were stratified into low-risk, medium-risk and high-risk drugs. Based on a modified Delphi technique, we created two lists of drugs stratified into a low-risk, a medium-risk and a high-risk group of clinically relevant interactions or risk of harm to patients. The lists could be incorporated into a risk-scoring tool that stratifies the performance of medication reviews according to patients' risk of experiencing adverse reactions. none. not relevant.

Future Directions for Business Education: A Delphi Study

ERIC Educational Resources Information Center

Kesten, Cyril A.; Lambrecht, Judith J.

2010-01-01

Purpose: The purpose of this study was to synthesize perceptions from the field about current issues and to propose future directions for the field of business education. Method: A modified three-stage Delphi study was carried out with business educators who attended national conferences and/or belonged to national professional organizations.…

[Modified Delphi method in the constitution of school sanitation standard].

PubMed

Yin, Xunqiang; Liang, Ying; Tan, Hongzhuan; Gong, Wenjie; Deng, Jing; Luo, Jiayou; Di, Xiaokang; Wu, Yue

2012-11-01

To constitute school sanitation standard using modified Delphi method, and to explore the feasibility and the predominance of Delphi method in the constitution of school sanitation standard. Two rounds of expert consultations were adopted in this study. The data were analyzed with SPSS15.0 to screen indices of school sanitation standard. Thirty-two experts accomplished the 2 rounds of consultations. The average length of expert service was (24.69 ±8.53) years. The authority coefficient was 0.729 ±0.172. The expert positive coefficient was 94.12% (32/34) in the first round and 100% (32/32) in the second round. The harmonious coefficients of importance, feasibility and rationality in the second round were 0.493 (P<0.05), 0.527 (P<0.01), and 0.535 (P<0.01), respectively, suggesting unanimous expert opinions. According to the second round of consultation, 38 indices were included in the framework. Theoretical analysis, literature review, investigation and so on are generally used in health standard constitution currently. Delphi method is a rapid, effective and feasible method in this field.

Exploring health literacy competencies towards patient education programme for Chinese-speaking healthcare professionals: a Delphi study

PubMed Central

Chang, Li-Chun; Chen, Yu-Chi; Wu, Fei Ling; Liao, Li-Ling

2017-01-01

Objectives To achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation. Setting Hospitals and community health centres in Taiwan. Method A 2-stage modified Delphi study involving a literature review was conducted, followed by qualitative interviews and 3 rounds of email-based data collection over a 3-month period in 2011. Participants 15 Chinese healthcare practitioners with more than 6 months’ experience in patient education were interviewed to collect data on health literacy practice. 24 experts (12 academic scholars in health literacy and 12 professionals with training related to health literacy practice) were invited to participate in the Delphi process. Results Qualitative data from the interviews were analysed and summarised to form 99 competency items for health literacy practice, which were categorised into 5 domains of health literacy practice including those pertaining to knowledge and skills. Consensus was reached on 92 of 99 competencies, using a modified Delphi technique. Conclusions The 92 competencies in health literacy practice embraced core components of patient education in the Chinese healthcare profession. PMID:28093428

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi

PubMed Central

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M

2017-01-01

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039

Using the modified Delphi method to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy.

PubMed

Zang, Lei; Fan, Ning; Hai, Yong; Lu, S B; Su, Q J; Yang, J C; Du, Peng; Gao, Y J

2015-06-01

Although cervical radiculopathy is very common, there is no standard treatment for this condition, with little high-level evidence available to guide the treatment choice. Thus, this study aimed to review the current data on the management of cervical radiculopathy; and, further, to establish a new Chinese clinical consensus of the treatments for cervical radiculopathy using the Delphi method. First, a systematic review of the previously established treatment guidelines and of articles related to cervical radiculopathy was conducted to establish a protocol for the clinical consensus of the treatment for cervical radiculopathy. Second, from February 2012 to June 2014, we performed a modified Delphi survey in which the current professional opinions from 30 experienced experts, representing almost all of the Chinese provinces, were gathered. Three rounds were performed, and consensus was defined as ≥70% agreement. Consensus of the treatments for cervical radiculopathy was reached on seven aspects, including the proportion of patients requiring only non-surgical therapies; the effectiveness of neck immobilization, physiotherapy, pharmacologic treatment; surgical indications; contraindications; surgery. The modified Delphi study conducted herein reached a consensus concerning several treatment issues for cervical radiculopathy. In the absence of high-level evidence, at present, these expert opinion findings will help guide health care providers to define the appropriate treatment in their regions. Items with no consensus provide excellent areas for future research.

Greenhouse Facility Management Experts Identification of Competencies and Teaching Methods to Support Secondary Agricultural Education Instructors: A Modified Delphi Study

ERIC Educational Resources Information Center

Franklin, Edward A.

2011-01-01

In this study the Delphi technique has been used to develop a list of educational competencies for preparing secondary agricultural education instructors to effectively manage their school greenhouse facilities. The use of specialized facilities in agricultural education requires appropriate preparation of agricultural education teachers. The…

Emerging Issues in the Utilization of Weblogs in Higher Education Classrooms

ERIC Educational Resources Information Center

Ayao-ao, Shirley

2014-01-01

This paper examines the emerging issues in the utilization of weblogs in Philippine higher education and how these issues affect the performance of students. This study used a modified Delphi method. The Delphi panel consisted of 12 experts in the integration of technology, particularly blogs, in their teaching. The study yielded the following…

Considerations when conducting e-Delphi research: a case study.

PubMed

Toronto, Coleen

2017-06-22

Background E-Delphi is a way to access a geographically dispersed group of experts. It is similar to other Delphi methods but conducted online. E-research methodologies, such as the e-Delphi method, have yet to undergo significant critical discussion. Aim To highlight some of the challenges nurse researchers may wish to consider when using e-Delphi in their research. Discussion This paper provides details about the author's approach to conducting an e-Delphi study in which a group of health literacy nurse experts (n=41) used an online survey platform to identify and prioritise essential health literacy competencies for registered nurses. Conclusion This paper advances methodological discourse about e-Delphi by critically assessing an e-Delphi case study. The online survey platform used in this study was advantageous for the researcher and the experts: the experts could participate at any time and place where the internet was available; the researcher could efficiently access a national group of experts, track responses and analyse data in each round. Implications for practice E-Delphi studies create opportunities for nurse researchers to conduct research nationally and internationally. Before conducting an e-Delphi study, researchers should carefully consider the design and methods for collecting data, to avoid challenges that could potentially compromise the quality of the findings. Researchers are encouraged to publish details about their approaches to e-Delphi studies, to advance the state of the science.

Examining the Roles of Blended Learning Approaches in Computer-Supported Collaborative Learning (CSCL) Environments: A Delphi Study

ERIC Educational Resources Information Center

So, Hyo-Jeong; Bonk, Curtis J.

2010-01-01

In this study, a Delphi method was used to identify and predict the roles of blended learning approaches in computer-supported collaborative learning (CSCL) environments. The Delphi panel consisted of experts in online learning from different geographic regions of the world. This study discusses findings related to (a) pros and cons of blended…

An Analysis of Factors that Inhibit Business Use of User-Centered Design Principles: A Delphi Study

ERIC Educational Resources Information Center

Hilton, Tod M.

2010-01-01

The use of user-centered design (UCD) principles has a positive impact on the use of web-based interactive systems in customer-centric organizations. User-centered design methodologies are not widely adopted in organizations due to intraorganizational factors. A qualitative study using a modified Delphi technique was used to identify the factors…

Using the Delphi Method for Selecting Effective Rehabilitation Practices for Case Study Research: Methods, Challenges, and Solutions and Implications for Future Research

ERIC Educational Resources Information Center

Fleming, Allison R.; Boeltzig-Brown, Heike; Foley, Susan M.

2015-01-01

Purpose: We describe a modified Delphi method used to select effective state vocational rehabilitation agency practices to prioritize rehabilitation services for individuals with most significant disabilities within the context of Order of Selection, an area where there is little known and published. Specifically, we describe how we applied the…

Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.

PubMed

Wakai, Abel; O'Sullivan, Ronan; Staunton, Paul; Walsh, Cathal; Hickey, Fergal; Plunkett, Patrick K

2013-04-01

The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm fractures (4.4; 95% CI 4.2-4.7). Employing a Delphi consensus process, it was possible to reach a consensus among EM specialists in Ireland on a suite of 97 KPIs for EDs.

Guiding Principles for Student Leadership Development in the Doctor of Pharmacy Program to Assist Administrators and Faculty Members in Implementing or Refining Curricula

PubMed Central

Boyle, Cynthia J.; Janke, Kristin K.

2013-01-01

Objective. To assist administrators and faculty members in colleges and schools of pharmacy by gathering expert opinion to frame, direct, and support investments in student leadership development. Methods. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define doctor of pharmacy (PharmD) student leadership instruction. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes to begin the generation of student leadership development guiding principles and competencies. Statements were identified as guiding principles when they were perceived as foundational to the instructional approach. Round 2 grouped responses for agreement rating and comment. Group consensus with a statement as a guiding principle was set prospectively at 80%. Round 3 allowed rating and comment on guidelines, modified from feedback in round 2, that did not meet consensus. The principles were verified by identifying common contemporary leadership development approaches in the literature. Results. Twelve guiding principles, related to concepts of leadership and educational philosophy, were defined and could be linked to contemporary leadership development thought. These guiding principles describe the motivation for teaching leadership, the fundamental precepts of student leadership development, and the core tenets for leadership instruction. Conclusions. Expert opinion gathered using a Delphi process resulted in guiding principles that help to address many of the fundamental questions that arise when implementing or refining leadership curricula. The principles identified are supported by common contemporary leadership development thought. PMID:24371345

Guiding principles for student leadership development in the doctor of pharmacy program to assist administrators and faculty members in implementing or refining curricula.

PubMed

Traynor, Andrew P; Boyle, Cynthia J; Janke, Kristin K

2013-12-16

To assist administrators and faculty members in colleges and schools of pharmacy by gathering expert opinion to frame, direct, and support investments in student leadership development. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define doctor of pharmacy (PharmD) student leadership instruction. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes to begin the generation of student leadership development guiding principles and competencies. Statements were identified as guiding principles when they were perceived as foundational to the instructional approach. Round 2 grouped responses for agreement rating and comment. Group consensus with a statement as a guiding principle was set prospectively at 80%. Round 3 allowed rating and comment on guidelines, modified from feedback in round 2, that did not meet consensus. The principles were verified by identifying common contemporary leadership development approaches in the literature. Twelve guiding principles, related to concepts of leadership and educational philosophy, were defined and could be linked to contemporary leadership development thought. These guiding principles describe the motivation for teaching leadership, the fundamental precepts of student leadership development, and the core tenets for leadership instruction. Expert opinion gathered using a Delphi process resulted in guiding principles that help to address many of the fundamental questions that arise when implementing or refining leadership curricula. The principles identified are supported by common contemporary leadership development thought.

Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

NASA Technical Reports Server (NTRS)

Buffalano, C.; Fogleman, S.; Gielecki, M.

1976-01-01

A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

Nursing physical assessment for patient safety in general wards: reaching consensus on core skills.

PubMed

Douglas, Clint; Booker, Catriona; Fox, Robyn; Windsor, Carol; Osborne, Sonya; Gardner, Glenn

2016-07-01

To determine consensus across acute care specialty areas on core physical assessment skills necessary for early recognition of changes in patient status in general wards. Current approaches to physical assessment are inconsistent and have not evolved to meet increased patient and system demands. New models of nursing assessment are needed in general wards that ensure a proactive and patient safety approach. A modified Delphi study. Focus group interviews with 150 acute care registered nurses at a large tertiary referral hospital generated a framework of core skills that were developed into a web-based survey. We then sought consensus with a panel of 35 senior acute care registered nurses following a classical Delphi approach over three rounds. Consensus was predefined as at least 80% agreement for each skill across specialty areas. Content analysis of focus group transcripts identified 40 discrete core physical assessment skills. In the Delphi rounds, 16 of these were consensus validated as core skills and were conceptually aligned with the primary survey: (Airway) Assess airway patency; (Breathing) Measure respiratory rate, Evaluate work of breathing, Measure oxygen saturation; (Circulation) Palpate pulse rate and rhythm, Measure blood pressure by auscultation, Assess urine output; (Disability) Assess level of consciousness, Evaluate speech, Assess for pain; (Exposure) Measure body temperature, Inspect skin integrity, Inspect and palpate skin for signs of pressure injury, Observe any wounds, dressings, drains and invasive lines, Observe ability to transfer and mobilise, Assess bowel movements. Among a large and diverse group of experienced acute care registered nurses consensus was achieved on a structured core physical assessment to detect early changes in patient status. Although further research is needed to refine the model, clinical application should promote systematic assessment and clinical reasoning at the bedside. © 2016 John Wiley & Sons Ltd.

Exploring health literacy competencies towards patient education programme for Chinese-speaking healthcare professionals: a Delphi study.

PubMed

Chang, Li-Chun; Chen, Yu-Chi; Wu, Fei Ling; Liao, Li-Ling

2017-01-16

To achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation. Hospitals and community health centres in Taiwan. A 2-stage modified Delphi study involving a literature review was conducted, followed by qualitative interviews and 3 rounds of email-based data collection over a 3-month period in 2011. 15 Chinese healthcare practitioners with more than 6 months' experience in patient education were interviewed to collect data on health literacy practice. 24 experts (12 academic scholars in health literacy and 12 professionals with training related to health literacy practice) were invited to participate in the Delphi process. Qualitative data from the interviews were analysed and summarised to form 99 competency items for health literacy practice, which were categorised into 5 domains of health literacy practice including those pertaining to knowledge and skills. Consensus was reached on 92 of 99 competencies, using a modified Delphi technique. The 92 competencies in health literacy practice embraced core components of patient education in the Chinese healthcare profession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Nutrition in primary health care: using a Delphi process to design new interdisciplinary services.

PubMed

Brauer, Paula; Dietrich, Linda; Davidson, Bridget

2006-01-01

A modified Delphi process was used to identify key features of interdisciplinary nutrition services, including provider roles and responsibilities for Ontario Family Health Networks (FHNs), a family physician-based type of primary care. Twenty-three representatives from interested professional organizations, including three FHN demonstration sites, completed a modified Delphi process. Participants reviewed evidence from a systematic literature review, a patient survey, a costing analysis, and key informant interview results before undertaking the Delphi process. Statements describing various options for services were developed at an in-person meeting, which was followed by two rounds of e-mail questionnaires. Teleconference discussions were held between rounds. An interdisciplinary model with differing and complementary roles for health care providers emerged from the process. Additional key features addressing screening for nutrition problems, health promotion and disease prevention, team collaboration, planning and evaluation, administrative support, access to care, and medical directives/delegated acts were identified. Under the proposed model, the registered dietitian is the team member responsible for managing all aspects of nutrition services, from needs assessment to program delivery, as well as for supporting all providers' nutrition services. The proposed interdisciplinary nutrition services model merits evaluation of cost, effectiveness, applicability, and sustainability in team-based primary care service settings.

A proposed minimum data set for international primary care optometry: a modified Delphi study.

PubMed

Davey, Christopher J; Slade, Sarah V; Shickle, Darren

2017-07-01

To identify a minimum list of metrics of international relevance to public health, research and service development which can be extracted from practice management systems and electronic patient records in primary optometric practice. A two stage modified Delphi technique was used. Stage 1 categorised metrics that may be recorded as being part of a primary eye examination by their importance to research using the results from a previous survey of 40 vision science and public health academics. Delphi stage 2 then gauged the opinion of a panel of seven vision science academics and achieved consensus on contentious metrics and methods of grading/classification. A consensus regarding inclusion and response categories was achieved for nearly all metrics. A recommendation was made of 53 metrics which would be appropriate in a minimum data set. This minimum data set should be easily integrated into clinical practice yet allow vital data to be collected internationally from primary care optometry. It should not be mistaken for a clinical guideline and should not add workload to the optometrist. A pilot study incorporating an additional Delphi stage prior to implementation is advisable to refine some response categories. © 2017 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom.

PubMed

Perry, D C; Wright, J G; Cooke, S; Roposch, A; Gaston, M S; Nicolaou, N; Theologis, T

2018-05-01

Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.

Academic Primer Series: Key Papers About Competency-Based Medical Education.

PubMed

Cooney, Robert; Chan, Teresa M; Gottlieb, Michael; Abraham, Michael; Alden, Sylvia; Mongelluzzo, Jillian; Pasirstein, Michael; Sherbino, Jonathan

2017-06-01

Competency-based medical education (CBME) presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME. Based on the online discussions of the 2016-2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed. Augmenting this list with suggestions by a guest expert and by an open call on Twitter for other important papers, we were able to generate a list of 21 papers in total. Subsequently, we used a modified Delphi study methodology to narrow the list to key papers that describe the importance and significance for educators interested in learning about CBME. To determine the most impactful papers, the mixed junior and senior faculty authorship group used three-round voting methodology based upon the Delphi method. Summaries of the five most highly rated papers on the topic of CBME, as determined by this modified Delphi approach, are presented in this paper. Major themes include a definition of core CBME themes, CBME principles to consider in the design of curricula, a history of the development of the CBME movement, and a rationale for changes to accreditation with CBME. The application of the study findings to junior faculty and faculty developers is discussed. We present five key papers on CBME that junior faculty members and faculty experts identified as essential to faculty development. These papers are a mix of foundational and explanatory papers that may provide a basis from which junior faculty members may build upon as they help to implement CBME programs.

The process of collecting and evaluating evidences for the development of Guidelines for the management of rheumatoid arthritis, Japan College of Rheumatology 2014: Utilization of GRADE approach.

PubMed

Kojima, Masayo; Nakayama, Takeo; Kawahito, Yutaka; Kaneko, Yuko; Kishimoto, Mitsumasa; Hirata, Shintaro; Seto, Yohei; Endo, Hirahito; Ito, Hiromu; Kojima, Toshihisa; Nishida, Keiichiro; Matsushita, Isao; Tsutani, Kiichiro; Igarashi, Ataru; Kamatani, Naoyuki; Hasegawa, Mieko; Miyasaka, Nobuyuki; Yamanaka, Hisashi

2016-01-01

To describe the process of collecting and evaluating evidence for treating rheumatoid arthritis (RA) for developing clinical practice guidelines (CPGs) for rheumatologists in Japan. The task force comprised rheumatologists, epidemiologists, health economists, and patients. First, the critical outcomes were determined according to a three-round Delphi method, and eight topics with 88 clinical questions (CQs) were formulated. A systematic review of CQs was conducted using the Cochran Database of Systematic Reviews, MEDLINE, and Japana Centra Revvo Medicina (2003-2012). A questionnaire survey and focus group interview were performed to capture the patients' values and preferences. Data from the National Health Insurance drug price list and product information provided by pharmaceutical companies were collected to evaluate drug cost and safety. The GRADE approach was used to describe the evidence quality and determine the strength of recommendations. Recommendations were developed using a modified Delphi method by a multidisciplinary panel including patients. Eight meetings and frequent e-mail communications were conducted to draft a quality assessment of evidence and recommendations. For 88 CQs, recommendation statements were determined. Using the GRADE approach, new CPGs successfully addressed important clinical issues for treating RA patients. Timely updating of recommendations should be routinely considered.

Teaching Competencies for Community Preceptors.

PubMed

Brink, Darin; Simpson, Deb; Crouse, Byron; Morzinski, Jeffrey; Bower, Douglas; Westra, Ruth

2018-05-01

Although community physicians provide one-fourth of the outpatient training received in medical school, usually there is no formal training of the preceptor. Currently there is no agreed-upon list of teaching competencies for community physician-preceptors. Using a modified Delphi process, the authors aimed to identify core teaching competencies for community preceptors for use in training and evaluation. A medical educator and three faculty members with expertise in faculty development created a list of teaching competencies organized in five domains. These competencies were finalized through a multiround modified Delphi technique with key stakeholder groups including (1) nonphysician medical educators, (2) academic physicians involved in faculty development, (3) community physicians who regularly precept medical students, (4) family medicine residents, (5) third-year medical students in a 9-month-long longitudinal clerkship. Proposed competencies were retained if 70% of the participants ranked it as "very or extremely important." In the first round, 24 competencies were evaluated by 40 physician preceptors participating in a rural faculty development conference. These were refined, and four additional competencies were added by the cohort. Subsequent rounds utilized a survey approach with broader audiences resulting in a final list of 21 competencies in five domains. Five competency domains with 21 teaching competencies can now be used to guide community preceptors' training and evaluation.

Devising a consensus definition and framework for non-technical skills in healthcare to support educational design: A modified Delphi study.

PubMed

Gordon, Morris; Baker, Paul; Catchpole, Ken; Darbyshire, Daniel; Schocken, Dawn

2015-01-01

Non-technical skills are a subset of human factors that focus on the individual and promote safety through teamwork and awareness. There is no widely adopted competency- or outcome-based framework for non-technical skills training in healthcare. The authors set out to devise such a framework using a modified Delphi approach. An exhaustive list of published and team suggested items was presented to the expert panel for ranking and to propose a definition. In the second round, a focused list was presented, as well as the proposed definition elements. The finalised framework was sent to the panel for review. Sixteen experts participated. The final framework consists of 16 competencies for all and eight specific competencies for team leaders. The consensus definition describes non-technical skills as "a set of social (communication and team work) and cognitive (analytical and personal behaviour) skills that support high quality, safe, effective and efficient inter-professional care within the complex healthcare system". The authors have produced a new competency framework, through the works of an International expert panel, which is not discipline specific that can be used by curriculum developers, educational innovators and clinical teachers to support developments in the field.

Using the Delphi Technique to Support Curriculum Development

ERIC Educational Resources Information Center

Sitlington, Helen Barbara; Coetzer, Alan John

2015-01-01

Purpose: The purpose of this paper is to present an analysis of the use of the Delphi technique to support curriculum development with a view to enhancing existing literature on use of the technique for renewal of business course curricula. Design/methodology/approach: The authors outline the Delphi process for obtaining consensus amongst a…

PIPc study: development of indicators of potentially inappropriate prescribing in children (PIPc) in primary care using a modified Delphi technique

PubMed Central

Barry, Emma; O'Brien, Kirsty; Cooper, Janine; Redmond, Patrick; Hughes, Carmel M; Bennett, Kathleen; Fahey, Tom; Smith, Susan M

2016-01-01

Objective There is limited evidence regarding the quality of prescribing for children in primary care. Several prescribing criteria (indicators) have been developed to assess the appropriateness of prescribing in older and middle-aged adults but few are relevant to children. The objective of this study was to develop a set of prescribing indicators that can be applied to prescribing or dispensing data sets to determine the prevalence of potentially inappropriate prescribing in children (PIPc) in primary care settings. Design Two-round modified Delphi consensus method. Setting Irish and UK general practice. Participants A project steering group consisting of academic and clinical general practitioners (GPs) and pharmacists was formed to develop a list of indicators from literature review and clinical expertise. 15 experts consisting of GPs, pharmacists and paediatricians from the Republic of Ireland and the UK formed the Delphi panel. Results 47 indicators were reviewed by the project steering group and 16 were presented to the Delphi panel. In the first round of this exercise, consensus was achieved on nine of these indicators. Of the remaining seven indicators, two were removed following review of expert panel comments and discussion of the project steering group. The second round of the Delphi process focused on the remaining five indicators, which were amended based on first round feedback. Three indicators were accepted following the second round of the Delphi process and the remaining two indicators were removed. The final list consisted of 12 indicators categorised by respiratory system (n=6), gastrointestinal system (n=2), neurological system (n=2) and dermatological system (n=2). Conclusions The PIPc indicators are a set of prescribing criteria developed for use in children in primary care in the absence of clinical information. The utility of these criteria will be tested in further studies using prescribing databases. PMID:27601499

PIPc study: development of indicators of potentially inappropriate prescribing in children (PIPc) in primary care using a modified Delphi technique.

PubMed

Barry, Emma; O'Brien, Kirsty; Moriarty, Frank; Cooper, Janine; Redmond, Patrick; Hughes, Carmel M; Bennett, Kathleen; Fahey, Tom; Smith, Susan M

2016-09-06

There is limited evidence regarding the quality of prescribing for children in primary care. Several prescribing criteria (indicators) have been developed to assess the appropriateness of prescribing in older and middle-aged adults but few are relevant to children. The objective of this study was to develop a set of prescribing indicators that can be applied to prescribing or dispensing data sets to determine the prevalence of potentially inappropriate prescribing in children (PIPc) in primary care settings. Two-round modified Delphi consensus method. Irish and UK general practice. A project steering group consisting of academic and clinical general practitioners (GPs) and pharmacists was formed to develop a list of indicators from literature review and clinical expertise. 15 experts consisting of GPs, pharmacists and paediatricians from the Republic of Ireland and the UK formed the Delphi panel. 47 indicators were reviewed by the project steering group and 16 were presented to the Delphi panel. In the first round of this exercise, consensus was achieved on nine of these indicators. Of the remaining seven indicators, two were removed following review of expert panel comments and discussion of the project steering group. The second round of the Delphi process focused on the remaining five indicators, which were amended based on first round feedback. Three indicators were accepted following the second round of the Delphi process and the remaining two indicators were removed. The final list consisted of 12 indicators categorised by respiratory system (n=6), gastrointestinal system (n=2), neurological system (n=2) and dermatological system (n=2). The PIPc indicators are a set of prescribing criteria developed for use in children in primary care in the absence of clinical information. The utility of these criteria will be tested in further studies using prescribing databases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prioritizing Measures of Digital Patient Engagement: A Delphi Expert Panel Study

PubMed Central

2017-01-01

Background Establishing a validated scale of patient engagement through use of information technology (ie, digital patient engagement) is the first step to understanding its role in health and health care quality, outcomes, and efficient implementation by health care providers and systems. Objective The aim of this study was to develop and prioritize measures of digital patient engagement based on patients’ use of the US Department of Veterans Affairs (VA)’s MyHealtheVet (MHV) portal, focusing on the MHV/Blue Button and Secure Messaging functions. Methods We aligned two models from the information systems and organizational behavior literatures to create a theory-based model of digital patient engagement. On the basis of this model, we conducted ten key informant interviews to identify potential measures from existing VA studies and consolidated the measures. We then conducted three rounds of modified Delphi rating by 12 national eHealth experts via Web-based surveys to prioritize the measures. Results All 12 experts completed the study’s three rounds of modified Delphi ratings, resulting in two sets of final candidate measures representing digital patient engagement for Secure Messaging (58 measures) and MHV/Blue Button (71 measures). These measure sets map to Donabedian’s three types of quality measures: (1) antecedents (eg, patient demographics); (2) processes (eg, a novel measure of Web-based care quality); and (3) outcomes (eg, patient engagement). Conclusions This national expert panel study using a modified Delphi technique prioritized candidate measures to assess digital patient engagement through patients’ use of VA’s My HealtheVet portal. The process yielded two robust measures sets prepared for future piloting and validation in surveys among Veterans. PMID:28550008

An international survey and modified Delphi process revealed editors’ perceptions, training needs, and ratings of competency-related statements for the development of core competencies for scientific editors of biomedical journals

PubMed Central

Galipeau, James; Cobey, Kelly D.; Barbour, Virginia; Baskin, Patricia; Bell-Syer, Sally; Deeks, Jonathan; Garner, Paul; Shamseer, Larissa; Sharon, Straus; Tugwell, Peter; Winker, Margaret; Moher, David

2017-01-01

Background: Scientific editors (i.e., those who make decisions on the content and policies of a journal) have a central role in the editorial process at biomedical journals. However, very little is known about the training needs of these editors or what competencies are required to perform effectively in this role. Methods: We conducted a survey of perceptions and training needs among scientific editors from major editorial organizations around the world, followed by a modified Delphi process in which we invited the same scientific editors to rate the importance of competency-related statements obtained from a previous scoping review. Results: A total of 148 participants completed the survey of perceptions and training needs. At least 80% of participants agreed on six of the 38 skill and expertise-related statements presented to them as being important or very important to their role as scientific editors. At least 80% agreed on three of the 38 statements as necessary skills they perceived themselves as possessing (well or very well).  The top five items on participants’ list of top training needs were training in statistics, research methods, publication ethics, recruiting and dealing with peer reviewers, and indexing of journals. The three rounds of the Delphi were completed by 83, 83, and 73 participants, respectively, which ultimately produced a list of 23 “highly rated” competency-related statements and another 86 “included” items. Conclusion: Both the survey and the modified Delphi process will be critical for understanding knowledge and training gaps among scientific editors when designing curriculum around core competencies in the future. PMID:28979768

An international survey and modified Delphi process revealed editors' perceptions, training needs, and ratings of competency-related statements for the development of core competencies for scientific editors of biomedical journals.

PubMed

Galipeau, James; Cobey, Kelly D; Barbour, Virginia; Baskin, Patricia; Bell-Syer, Sally; Deeks, Jonathan; Garner, Paul; Shamseer, Larissa; Sharon, Straus; Tugwell, Peter; Winker, Margaret; Moher, David

2017-01-01

Background: Scientific editors (i.e., those who make decisions on the content and policies of a journal) have a central role in the editorial process at biomedical journals. However, very little is known about the training needs of these editors or what competencies are required to perform effectively in this role. Methods: We conducted a survey of perceptions and training needs among scientific editors from major editorial organizations around the world, followed by a modified Delphi process in which we invited the same scientific editors to rate the importance of competency-related statements obtained from a previous scoping review. Results: A total of 148 participants completed the survey of perceptions and training needs. At least 80% of participants agreed on six of the 38 skill and expertise-related statements presented to them as being important or very important to their role as scientific editors. At least 80% agreed on three of the 38 statements as necessary skills they perceived themselves as possessing (well or very well).  The top five items on participants' list of top training needs were training in statistics, research methods, publication ethics, recruiting and dealing with peer reviewers, and indexing of journals. The three rounds of the Delphi were completed by 83, 83, and 73 participants, respectively, which ultimately produced a list of 23 "highly rated" competency-related statements and another 86 "included" items. Conclusion: Both the survey and the modified Delphi process will be critical for understanding knowledge and training gaps among scientific editors when designing curriculum around core competencies in the future.

Prioritizing Measures of Digital Patient Engagement: A Delphi Expert Panel Study.

PubMed

Garvin, Lynn A; Simon, Steven R

2017-05-26

Establishing a validated scale of patient engagement through use of information technology (ie, digital patient engagement) is the first step to understanding its role in health and health care quality, outcomes, and efficient implementation by health care providers and systems. The aim of this study was to develop and prioritize measures of digital patient engagement based on patients' use of the US Department of Veterans Affairs (VA)'s MyHealtheVet (MHV) portal, focusing on the MHV/Blue Button and Secure Messaging functions. We aligned two models from the information systems and organizational behavior literatures to create a theory-based model of digital patient engagement. On the basis of this model, we conducted ten key informant interviews to identify potential measures from existing VA studies and consolidated the measures. We then conducted three rounds of modified Delphi rating by 12 national eHealth experts via Web-based surveys to prioritize the measures. All 12 experts completed the study's three rounds of modified Delphi ratings, resulting in two sets of final candidate measures representing digital patient engagement for Secure Messaging (58 measures) and MHV/Blue Button (71 measures). These measure sets map to Donabedian's three types of quality measures: (1) antecedents (eg, patient demographics); (2) processes (eg, a novel measure of Web-based care quality); and (3) outcomes (eg, patient engagement). This national expert panel study using a modified Delphi technique prioritized candidate measures to assess digital patient engagement through patients' use of VA's My HealtheVet portal. The process yielded two robust measures sets prepared for future piloting and validation in surveys among Veterans. ©Lynn A Garvin, Steven R Simon. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.05.2017.

European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique

PubMed Central

Masud, Tahir; Blundell, Adrian; Gordon, Adam Lee; Mulpeter, Ken; Roller, Regina; Singler, Katrin; Goeldlin, Adrian; Stuck, Andreas

2014-01-01

Introduction: the rise in the number of older, frail adults necessitates that future doctors are adequately trained in the skills of geriatric medicine. Few countries have dedicated curricula in geriatric medicine at the undergraduate level. The aim of this project was to develop a consensus among geriatricians on a curriculum with the minimal requirements that a medical student should achieve by the end of medical school. Methods: a modified Delphi process was used. First, educational experts and geriatricians proposed a set of learning objectives based on a literature review. Second, three Delphi rounds involving a panel with 49 experts representing 29 countries affiliated to the European Union of Medical Specialists (UEMS) was used to gain consensus for a final curriculum. Results: the number of disagreements following Delphi Rounds 1 and 2 were 81 and 53, respectively. Complete agreement was reached following the third round. The final curriculum consisted of detailed objectives grouped under 10 overarching learning outcomes. Discussion: a consensus on the minimum requirements of geriatric learning objectives for medical students has been agreed by European geriatricians. Major efforts will be needed to implement these requirements, given the large variation in the quality of geriatric teaching in medical schools. This curriculum is a first step to help improve teaching of geriatrics in medical schools, and will also serve as a basis for advancing postgraduate training in geriatrics across Europe. PMID:24603283

Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.

PubMed

Jünger, Saskia; Payne, Sheila A; Brine, Jenny; Radbruch, Lukas; Brearley, Sarah G

2017-09-01

The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE. Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting. A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'. Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.

DELPHI: An introduction to output layout and data content

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, C.F.

1994-08-16

DELPHI was the data summary and interpretation code used by gas diagnostics personnel during the period from 1968 through 1986. It was written by Floyd Momyer, and went through several revisions during its period of use. Described here is the final version, which provided the most extensive set of summary tables. Earlier versions of the code lacked some of the capabilities of the final version, but what they did include was of substantially the same format. DELPHI was run against most available input decks in the mid 1980s. Microfiche and hardcopy output were generated. Both now reside in our archives.more » These reruns used modified input decks, which may not have had the proper {open_quotes}trigger{close_quotes} to instruct DELPHI to output some tables. These tables could, therefore be missing from a printout even though the necessary data was present. Also, modifications to DELPHI did, in some instances, eliminate DELPHIs` capability to correctly output some of the earlier optional tables. This monologue is intended to compliment the archived printout, and to provide enough insight so that someone unfamiliar with the techniques of Gas Diagnostics can retrieve the results at some future date. DELPHI last ran on the CDC-7600 machines, and was not converted to run on the Crays when the CDC-7600`s were decommissioned. DELPHI accepted data from various analytical systems, set up data summary tables, and combined preshot tracer and detector data with these results to calculate the total production of measured species and the indicated fission yields and detector conversions.« less

Evaluating the construct of triage acuity against a set of reference vignettes developed via modified Delphi method.

PubMed

Twomey, Michèle; Wallis, Lee A; Myers, Jonathan E

2014-07-01

To evaluate the construct of triage acuity as measured by the South African Triage Scale (SATS) against a set of reference vignettes. A modified Delphi method was used to develop a set of reference vignettes. Delphi participants completed a 2-round consensus-building process, and independently assigned triage acuity ratings to 100 written vignettes unaware of the ratings given by others. Triage acuity ratings were summarised for all vignettes, and only those that reached 80% consensus during round 2 were included in the reference set. Triage ratings for the reference vignettes given by two independent experts using the SATS were compared with the ratings given by the international Delphi panel. Measures of sensitivity, specificity, associated percentages for over-triage/under-triage were used to evaluate the construct of triage acuity (as measured by the SATS) by examining the association between the ratings by the two experts and the international panel. On completion of the Delphi process, 42 of the 100 vignettes reached 80% consensus on their acuity rating and made up the reference set. On average, over all acuity levels, sensitivity was 74% (CI 64% to 82%), specificity 92% (CI 87% to 94%), under-triage occurred 14% (CI 8% to 23%) and over-triage 12% (CI 8% to 23%) of the time. The results of this study provide an alternative to evaluating triage scales against the construct of acuity as measured with the SATS. This method of using 80% consensus vignettes may, however, systematically bias the validity estimate towards better performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Development of an active behavioural physiotherapy intervention (ABPI) for acute whiplash-associated disorder (WAD) II management: a modified Delphi study.

PubMed

Wiangkham, Taweewat; Duda, Joan; Haque, M Sayeed; Rushton, Alison

2016-09-14

To develop an active behavioural physiotherapy intervention (ABPI) for managing acute whiplash-associated disorder (WAD) II using a modified Delphi method to develop consensus for the basic features of the ABPI. Modified Delphi study. Our systematic review and meta-analysis evaluating conservative management for acute WADII found that a combined ABPI may be a useful intervention to prevent patients progressing to chronicity. No previous research has considered a combined behavioural approach and active physiotherapy in the management of acute WADII patients. The ABPI was therefore developed using a rigorous consensus method using international research and local clinical whiplash experts. Descriptive statistics were used to assess consensus in each round. Online international survey. A purposive sample of 97 potential participants (aiming to recruit n=30) consisting of international research whiplash experts, UK private physiotherapists and UK postgraduate musculoskeletal physiotherapy students were invited to participate via electronic mail with an attached participant information sheet and consent form. 36 individuals signed and returned the consent form. In round 1, 32/36 participants (response rate=89%, mean age±SD=36.03±13.22 years) across 8 countries (Australia, Finland, Greece, India, Netherlands, Norway, Sweden and UK) contributed to round 1 questionnaire. Response rates were 78% and 75% for rounds 2 and 3, respectively. Following round 3, 12 underlying principles (eg, return to normal function as soon as possible, pain management, encouragement of self-management, reduce fear avoidance and anxiety) achieved consensus. The treatment components reaching consensus included behavioural (eg, education, reassurance, self-management) and physiotherapy components (eg, exercises for stability and mobility). No passive intervention achieved consensus. Experts suggested and agreed the underlying principles and treatment components of the ABPI for the management of acute WADII. The ABPI was underpinned by social cognitive theory focusing on self-efficacy enhancement prior to conducting a phase II trial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Integration of Health Protection and Health Promotion: Rationale, Indicators, and Metrics

PubMed Central

Sorensen, Glorian; McLellan, Deborah; Dennerlein, Jack T.; Pronk, Nicolaas P.; Allen, Jennifer D.; Boden, Leslie I.; Okechukwu, Cassandra A.; Hashimoto, Dean; Stoddard, Anne; Wagner, Gregory R

2014-01-01

Objective To offer a definition of an “integrated” approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. Methods Guided by the question, “How will we know it when we see it?” we reviewed relevant literature to identify available definitions and metrics, and used a modified-Delphi process to review and refine indicators and measures of integrated approaches. Results A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers and workers. Conclusions A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process. PMID:24284762

Identifying Core Mobile Learning Faculty Competencies Based Integrated Approach: A Delphi Study

ERIC Educational Resources Information Center

Elbarbary, Rafik Said

2015-01-01

This study is based on the integrated approach as a concept framework to identify, categorize, and rank a key component of mobile learning core competencies for Egyptian faculty members in higher education. The field investigation framework used four rounds Delphi technique to determine the importance rate of each component of core competencies…

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors

PubMed Central

Porta-Sales, Josep; Alonso-Babarro, Alberto; Altisent, Rogelio; Aradilla-Herrero, Amor; Bellido-Pérez, Mercedes; Breitbart, William; Centeno, Carlos; Cuervo, Miguel Angel; Deliens, Luc; Frerich, Gerrit; Gastmans, Chris; Lichtenfeld, Stephanie; Limonero, Joaquín T; Maier, Markus A; Materstvedt, Lars Johan; Nabal, María; Rodin, Gary; Rosenfeld, Barry; Schroepfer, Tracy; Tomás-Sábado, Joaquín; Trelis, Jordi; Villavicencio-Chávez, Christian; Voltz, Raymond

2016-01-01

Background The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. Methods Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. Findings All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. Conclusions This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention. PMID:26726801

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors.

PubMed

Balaguer, Albert; Monforte-Royo, Cristina; Porta-Sales, Josep; Alonso-Babarro, Alberto; Altisent, Rogelio; Aradilla-Herrero, Amor; Bellido-Pérez, Mercedes; Breitbart, William; Centeno, Carlos; Cuervo, Miguel Angel; Deliens, Luc; Frerich, Gerrit; Gastmans, Chris; Lichtenfeld, Stephanie; Limonero, Joaquín T; Maier, Markus A; Materstvedt, Lars Johan; Nabal, María; Rodin, Gary; Rosenfeld, Barry; Schroepfer, Tracy; Tomás-Sábado, Joaquín; Trelis, Jordi; Villavicencio-Chávez, Christian; Voltz, Raymond

2016-01-01

The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention.

Task-specific usability requirements of electronic medical records systems: Lessons learned from a national survey of end-users.

PubMed

Farzandipour, Mehrdad; Meidani, Zahra; Riazi, Hossein; Sadeqi Jabali, Monireh

2018-09-01

There are various approaches to evaluating the usability of electronic medical record (EMR) systems. User perspectives are an integral part of evaluation. Usability evaluations efficiently and effectively contribute to user-centered design and supports tasks and increase user satisfaction. This study determined the main usability requirements for EMRs by means of an end-user survey. A mixed-method strategy was conducted in three phases. A qualitative approach was employed to collect and formulate EMR usability requirements using the focus group method and the modified Delphi technique. Classic Delphi technique was used to evaluate the proposed requirements among 380 end-users in Iran. The final list of EMR usability requirements was verified and included 163 requirements divided into nine groups. The highest rates of end-user agreement relate to EMR visual clarity (3.65 ± 0.61), fault tolerance (3.58 ± 0.56), and suitability for learning (3.55 ± 0.54). The lowest end-user agreement was for auditory presentation (3.18 ± 0.69). The highest and lowest agreement among end-users was for visual clarity and auditory presentation by EMRs, respectively. This suggests that user priorities in determination of EMR usability and their understanding of the importance of the types of individual tasks and context characteristics differ.

Developing a research agenda for the American Society of Colon and Rectal Surgeons: results of a delphi approach.

PubMed

Burt, Caroline G; Cima, Robert R; Koltun, Walter A; Littlejohn, Charles E; Ricciardi, Rocco; Temple, Larissa K; Rothenberger, David A; Baxter, Nancy N

2009-05-01

By use of a systematic approach, the aim of this project was to survey a group of colorectal specialists and reach a consensus on the research questions of highest importance in terms of clinical care. A modified Delphi process was performed. In Round 1 research questions were solicited from members of The American Society of Colon and Rectal Surgeons. A review group categorized the results, combined similar questions, and presented them to The American Society of Colon and Rectal Surgeons membership in Round 2 for prioritizing according to importance. In Round 3 the 50 questions with the highest scores in Round 2 were reranked by The American Society of Colon and Rectal Surgeons membership to produce the 20 highest-priority research questions. A total of 203 respondents in Round 1 submitted 746 questions. The review team reduced these to 105 individual questions encompassing 21 topics in colorectal surgical practice. In Rounds 2 and 3, 399 and 360 respondents, respectively, prioritized the questions presented. The final 20 items included 14 questions related to colorectal cancer, and 6 were on benign disease topics. The research agenda produced by this study reflects the clinical issues of greatest importance to colorectal surgeons. The results are of potential benefit to researchers, funding organizations, medical journals, and ultimately, patients.

Revised Conceptual Framework of Parent-to-Parent Support for Parents of Children Who Are Deaf or Hard of Hearing: A Modified Delphi Study.

PubMed

Henderson, Rebecca J; Johnson, Andrew M; Moodie, Sheila T

2016-06-01

A scoping review of the literature was conducted, resulting in the development of a conceptual framework of parent-to-parent support for parents with children who are Deaf or hard of hearing. This is the 2nd stage of a dual-stage scoping review. This study sought stakeholder opinion and feedback with an aim to achieve consensus on the constructs, components, and design of the initial conceptual framework. A modified electronic Delphi study was completed with 21 handpicked experts from 7 countries who have experience in provision, research, or experience in the area of parent-to-parent support. Participants completed an online questionnaire using an 11-point Likert scale (strongly disagree to strongly agree) and open-ended questions to answer various questions related to the descriptor terms, definitions, constructs, components, and overall design of the framework. Participant responses led to the revision of the original conceptual framework. The findings from this dual-stage scoping review and electronic Delphi study provide a conceptual framework that defines the vital contribution of parents in Early Hearing Detection and Intervention programs that will be a useful addition to these programs.

Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review

PubMed Central

Boulkedid, Rym; Abdoul, Hendy; Loustau, Marine; Sibony, Olivier; Alberti, Corinne

2011-01-01

Objective Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. Methodology and Main Finding Three electronic data bases were searched over a 30 years period (1978–2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. Conclusion The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys. PMID:21694759

Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review.

PubMed

Boulkedid, Rym; Abdoul, Hendy; Loustau, Marine; Sibony, Olivier; Alberti, Corinne

2011-01-01

Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.

Evaluation of Nine Consensus Indices in Delphi Foresight Research and Their Dependency on Delphi Survey Characteristics: A Simulation Study and Debate on Delphi Design and Interpretation.

PubMed

Birko, Stanislav; Dove, Edward S; Özdemir, Vural

2015-01-01

The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger's Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss' Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts' opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency = 0.087 and 0.083, respectively). Scholars in technology design, foresight research and future(s) studies might consider these new findings in strategic planning of Delphi studies, for example, in rational choice of consensus indices and sample size, or accounting for confounding factors such as experts' variable degrees of conformity (stubbornness/flexibility) in modifying their opinions.

Evaluation of Nine Consensus Indices in Delphi Foresight Research and Their Dependency on Delphi Survey Characteristics: A Simulation Study and Debate on Delphi Design and Interpretation

PubMed Central

Birko, Stanislav; Dove, Edward S.; Özdemir, Vural

2015-01-01

The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger’s Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss’ Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts’ opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency = 0.087 and 0.083, respectively). Scholars in technology design, foresight research and future(s) studies might consider these new findings in strategic planning of Delphi studies, for example, in rational choice of consensus indices and sample size, or accounting for confounding factors such as experts’ variable degrees of conformity (stubbornness/flexibility) in modifying their opinions. PMID:26270647

Academic Primer Series: Key Papers About Competency-Based Medical Education

PubMed Central

Cooney, Robert; Chan, Teresa M.; Gottlieb, Michael; Abraham, Michael; Alden, Sylvia; Mongelluzzo, Jillian; Pasirstein, Michael; Sherbino, Jonathan

2017-01-01

Introduction Competency-based medical education (CBME) presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME. Methods Based on the online discussions of the 2016–2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed. Augmenting this list with suggestions by a guest expert and by an open call on Twitter for other important papers, we were able to generate a list of 21 papers in total. Subsequently, we used a modified Delphi study methodology to narrow the list to key papers that describe the importance and significance for educators interested in learning about CBME. To determine the most impactful papers, the mixed junior and senior faculty authorship group used three-round voting methodology based upon the Delphi method. Results Summaries of the five most highly rated papers on the topic of CBME, as determined by this modified Delphi approach, are presented in this paper. Major themes include a definition of core CBME themes, CBME principles to consider in the design of curricula, a history of the development of the CBME movement, and a rationale for changes to accreditation with CBME. The application of the study findings to junior faculty and faculty developers is discussed. Conclusion We present five key papers on CBME that junior faculty members and faculty experts identified as essential to faculty development. These papers are a mix of foundational and explanatory papers that may provide a basis from which junior faculty members may build upon as they help to implement CBME programs. PMID:28611893

Cardiovascular–renal axis disorders in the domestic dog and cat: a veterinary consensus statement

PubMed Central

Pouchelon, J L; Atkins, C E; Bussadori, C; Oyama, M A; Vaden, S L; Bonagura, J D; Chetboul, V; Cowgill, L D; Elliot, J; Francey, T; Grauer, G F; Luis Fuentes, V; Sydney Moise, N; Polzin, D J; Van Dongen, A M; Van Israël, N

2015-01-01

OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term “cardiorenal syndrome” (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with “cardiovascular-renal disorders” (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine. PMID:26331869

Modified Policy-Delphi study for exploring obesity prevention priorities

PubMed Central

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-01-01

Introduction Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of ‘intrusiveness’ has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. Methods and analysis The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethics and dissemination Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. PMID:27601495

Modified Policy-Delphi study for exploring obesity prevention priorities.

PubMed

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-09-06

Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of 'intrusiveness' has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A Delphi-Based Approach for Detecting Key E-Learning Trends in Postgraduate Education: The Spanish Case

ERIC Educational Resources Information Center

Lopez-Catalan, Blanca; Bañuls, Victor A.

2017-01-01

Purpose: The purpose of this paper is to present the results of national level Delphi study carried out in Spain aimed at providing inputs for higher education administrators and decision makers about key e-learning trends for supporting postgraduate courses. Design/methodology/approach: The ranking of the e-learning trends is based on a…

A Delphi-matrix approach to SEA and its application within the tourism sector in Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuo, N.-W.; Hsiao, T.-Y.; Yu, Y.-H.

Strategic Environmental Assessment (SEA) is a procedural tool and within the framework of SEA, several different types of analytical methods can be used in the assessment. However, the impact matrix used currently in Taiwan has some disadvantages. Hence, a Delphi-matrix approach to SEA is proposed here to improve the performance of Taiwan's SEA. This new approach is based on the impact matrix combination with indicators of sustainability, and then the Delphi method is employed to collect experts' opinions. In addition, the assessment of National Floriculture Park Plan and Taiwan Flora 2008 Program is taken as an example to examine thismore » new method. Although international exhibition is one of the important tourism (economic) activities, SEA is seldom about tourism sector. Finally, the Delphi-matrix approach to SEA for tourism development plan is established containing eight assessment topics and 26 corresponding categories. In summary, three major types of impacts: resources' usages, pollution emissions, and local cultures change are found. Resources' usages, such as water, electricity, and natural gas demand, are calculated on a per capita basis. Various forms of pollution resulting from this plan, such as air, water, soil, waste, and noise, are also identified.« less

Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training: A Mixed-Methods Approach.

PubMed

Taylor, David R; Park, Yoon Soo; Smith, Christopher A; Karpinski, Jolanta; Coke, William; Tekian, Ara

2018-05-15

Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem"). A modified Delphi process involving clinical experts followed by a conference of educational experts. The Royal College of Physicians and Surgeons of Canada. In phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results. Phase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and assigned activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education. The project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents. These activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada. Identification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks. Southeastern Ontario Academic Medical Organization Endowed Scholarship and Education Fund and Queen's University Department of Medicine Innovation Fund.

Expert validation of a teamwork assessment rubric: A modified Delphi study.

PubMed

Parratt, Jenny A; Fahy, Kathleen M; Hutchinson, Marie; Lohmann, Gui; Hastie, Carolyn R; Chaseling, Marilyn; O'Brien, Kylie

2016-01-01

Teamwork is a 'soft skill' employability competence desired by employers. Poor teamwork skills in healthcare have an impact on adverse outcomes. Teamwork skills are rarely the focus of teaching and assessment in undergraduate courses. The TeamUP Rubric is a tool used to teach and evaluate undergraduate students' teamwork skills. Students also use the rubric to give anonymised peer feedback during team-based academic assignments. The rubric's five domains focus on planning, environment, facilitation, conflict management and individual contribution; each domain is grounded in relevant theory. Students earn marks for their teamwork skills; validity of the assessment rubric is critical. To what extent do experts agree that the TeamUP Rubric is a valid assessment of 'teamwork skills'? Modified Delphi technique incorporating Feminist Collaborative Conversations. A heterogeneous panel of 35 professionals with recognised expertise in communications and/or teamwork. Three Delphi rounds using a survey that included the rubric were conducted either face-to-face, by telephone or online. Quantitative analysis yielded item content validity indices (I-CVI); minimum consensus was pre-set at 70%. An average of the I-CVI also yielded sub-scale (domain) (D-CVI/Ave) and scale content validity indices (S-CVI/Ave). After each Delphi round, qualitative data were analysed and interpreted; Feminist Collaborative Conversations by the research team aimed to clarify and confirm consensus about the wording of items on the rubric. Consensus (at 70%) was obtained for all but one behavioural descriptor of the rubric. We modified that descriptor to address expert concerns. The TeamUP Rubric (Version 4) can be considered to be well validated at that level of consensus. The final rubric reflects underpinning theory, with no areas of conceptual overlap between rubric domains. The final TeamUP Rubric arising from this study validly measures individual student teamwork skills and can be used with confidence in the university setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

A DELPHI STUDY OF RISK FACTORS FOR ACHILLES TENDINOPATHY- OPINIONS OF WORLD TENDON EXPERTS

PubMed Central

Watson, Paul J.; Barry, Simon

2016-01-01

Background and Purpose Achilles tendinopathy can be a debilitating chronic condition for both active and inactive individuals. The identification of risk facors is important both in preventing but also treating tendinopathy, many factors have been proposed but there is a lack of primary epidemiological data. The purpose of this study was to develop a statement of expert consensus on risk factors for Achilles tendinopathy in active and sedentary patient populations to inform a primary epidemiological study. Study design Delphi study Methods and Measures An online Delphi study was completed inviting participation from world tendon experts. The consensus was developed using three rounds of the Delphi technique. The first round developed a complete list of potential risk factors, the second round refined this list but also separated the factors into two population groups – active/athletic and inactive/sedentary. The third round ranked this list in order of perceived importance. Results Forty-four experts were invited to participate, 16 participated in the first round (response rate 40%) and two dropped out in the second round (resulting in a response rate of 35%). A total of 27 intrinsic and eight extrinsic risk factors were identified during round one. During round two only 12 intrinsic and five extrinsic risk factors were identified as important in active/athletic tendinopathy while 14 intrinsic and three extrinsic factors were identified as important for inactive/sedentary tendinopathy. Conclusions Risk factors for Achilles tendinopathy were identified based on expert consensus, and these factors provide a basis for primary epidemiological studies. Plantarflexor strength was identified as the primary modifiable factor in the active/athletic group while systemic factors were identified as important in the inactive/sedentary group, many of the potential factors suggested for either group were non-modifiable. Non-modifiable factors include: previous tendinopathy, previous injury, advancing age, sex, steroid exposure, and antibiotic treatment. Level of evidence Level V PMID:27757281

Identifying criteria for the assessment of pharmacy students' communication skills with patients.

PubMed

Mackellar, Adele; Ashcroft, Darren M; Bell, Dawn; James, Delyth Higman; Marriott, John

2007-06-15

To identify criteria by which patients can assess the communication skills of pharmacy students. Potential assessment criteria were generated from 2 main sources: a literature review and a focus group discussion. A modified two-round Delphi survey was subsequently conducted with 35 professionals who were actively involved in teaching and assessing communication skills of pharmacy students to determine the importance and reliability of each criterion. Consensus ratings identified 7 criteria that were important measures of pharmacy students' communication skills and could be reliably assessed by patients. A modified two-round Delphi consultation survey successfully identified criteria that can be used by patients to assess the communication skills of pharmacy undergraduates. Future work will examine the feasibility of using patients as assessors of communication skills of pharmacy students, preregistration pharmacists, and qualified pharmacists.

Validation of quality indicators for the organization of palliative care: a modified RAND Delphi study in seven European countries (the Europall project).

PubMed

Woitha, Kathrin; Van Beek, Karen; Ahmed, Nisar; Jaspers, Birgit; Mollard, Jean M; Ahmedzai, Sam H; Hasselaar, Jeroen; Menten, Johan; Vissers, Kris; Engels, Yvonne

2014-02-01

Validated quality indicators can help health-care professionals to evaluate their medical practices in a comparative manner to deliver optimal clinical care. No international set of quality indicators to measure the organizational aspects of palliative care settings exists. To develop and validate a set of structure and process indicators for palliative care settings in Europe. A two-round modified RAND Delphi process was conducted to rate clarity and usefulness of a previously developed set of 110 quality indicators. In total, 20 multi-professional palliative care teams of centers of excellence from seven European countries. In total, 56 quality indicators were rated as useful. These valid quality indicators concerned the following domains: the definition of a palliative care service (2 quality indicators), accessibility to palliative care (16 quality indicators), specific infrastructure to deliver palliative care (8 quality indicators), symptom assessment tools (1 quality indicator), specific personnel in palliative care services (9 quality indicators), documentation methodology of clinical data (14 quality indicators), evaluation of quality and safety procedures (1 quality indicator), reporting of clinical activities (1 quality indicator), and education in palliative care (4 quality indicator). The modified RAND Delphi process resulted in 56 international face-validated quality indicators to measure and compare organizational aspects of palliative care. These quality indicators, aimed to assess and improve the organization of palliative care, will be pilot tested in palliative care settings all over Europe and be used in the EU FP7 funded IMPACT project.

Moving forward through consensus: protocol for a modified Delphi approach to determine the top research priorities in the field of orthopaedic oncology.

PubMed

Schneider, Patricia; Evaniew, Nathan; Rendon, Juan Sebastian; McKay, Paula; Randall, R Lor; Turcotte, Robert; Vélez, Roberto; Bhandari, Mohit; Ghert, Michelle

2016-05-24

Orthopaedic oncology researchers face several obstacles in the design and execution of randomised controlled trials, including finite fiscal resources to support the rising costs of clinical research and insufficient patient volume at individual sites. As a result, high-quality research to guide clinical practice has lagged behind other surgical subspecialties. A focused approach is imperative to design a research programme that is economical, streamlined and addresses clinically relevant endpoints. The primary objective of this study will be to use a consensus-based approach to identify research priorities for international clinical trials in orthopaedic oncology. We will conduct a 3-phase modified Delphi method consisting of 2 sequential rounds of anonymous web-based questionnaires (phases I and II), and an in-person consensus meeting (phase III). Participants will suggest research questions that they believe are of particular importance to the field (phase I), and individually rate each proposed question on 5 criteria (phase II). Research questions that meet predetermined consensus thresholds will be brought forward to the consensus meeting (phase III) for discussion by an expert panel. Following these discussions, the expert panel will be asked to assign scores for each research question, and research questions meeting predetermined criteria will be brought forward for final ranking. The expert panel will then be asked to rank the top 3 research questions, and these 3 research questions will be distributed to the initial group of participants for validation. An ethics application is currently under review with the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this initiative will be disseminated through peer-reviewed publications and conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Quality of care for cancer patients on home parenteral nutrition: development of key interventions and outcome indicators using a two-round Delphi approach.

PubMed

Dreesen, Mira; Foulon, Veerle; Hiele, Martin; Vanhaecht, Kris; De Pourcq, Lutgart; Pironi, Loris; Van Gossum, André; Arends, Jann; Cuerda, Cristina; Thul, Paul; Bozzetti, Frederico; Willems, Ludo

2013-05-01

Clear recommendations on how to guide patients with cancer on home parenteral nutrition (HPN) are lacking as the use of HPN in this population remains a controversial issue. Therefore, the aims of this study were to rank treatment recommendations and main outcome indicators to ensure high-quality care and to indicate differences in care concerning benign versus malignant patients. Treatment recommendations, identified from published guidelines, were used as a starting point for a two-round Delphi approach. Comments and additional interventions proposed in the first round were reevaluated in the second round. Ordinal logistic regression with SPSS 2.0 was used to identify differences in care concerning benign versus malignant patients. Twenty-seven experts from five European countries completed two Delphi rounds. After the second Delphi round, the top three most important outcome indicators were (1) quality of life (QoL), (2) incidence of hospital readmission and (3) incidence of catheter-related infections. Forty-two interventions were considered as important for quality of care (28/42 based on published guidelines; 14/42 newly suggested by Delphi panel). The topics 'Liver disease' and 'Metabolic bone disease' were considered less important for cancer patients, together with use of infusion pumps (p = 0.004) and monitoring of vitamins and trace elements (p = 0.000). Monitoring of QoL is considered more important for cancer patients (p = 0.03). Using a two-round Delphi approach, we developed a minimal set of 42 interventions that may be used to determine quality of care in HPN patients with malignancies. This set of interventions differs from a similar set developed for benign patients.

Curated Collection for Educators: Five Key Papers about the Flipped Classroom Methodology.

PubMed

King, Andrew; Boysen-Osborn, Megan; Cooney, Robert; Mitzman, Jennifer; Misra, Asit; Williams, Jennifer; Dulani, Tina; Gottlieb, Michael

2017-10-25

The flipped classroom (FC) pedagogy is becoming increasingly popular in medical education due to its appeal to the millennial learner and potential benefits in knowledge acquisition. Despite its popularity and effectiveness, the FC educational method is not without challenges. In this article, we identify and summarize several key papers relevant to medical educators interested in exploring the FC teaching methodology. The authors identified an extensive list of papers relevant to FC pedagogy via online discussions within the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. This list was augmented by an open call on Twitter (utilizing the #meded, #FOAMed, and #flippedclassroom hashtags) yielding a list of 33 papers. We then conducted a three-round modified Delphi process within the authorship group, which included both junior and senior clinician educators, to identify the most impactful papers for educators interested in FC pedagogy. The three-round modified Delphi process ranked all of the selected papers and selected the five most highly-rated papers for inclusion. The authorship group reviewed and summarized these papers with specific consideration given to their value to junior faculty educators and faculty developers interested in the flipped classroom approach. The list of papers featured in this article serves as a key reading list for junior clinician educators and faculty developers interested in the flipped classroom technique. The associated commentaries contextualize the importance of these papers for medical educators aiming to optimize their understanding and implementation of the flipped classroom methodology in their teaching and through faculty development.

Using Delphi technique in a consensual curriculum for periodontics.

PubMed

Fried, Hana; Leao, Anna Thereza

2007-11-01

Periodontics has experienced several important conceptual changes in the last few decades. As such, it is important to have a periodontics curriculum built upon the expertise of specialists in that discipline and reflecting those changes. The main goal of this study was to attain a consensus, through the use of the Delphi technique, on the topics that should be included in a periodontics curriculum for undergraduate dental students. A sample of periodontics lecturers from nine dental schools in two Brazilian cities was used, and a Delphi technique approach was followed to investigate sample member perceptions on the subject. Participants received four postal mail questionnaires asking them to rate and rerate eighty-nine topics for possible inclusion in the curriculum. A descriptive analysis was conducted, and topic frequencies were calculated. Topics rated as highly important for inclusion were the following: health, ailment, prevention, etiology, epidemiology, diagnosis, and treatment. The Delphi technique approach proved successful in involving periodontics lecturers in the design of a periodontics curriculum for undergraduate dental students.

A Screening Tool to Identify Spasticity in Need of Treatment

PubMed Central

Zorowitz, Richard D.; Wein, Theodore H.; Dunning, Kari; Deltombe, Thierry; Olver, John H.; Davé, Shashank J.; Dimyan, Michael A.; Kelemen, John; Pagan, Fernando L.; Evans, Christopher J.; Gillard, Patrick J.; Kissela, Brett M.

2017-01-01

Objective To develop a clinically useful patient-reported screening tool for health care providers to identify patients with spasticity in need of treatment regardless of etiology. Design Eleven spasticity experts participated in a modified Delphi panel and reviewed and revised 2 iterations of a screening tool designed to identify spasticity symptoms and impact on daily function and sleep. Spasticity expert panelists evaluated items pooled from existing questionnaires to gain consensus on the screening tool content. The study also included cognitive interviews of 20 patients with varying spasticity etiologies to determine if the draft screening tool was understandable and relevant to patients with spasticity. Results The Delphi panel reached an initial consensus on 21 of 47 items for the screening tool and determined that the tool should have no more than 11 to 15 items and a 1-month recall period for symptom and impact items. After 2 rounds of review, 13 items were selected and modified by the expert panelists. Most patients (n = 16 [80%]) completed the cognitive interview and interpreted the items as intended. Conclusions Through the use of a Delphi panel and patient interviews, a 13-item spasticity screening tool was developed that will be practical and easy to use in routine clinical practice. PMID:27552355

A hospital-based child protection programme evaluation instrument: a modified Delphi study.

PubMed

Wilson, Denise; Koziol-McLain, Jane; Garrett, Nick; Sharma, Pritika

2010-08-01

Refine instrument for auditing hospital-based child abuse and neglect violence intervention programmes prior to field-testing. A modified Delphi study to identify and rate items and domains indicative of an effective and quality child abuse and neglect intervention programme. Experts participated in four Delphi rounds: two surveys, a one-day workshop and the opportunity to comment on the penultimate instrument. New Zealand. Twenty-four experts in the field of care and protection of children. Items with panel agreement >or=85% and mean importance rating >or=4.0 (scale from 1 (not important) to 5 (very important)). There was high-level consensus on items across Rounds 1 and 2 (89% and 85%, respectively). In Round 3 an additional domain (safety and security) was agreed upon and cultural issues, alert systems for children at risk, and collaboration among primary care, community, non-government and government agencies were discussed. The final instrument included nine domains ('policies and procedures', 'safety and security', 'collaboration', 'cultural environment', 'training of providers', 'intervention services', 'documentation' 'evaluation' and 'physical environment') and 64 items. The refined instrument represents the hallmarks of an ideal child abuse and neglect programme given current knowledge and experience. The instrument enables rigorous evaluations of hospital-based child abuse and neglect intervention programmes for quality improvement and benchmarking with other programmes.

Guidelines for Graduate Medical Education in Geriatrics.

ERIC Educational Resources Information Center

Robbins, Alan S.; Beck, John C.

1982-01-01

Performance objectives, core content, training experiences, and clinical exposure and program evaluations are described for geriatric fellows and house staff members in internal medicine, family practice, neurology, and psychiatry. A modified Delphi study was used. (Author/MLW)

Derivation of a Performance Checklist for Ultrasound-Guided Arthrocentesis Using the Modified Delphi Method.

PubMed

Kunz, Derek; Pariyadath, Manoj; Wittler, Mary; Askew, Kim; Manthey, David; Hartman, Nicholas

2017-06-01

Arthrocentesis is an important skill for physicians in multiple specialties. Recent studies indicate a superior safety and performance profile for this procedure using ultrasound guidance for needle placement, and improving quality of care requires a valid measurement of competency using this modality. We endeavored to create a validated tool to assess the performance of this procedure using the modified Delphi technique and experts in multiple disciplines across the United States. We derived a 22-item checklist designed to assess competency for the completion of ultrasound-guided arthrocentesis, which demonstrated a Cronbach's alpha of 0.89, indicating an excellent degree of internal consistency. Although we were able to demonstrate content validity for this tool, further validity evidence should be acquired after the tool is used and studied in clinical and simulated contexts. © 2017 by the American Institute of Ultrasound in Medicine.

Design and validation of key text messages (Tonsil-Text-To-Me) to improve parent and child perioperative tonsillectomy experience: A modified Delphi study.

PubMed

Song, Jin Soo A; Wozney, Lori; Chorney, Jill; Ishman, Stacey L; Hong, Paul

2017-11-01

Parents can struggle while providing perioperative tonsillectomy care for their children at home. Short message service (SMS) technology is an accessible and direct modality to communicate timely, evidence-based recommendations to parents across the perioperative period. This study focused on validating a SMS protocol, Tonsil-Text-To-Me (TTTM), for parents of children undergoing tonsillectomy. This study used a modified Delphi expert consensus method. Participants were an international sample of 27 clinicians/researchers. Participants rated level of agreement with recommendations across seven perioperative domains, derived systematically from scientific and lay literature. A priori consensus analysis was conducted using threshold criterion. A multidisciplinary team of local clinicians were also individually interviewed to consolidate text messages and implement recurrent suggestions. In the modified Delphi panel, 30 statements reached threshold agreement (>3.0 of 4.0); recommendations surrounding diet (3.87) and hygiene (3.83) had the highest level of consensus, while recommendations regarding activity (3.42) and non-pharmacologic pain management (3.55) had the lowest consensus. The 30 statements reconfigured into 12 concise text messages. After further interviews with local clinicians, 14 final text messages were included in the SMS protocol to be sent two weeks preoperatively to one week postoperatively. This study illustrates the development of TTTM which is designed to deliver key sequential text messages at the optimal time during the perioperative setting to parents caring for their children who are undergoing tonsillectomy. Copyright © 2017 Elsevier B.V. All rights reserved.

Factors Influencing Continuing Professional Development: A Delphi Study among Nursing Experts

ERIC Educational Resources Information Center

Brekelmans, Gerard; Poell, Rob F.; van Wijk, Kees

2013-01-01

Purpose: The aim of this paper is to present an inventory of expert opinions on the factors that influence the participation of registered nurses in continuing professional development (CPD) activities. Design/methodology/approach: A Delphi study was conducted among 38 Dutch experts (nursing employers, managers, education institutions, and…

Assessment Leaders' Perspectives of Institutional Cultures of Assessment: A Delphi Study

ERIC Educational Resources Information Center

Fuller, Matthew; Henderson, Susan; Bustamante, Rebecca

2015-01-01

Institutional cultures of assessment are praised as beneficial to student learning. Yet, extant studies have not explored the theoretical foundations and pragmatic approaches to shaping cultures of assessment. The researchers used the Delphi method to explore 10 higher education assessment leaders' attitudes and theoretical perspectives regarding…

Development of a list of high-risk operations for patients 65 years and older.

PubMed

Schwarze, Margaret L; Barnato, Amber E; Rathouz, Paul J; Zhao, Qianqian; Neuman, Heather B; Winslow, Emily R; Kennedy, Gregory D; Hu, Yue-Yung; Dodgion, Christopher M; Kwok, Alvin C; Greenberg, Caprice C

2015-04-01

No consensus exists regarding the definition of high-risk surgery in older adults. An inclusive and precise definition of high-risk surgery may be useful for surgeons, patients, researchers, and hospitals. To develop a list of high-risk operations. Retrospective cohort study and modified Delphi procedure. The setting included all Pennsylvania acute care hospitals (Pennsylvania Health Care Cost Containment Council [PHC4] April 1, 2001, to December 31, 2007) and a nationally representative sample of US acute care hospitals (Nationwide Inpatient Sample [NIS], Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality January 1, 2001, to December 31, 2006). Patients included were those 65 years and older admitted to PHC4 hospitals and those 18 years and older admitted to NIS hospitals. We identified International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes associated with at least 1% inpatient mortality in the PHC4. We used a modified Delphi procedure with 5 board-certified surgeons to further refine this list by excluding nonoperative procedures and operations that were unlikely to be the proximate cause of mortality and were instead a marker of critical illness (eg, tracheostomy). We then cross-validated this list of ICD-9-CM codes in the NIS. Modified Delphi procedure consensus of at least 4 of 5 panelists and proportion agreement in the NIS. Among 4,739,522 admissions of patients 65 years and older in the PHC4, a total of 2,569,589 involved a procedure, encompassing 2853 unique procedures. Of 1130 procedures associated with a crude inpatient mortality of at least 1%, 264 achieved consensus as high-risk operations by the modified Delphi procedure. The observed inpatient mortality in the NIS was at least 1% for 227 of 264 procedures (86%) in patients 65 years and older. The pooled inpatient mortality for these identified high-risk procedures performed on patients 65 years and older was double the pooled inpatient mortality for correspondingly identified high-risk operations for patients younger than 65 years (6% vs 3%). We developed a list of procedure codes to identify high-risk surgical procedures in claims data. This list of high-risk operations can be used to standardize the definition of high-risk surgery in quality and outcomes-based studies and to design targeted clinical interventions.

[University studies plan in geriatric medicine developed using a modified Delphi technique].

PubMed

Vilches-Moraga, Arturo; Ariño-Blasco, Sergio; Verdejo-Bravo, Carlos; Mateos-Nozal, Jesús

2015-01-01

The increase in the number of frail elderly people has led to the necessity that all doctors of the future acquire sufficient knowledge on human ageing and the skills in the management of the patient of advanced age, as well as the diseases associated with ageing. Few countries offer geriatric medicine within undergraduate training. The purpose of the present project was to obtain a consensus between European geriatricians on the minimum requirements that medical students must achieve at the end of their university degree course. A modified Delphi process was used. Firstly, experts in education and geriatrics proposed a set of learning objectives based on a review of the literature. Three Delphi rounds were then performed, in which a panel of 49 experts representing 29 countries affiliated to the European Union of Medical Specialists took part. This enabled them to reach a consensus on a definitive study plan. The number of disagreements after the Delphi rounds 1 and 2 were 81 and 53, respectively. Full agreement was reached after the third round. The definitive study plan consisted of detailed objectives grouped under 10 general training objectives. A consensus has been reached between European geriatricians that sets specific training objectives for medical students. Great efforts will be required for the introduction of these requirements, given the variability there is in the quality of teaching in geriatrics. This study plan is a first step in helping to improve geriatrics teaching in faculties of medicine, and will also serve as a basis to make advances in the training in post-graduate geriatrics throughout Europe. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Crucial design issues for special access technology; a Delphi study.

PubMed

O'Rourke, Pearl; Ekins, Ray; Timmins, Bernard; Timmins, Fiona; Long, Siobhan; Coyle, Eugene

2014-01-01

To develop and demonstrate a method to involve professional users of assistive technology (AT) in the development process of customisable products. Employing the ideas of user participation and mass customisation, this research addresses the need for reduced product costs and optimised product flexibility. An adaptable six-question Delphi study was developed to establish consensus among AT professionals on design issues relating to a specified AT domain requiring innovation. The study is demonstrated for the special access technology (SAT) domain. A modified morphological matrix structures the application of the study results to the product design process. Fourteen professionals from the Republic of Ireland and the UK participated. Consensus was reached on prevalent parts of SAT that malfunction, primary reasons for SAT malfunction, characteristics of clients associated with SAT selection, client needs regarding SAT use and training, desirable traits of SAT and clinicians' frustrations with SAT. The study revealed a range of problems related to SAT, highlighting the complexities of successful SAT adoption. The questions led to differentiated insights and enabled design solution conceptualisation from various perspectives. The approach was found to help facilitate efficient generation and application of professional users' knowledge during the design process of customisable AT.

Achieving 90% Adoption of Clinical Practice Guidelines Using the Delphi Consensus Method in a Large Orthopedic Group.

PubMed

Bini, Stefano A; Mahajan, John

2016-11-01

Little is known about the implementation rate of clinical practice guidelines (CPGs). Our purpose was to report on the adoption rate of CPGs created and implemented by a large orthopedic group using the Delphi consensus method. The draft CPGs were created before the group's annual meeting by 5 teams each assigned a subset of topics. The draft guidelines included a statement and a summary of the available evidence. Each guideline was debated in both small-group and plenary sessions. Voting was anonymous and a 75% supermajority was required for passage. A Likert scale was used to survey the patient's experience with the process at 1 week, and the Kirkpatrick evaluation model was used to gauge the efficacy of the process over a 6-month time frame. Eighty-five orthopedic surgeons attended the meeting. Fifteen guidelines grouped into 5 topics were created. All passed. Eighty-six percent of attendees found the process effective and 84% felt that participating in the process made it more likely that they would adopt the guidelines. At 1 week, an average of 62% of attendees stated they were practicing the guideline as written (range: 35%-72%), and at 6 months, 96% stated they were practicing them (range: 82%-100%). We have demonstrated that a modified Delphi method for reaching consensus can be very effective in both creating CPGs and leading to their adoption. Further we have shown that the process is well received by participants and that an inclusionary approach can be highly successful. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality pharmacy services and key performance indicators in Polish NICUs: a Delphi approach.

PubMed

Krzyżaniak, Natalia; Pawłowska, Iga; Bajorek, Beata

2018-03-31

Background Currently, there is no literature describing what a quality level of practice entails in Polish neonatal intensive care units (NICUs), nor are there any means of currently measuring the quality of pharmaceutical care provided to NICU patients. Objective To identify a set of essential pharmacist roles and pharmacy-relevant key performance indicators (KPI's) suitable for Polish neonatal intensive units (NICUs). Setting Polish hospital pharmacies and NICUs. Method Using a modified Delphi technique, potential KPI's structured along Donabedian's domains as well as pharmacy services were presented to an expert panel of stakeholders. Two online, consecutive Delphi rounds, were completed by panellists between August and September 2017. Main outcome measure To identify the minimum level of pharmacy services that should be consistently provided to NICU patients. Results A total of 16 panellists contributed to the expert panel. Overall, consensus of 75% was reached for 23 indicators and for 28 roles. When considering pharmacy services for the NICU, the experts were found to highly value traditional pharmacy roles, such as dispensing and extemporaneous compounding, however, they were still eager for roles in the other domains, such as educational and clinical services, to be listed as essential for NICU practice. Panellists were found to positively value the list of indicators presented, and excluded only 9 out of the total list. Conclusion There is a need for future research to establish a minimum standard of practice for Polish pharmacists to encourage the progression and standardisation of hospital pharmacy services to meet the level of practice seen in NICUs worldwide.

Developing a tool for the preparation of GMP audit of pharmaceutical contract manufacturer.

PubMed

Linna, Anu; Korhonen, Mirka; Mannermaa, Jukka-Pekka; Airaksinen, Marja; Juppo, Anne Mari

2008-06-01

Outsourcing is rapidly growing in the pharmaceutical industry. When the manufacturing activities are outsourced, control of the product's quality has to be maintained. One way to confirm contract manufacturer's GMP (Good Manufacturing Practice) compliance is auditing. Audits can be supported for instance by using GMP questionnaires. The objective of this study was to develop a tool for the audit preparation of pharmaceutical contract manufacturers and to validate its contents by using Delphi method. At this phase of the study the tool was developed for non-sterile finished product contract manufacturers. A modified Delphi method was used with expert panel consisting of 14 experts from pharmaceutical industry, authorities and university. The content validity of the developed tool was assessed by a Delphi questionnaire round. The response rate in Delphi questionnaire round was 86%. The tool consisted of 103 quality items, from which 90 (87%) achieved the pre-defined agreement rate level (75%). Thirteen quality items which did not achieve the pre-defined agreement rate were excluded from the tool. The expert panel suggested only minor changes to the tool. The results show that the content validity of the developed audit preparation tool was good.

[Construction of a physiological aging scale for healthy people based on a modified Delphi method].

PubMed

Long, Yao; Zhou, Xuan; Deng, Pengfei; Liao, Xiong; Wu, Lei; Zhou, Jianming; Huang, Helang

2016-04-01

To build a physiological aging scale for healthy people.
 We collected age-related physiologic items through literature screening and expert interview. Two rounds of Delphi were implemented. The importance, feasibility and the degree of authority for the physiological index system were graded. Using analytic hierarchy process, we determined the weight of dimensions and items.
 Using Delphy mothod, 17 physiological and other professional experts offered the results as follow: coefficient of expert authorities Cr was 0.86±0.03, coordination coefficients for the first and second round were 0.264(χ2=229.691, P<0.001) and 0.293(χ2=228.474，P<0.001), respectively. The consistency was good. The aging scale for healthy people included 3 dimensions, namely physical form, feeling movement and functional status. Each dimension had 8 items. The weight coefficients for the 3 dimensions were 0.54, 0.16, and 0.30, respectively. The Cronbach's α coefficient of the scale was 0.893, the reliability was 0.796, and the variance of the common factor was 58.17%.
 The improved Delphi method or physiological aging scale is satisfied, which can provide reference for the evaluation of aging.

Procedure competencies and job functions of the urologic advanced practice nurse.

PubMed

Kleier, Jo Ann

2009-01-01

A 2-round modified Delphi study recruited a panel urologic advanced practice nurse experts to identify the procedure competencies and job functions unique to the role of the advanced practice nurse specializing in the care of urology patients.

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

Medical Students and informed consent: A consensus statement prepared by the Faculties of Medical and Health Science of the Universities of Auckland and Otago, Chief Medical Officers of District Health Boards, New Zealand Medical Students' Association and the Medical Council of New Zealand.

PubMed

Bagg, Warwick; Adams, John; Anderson, Lynley; Malpas, Phillipa; Pidgeon, Grant; Thorn, Michael; Tulloch, David; Zhong, Cathy; Merry, Alan F

2015-05-15

To develop a national consensus statement to promote a pragmatic, appropriate and unified approach to seeking consent for medical student involvement in patient care. A modified Delphi technique was used to develop the consensus statement involving stakeholders. Feedback from consultation and each stakeholder helped to shape the final consensus statement. The consensus statement is a nationally-agreed statement concerning medical student involvement in patient care, which will be useful for medical students, health care professionals and patients.

Multidisciplinary Delphi Development of a Scale to Evaluate Team Function in Obstetric Emergencies: The PETRA Scale.

PubMed

Balki, Mrinalini; Hoppe, David; Monks, David; Cooke, Mary Ellen; Sharples, Lynn; Windrim, Rory

2017-06-01

The objective of this study was to develop a new interdisciplinary teamwork scale, the Perinatal Emergency: Team Response Assessment (PETRA), for the management of obstetric crises, through consensus agreement of obstetric caregivers. This prospective study was performed using expert consensus, based on a Delphi method. The study investigators developed a new PETRA tool, specifically related to obstetric crisis management, based on the existing literature and discussions among themselves. The scale was distributed to a selected panel of experts in the field for the Delphi process. After each round of Delphi, every component of the scale was analyzed quantitatively by the percentage of agreement ratings and each comment reviewed by the blinded investigators. The assessment scale was then modified, with components of less than 80% agreement removed from the scale. The process was repeated on three occasions to reach a consensus and final PETRA scale. Fourteen of 24 invited experts participated in the Delphi process. The original PETRA scale included six categories and 48 items, one global scale item, and a 3-point rubric for rating. The overall percentage agreement by experts in the first, second, and third rounds was 95.0%, 93.2%, and 98.5%, respectively. The final scale after the third round of Delphi consisted of the following seven categories: shared mental model, communication, situational awareness, leadership, followership, workload management, and positive/effective behaviours and attitudes. There were 34 individual items within these categories, each with a 5-point rating rubric (1 = unacceptable to 5 = perfect). Using a structured Delphi method, we established the face and content validity of this assessment scale that focuses on important aspects of interdisciplinary teamwork in the management of obstetric crises. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

An international delphi survey for the definition of the variables for the development of new classification criteria for periodic fever aphtous stomatitis pharingitis cervical adenitis (PFAPA).

PubMed

Vanoni, Federica; Federici, Silvia; Antón, Jordi; Barron, Karyl S; Brogan, Paul; De Benedetti, Fabrizio; Dedeoglu, Fatma; Demirkaya, Erkan; Hentgen, Veronique; Kallinich, Tilmann; Laxer, Ronald; Russo, Ricardo; Toplak, Natasa; Uziel, Yosef; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Hofer, Michael

2018-04-18

Diagnosis of Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is currently based on a set of criteria proposed in 1999 modified from Marshall's criteria. Nevertheless no validated evidence based set of classification criteria for PFAPA has been established so far. The aim of this study was to identify candidate classification criteria PFAPA syndrome using international consensus formation through a Delphi questionnaire survey. A first open-ended questionnaire was sent to adult and pediatric clinicians/researchers, asking to identify the variables thought most likely to be helpful and relevant for the diagnosis of PFAPA. In a second survey, respondents were asked to select, from the list of variables coming from the first survey, the 10 features that they felt were most important, and to rank them in descending order from most important to least important. The response rate to the first and second Delphi was respectively 109/124 (88%) and 141/162 (87%). The number of participants that completed the first and second Delphi was 69/124 (56%) and 110/162 (68%). From the first Delphi we obtained a list of 92 variables, of which 62 were selected in the second Delphi. Variables reaching the top five position of the rank were regular periodicity, aphthous stomatitis, response to corticosteroids, cervical adenitis, and well-being between flares. Our process led to identification of features that were felt to be the most important as candidate classification criteria for PFAPA by a large sample of international rheumatologists. The performance of these items will be tested further in the next phase of the study, through analysis of real patient data.

BCQ+: a body constitution questionnaire to assess Yang-Xu. Part I: establishment of a first final version through a Delphi process.

PubMed

Su, Yi-Chang; Chen, Li-Li; Lin, Jun-Dai; Lin, Jui-Shan; Huang, Yi-Chia; Lai, Jim-Shoung

2008-12-01

Assessing an individual's level of Yang deficiency (Yang-Xu) by its manifestations is a frequent issue in traditional Chinese medicine (TCM) clinical trials. To this end, an objective, reliable and rigorous diagnostic tool is required. This study aimed to develop a first final version of the Yang-Xu Constitution Questionnaire. We conducted 3 steps to develop such an objective measurement tool: 1) the research team was formed and a panel of 26 experts was selected for the Delphi process; 2) items for the questionnaire were generated by literature review and a Delphi process; items were reworded into colloquial questions; face and content validity of the items were evaluated through a Delphi process again; 3) the difficulty of the questionnaire was evaluated in a pilot study with 81 subjects aged 20-60 years. The literature review retrieved 35 relevant items which matched the definition of 'constitution' and 'Yang-Xu'. After a first Delphi process, 22 items were retained and translated into colloquial questions. According to the second part of the Delphi process, the content validity index of each of the 22 questions ranged between 0.85-1. These 22 questions were evaluated by 81 subjects, 2 questions that were hard to tell the difference were combined; 3 questions were modified after the research team had discussed the participants' feedback. Finally, the questionnaire was established with 21 questions. This first final version of a questionnaire to assess Yang-Xu constitution with considerable face and content validity may serve as a basis to develop an advanced Yang-Xu questionnaire. 2008 S. Karger AG, Basel.

Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study.

PubMed

Elledge, Ross O C; McAleer, Sean

2015-02-01

It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation.

PubMed

Perry, Lin; Nicholls, Rachel; Duffield, Christine; Gallagher, Robyn

2017-11-01

To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. The study used a modified Delphi design conducted between September and November 2015. Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions; smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health. © 2017 John Wiley & Sons Ltd.

Core Outcome Domains for early phase clinical trials of sound-, psychology-, and pharmacology-based interventions to manage chronic subjective tinnitus in adults: the COMIT'ID study protocol for using a Delphi process and face-to-face meetings to establish consensus.

PubMed

Fackrell, Kathryn; Smith, Harriet; Colley, Veronica; Thacker, Brian; Horobin, Adele; Haider, Haúla F; Londero, Alain; Mazurek, Birgit; Hall, Deborah A

2017-08-23

The reporting of outcomes in clinical trials of subjective tinnitus indicates that many different tinnitus-related complaints are of interest to investigators, from perceptual attributes of the sound (e.g. loudness) to psychosocial impacts (e.g. quality of life). Even when considering one type of intervention strategy for subjective tinnitus, there is no agreement about what is critically important for deciding whether a treatment is effective. The main purpose of this observational study is, therefore to, develop Core Outcome Domain Sets for the three different intervention strategies (sound, psychological, and pharmacological) for adults with chronic subjective tinnitus that should be measured and reported in every clinical trial of these interventions. Secondary objectives are to identify the strengths and limitations of our study design for recruiting and reducing attrition of participants, and to explore uptake of the core outcomes. The 'Core Outcome Measures in Tinnitus: International Delphi' (COMIT'ID) study will use a mixed-methods approach that incorporates input from health care users at the pre-Delphi stage, a modified three-round Delphi survey and final consensus meetings (one for each intervention). The meetings will generate recommendations by stakeholder representatives on agreed Core Outcome Domain Sets specific to each intervention. A subsequent step will establish a common cross-cutting Core Outcome Domain Set by identifying the common outcome domains included in all three intervention-specific Core Outcome Domain Sets. To address the secondary objectives, we will gather feedback from participants about their experience of taking part in the Delphi process. We aspire to conduct an observational cohort study to evaluate uptake of the core outcomes in published studies at 7 years following Core Outcome Set publication. The COMIT'ID study aims to develop a Core Outcome Domain Set that is agreed as critically important for deciding whether a treatment for subjective tinnitus is effective. Such a recommendation would help to standardise future clinical trials worldwide and so we will determine if participation increases use of the Core Outcome Set in the long term. This project has been registered (November 2014) in the database of the Core Outcome Measures in Effectiveness Trials (COMET) initiative.

Chiropractic Integrated Care Pathway for Low Back Pain in Veterans: Results of a Delphi Consensus Process.

PubMed

Lisi, Anthony J; Salsbury, Stacie A; Hawk, Cheryl; Vining, Robert D; Wallace, Robert B; Branson, Richard; Long, Cynthia R; Burgo-Black, A Lucille; Goertz, Christine M

2018-02-01

The purpose of this study was to develop an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within Department of Veterans Affairs health care facilities. The research method used was a consensus process. A multidisciplinary investigative team reviewed clinical guidelines and Veterans Affairs pain and mental health initiatives to develop seed statements and care algorithms to guide chiropractic management and collaborative care of veterans with low back pain. A 5-member advisory committee approved initial recommendations. Veterans Affairs-based panelists (n = 58) evaluated the pathway via e-mail using a modified RAND/UCLA methodology. Consensus was defined as agreement by 80% of panelists. The modified Delphi process was conducted in July to December 2016. Most (93%) seed statements achieved consensus during the first round, with all statements reaching consensus after 2 rounds. The final care pathway addressed the topics of informed consent, clinical evaluation including history and examination, screening for red flags, documentation, diagnostic imaging, patient-reported outcomes, adverse event reporting, chiropractic treatment frequency and duration standards, tailored approaches to chiropractic care in veteran populations, and clinical presentation of common mental health conditions. Care algorithms outlined chiropractic case management and interprofessional collaboration and referrals between doctors of chiropractic and primary care and mental health providers. This study offers an integrative care pathway that includes chiropractic care for veterans with low back pain. Copyright © 2018. Published by Elsevier Inc.

A modified Delphi study of structures and processes related to medicines management for elderly hospitalised patients in the United Arab Emirates.

PubMed

Al Shemeili, Saeed; Klein, Susan; Strath, Alison; Fares, Saleh; Stewart, Derek

2016-10-01

The structures and processes around the management of medicines for elderly, hospitalized patients are ill defined. This study aimed to determine consensus related to strategic and operational approaches in the United Arab Emirates. A modified Delphi technique, consensus study with first round statements developed from systematic reviews related to medicines management. Normalization process theory and the theoretical domains framework were applied in the construction of statements, organized into key elements of medicines management: guidelines for medicines management, medicines reconciliation, medicines selection, prescribing and review, medicines adherence, medicines counselling, health professional training and evaluation research. Seventy per cent (summative agree and strongly agree) was set as the target for consensus. Thirty panellists were recruited, representing senior physicians working within geriatrics, hospital pharmacy and nursing directors, chief health professionals (including social workers) and policy makers within the Health Authority of Abu Dhabi and academics. A high level of consensus was obtained for most statements relating to the structures and processes of medicines management. While consensus was not achieved for targeting only those patients with medicines related issues, it was achieved for focusing on all elderly admissions. Similarly, consensus was not achieved for which professions were most suited to roles but was achieved for trained and competent staff. High levels of consensus were obtained for structures and processes of medicines management relating to elderly hospitalized patients. Trained and competent health professionals were preferred to specific professions for any tasks and that all elderly patients and not targeted patients should be the focus for medicines management. © 2016 John Wiley & Sons, Ltd.

Deriving ICD-10 Codes for Patient Safety Indicators for Large-scale Surveillance Using Administrative Hospital Data.

PubMed

Southern, Danielle A; Burnand, Bernard; Droesler, Saskia E; Flemons, Ward; Forster, Alan J; Gurevich, Yana; Harrison, James; Quan, Hude; Pincus, Harold A; Romano, Patrick S; Sundararajan, Vijaya; Kostanjsek, Nenad; Ghali, William A

2017-03-01

Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. We undertook de novo PSI development through a data-driven approach that drew upon "diagnosis timing" information available in some countries' administrative hospital data. Administrative database analysis and modified Delphi rating process. All hospitalized adults in Canada in 2009. We queried all hospitalizations for ICD-10-CA diagnosis codes arising during hospital stay. We then undertook a modified Delphi panel process to rate the extent to which each of the identified diagnoses has a potential link to suboptimal quality of care. We grouped the identified quality/safety-related diagnoses into relevant clinical categories. Lastly, we queried Alberta hospital discharge data to assess the frequency of the newly defined PSI events. Among 2,416,413 national hospitalizations, we found 2590 unique ICD-10-CA codes flagged as having arisen after admission. Seven panelists evaluated these in a 2-round review process, and identified a listing of 640 ICD-10-CA diagnosis codes judged to be linked to suboptimal quality of care and thus appropriate for inclusion in PSIs. These were then grouped by patient safety experts into 18 clinically relevant PSI categories. We then analyzed data on 2,381,652 Alberta hospital discharges from 2005 through 2012, and found that 134,299 (5.2%) hospitalizations had at least 1 PSI diagnosis. The resulting work creates a foundation for a new set of PSIs for routine large-scale surveillance of hospital and health system performance.

Curated Collection for Educators: Five Key Papers about the Flipped Classroom Methodology

PubMed Central

Boysen-Osborn, Megan; Cooney, Robert; Mitzman, Jennifer; Misra, Asit; Williams, Jennifer; Dulani, Tina; Gottlieb, Michael

2017-01-01

The flipped classroom (FC) pedagogy is becoming increasingly popular in medical education due to its appeal to the millennial learner and potential benefits in knowledge acquisition. Despite its popularity and effectiveness, the FC educational method is not without challenges. In this article, we identify and summarize several key papers relevant to medical educators interested in exploring the FC teaching methodology. The authors identified an extensive list of papers relevant to FC pedagogy via online discussions within the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. This list was augmented by an open call on Twitter (utilizing the #meded, #FOAMed, and #flippedclassroom hashtags) yielding a list of 33 papers. We then conducted a three-round modified Delphi process within the authorship group, which included both junior and senior clinician educators, to identify the most impactful papers for educators interested in FC pedagogy. The three-round modified Delphi process ranked all of the selected papers and selected the five most highly-rated papers for inclusion. The authorship group reviewed and summarized these papers with specific consideration given to their value to junior faculty educators and faculty developers interested in the flipped classroom approach. The list of papers featured in this article serves as a key reading list for junior clinician educators and faculty developers interested in the flipped classroom technique. The associated commentaries contextualize the importance of these papers for medical educators aiming to optimize their understanding and implementation of the flipped classroom methodology in their teaching and through faculty development. PMID:29282445

Using the Delphi expert consensus method in mental health research.

PubMed

Jorm, Anthony F

2015-10-01

The article gives an introductory overview of the use of the Delphi expert consensus method in mental health research. It explains the rationale for using the method, examines the range of uses to which it has been put in mental health research, and describes the stages of carrying out a Delphi study using examples from the literature. To ascertain the range of uses, a systematic search was carried out in PubMed. The article also examines the implications of 'wisdom of crowds' research for how to conduct Delphi studies. The Delphi method is a systematic way of determining expert consensus that is useful for answering questions that are not amenable to experimental and epidemiological methods. The validity of the approach is supported by 'wisdom of crowds' research showing that groups can make good judgements under certain conditions. In mental health research, the Delphi method has been used for making estimations where there is incomplete evidence (e.g. What is the global prevalence of dementia?), making predictions (e.g. What types of interactions with a person who is suicidal will reduce their chance of suicide?), determining collective values (e.g. What areas of research should be given greatest priority?) and defining foundational concepts (e.g. How should we define 'relapse'?). A range of experts have been used in Delphi research, including clinicians, researchers, consumers and caregivers. The Delphi method has a wide range of potential uses in mental health research. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Physical Restraints: Consensus of a Research Definition Using a Modified Delphi Technique.

PubMed

Bleijlevens, Michel H C; Wagner, Laura M; Capezuti, Elizabeth; Hamers, Jan P H

2016-11-01

To develop an internationally accepted research definition of physical restraint. Comprehensive literature search followed by a web-based, three-round, modified Delphi technique comprising reviews and feedback. Clinical care settings. An international group of 48 experts consisting of researchers and clinicians from 14 countries who have made sustained contribution to research and clinical application in the field of physical restraint in clinical care. Data were collected using an online survey program and one in-person meeting. Results of the online survey and the in-person meeting were used for distribution in subsequent rounds until consensus on a definition was reached. Consensus was defined as 90% of the participating experts agreeing with the proposed definition of physical restraint. Thirty-four different definitions were identified during the literature search and served as a starting point for the modified Delphi technique. After three rounds, 45 (95.7%) of 47 remaining experts agreed with the newly proposed definition: "Physical restraint is defined as any action or procedure that prevents a person's free body movement to a position of choice and/or normal access to his/her body by the use of any method, attached or adjacent to a person's body that he/she cannot control or remove easily." A multidisciplinary, internationally representative panel of experts reached consensus on a research definition for physical restraints in older persons. This is a necessary step toward improved comparisons of the prevalence of physical restraint use across studies and countries. This definition can further guide research interventions aimed at reducing use of physical restraints. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Allied health clinicians using translational research in action to develop a reliable stroke audit tool.

PubMed

Abery, Philip; Kuys, Suzanne; Lynch, Mary; Low Choy, Nancy

2018-05-23

To design and establish reliability of a local stroke audit tool by engaging allied health clinicians within a privately funded hospital. Design: Two-stage study involving a modified Delphi process to inform stroke audit tool development and inter-tester reliability. Allied health clinicians. A modified Delphi process to select stroke guideline recommendations for inclusion in the audit tool. Reliability study: 1 allied health representative from each discipline audited 10 clinical records with sequential admissions to acute and rehabilitation services. Recommendations were admitted to the audit tool when 70% agreement was reached, with 50% set as the reserve agreement. Inter-tester reliability was determined using intra-class correlation coefficients (ICCs) across 10 clinical records. Twenty-two participants (92% female, 50% physiotherapists, 17% occupational therapists) completed the modified Delphi process. Across 6 voting rounds, 8 recommendations reached 70% agreement and 2 reached 50% agreement. Two recommendations (nutrition/hydration; goal setting) were added to ensure representation for all disciplines. Substantial consistency across raters was established for the audit tool applied in acute stroke (ICC .71; range .48 to .90) and rehabilitation (ICC.78; range .60 to .93) services. Allied health clinicians within a privately funded hospital generally agreed in an audit process to develop a reliable stroke audit tool. Allied health clinicians agreed on stroke guideline recommendations to inform a stroke audit tool. The stroke audit tool demonstrated substantial consistency supporting future use for service development. This process, which engages local clinicians, could be adopted by other facilities to design reliable audit tools to identify local service gaps to inform changes to clinical practice. © 2018 John Wiley & Sons, Ltd.

Validation of virtual learning object to support the teaching of nursing care systematization.

PubMed

Salvador, Pétala Tuani Candido de Oliveira; Mariz, Camila Maria Dos Santos; Vítor, Allyne Fortes; Ferreira Júnior, Marcos Antônio; Fernandes, Maria Isabel Domingues; Martins, José Carlos Amado; Santos, Viviane Euzébia Pereira

2018-01-01

to describe the content validation process of a Virtual Learning Object to support the teaching of nursing care systematization to nursing professionals. methodological study, with quantitative approach, developed according to the methodological reference of Pasquali's psychometry and conducted from March to July 2016, from two-stage Delphi procedure. in the Delphi 1 stage, eight judges evaluated the Virtual Object; in Delphi 2 stage, seven judges evaluated it. The seven screens of the Virtual Object were analyzed as to the suitability of its contents. The Virtual Learning Object to support the teaching of nursing care systematization was considered valid in its content, with a Total Content Validity Coefficient of 0.96. it is expected that the Virtual Object can support the teaching of nursing care systematization in light of appropriate and effective pedagogical approaches.

DEVELOPMENT OF A PHYSICAL PERFORMANCE ASSESSMENT CHECKLIST FOR ATHLETES WHO SUSTAINED A LOWER EXTREMITY INJURY IN PREPARATION FOR RETURN TO SPORT: A DELPHI STUDY

PubMed Central

Haines, Sara; Baker, Tricia

2013-01-01

Purpose/Background: To develop a consensus on the critical constructs necessary to be included in a physical performance assessment checklist (PPAC) to assess an athlete's ability for return to sport following a lower extremity injury. Methods: The study used a 3‐round Delphi method to finalize the PPAI originally developed by a panel of experts. Fourteen Delphi representative sample participants were randomly derived from the authors of peer‐reviewed publications of lower extremity injuries. Nine participants completed all 3 rounds. Results: Throughout the 3 rounds, the 10 initial constructs were modified and revised to produce the finalized PPAC consisting of 12 constructs necessary to consider for an athlete's return to sport after a lower extremity injury. Conclusions: This instrument can be used as a checklist to advocate for prospective batteries of physical performance tests to incorporate the elements identified by this study. Level of Evidence: 5 PMID:23439809

Family Medicine Global Health Fellowship Competencies: A Modified Delphi Study.

PubMed

Rayess, Fadya El; Filip, Anna; Doubeni, Anna; Wilson, Calvin; Haq, Cynthia; Debay, Marc; Anandarajah, Gowri; Heffron, Warren; Jayasekera, Neil; Larson, Paul; Dahlman, Bruce; Valdman, Olga; Hunt, Vince

2017-02-01

Many US medical schools and family medicine departments have responded to a growing interest in global health by developing global health fellowships. However, there are no guidelines or consensus statements outlining competencies for global health fellows. Our objective was to develop a mission and core competencies for Family Medicine Global Health Fellowships. A modified Delphi technique was used to develop consensus on fellowship competencies. A panel, comprised of 13 members with dual expertise in global health and medical education, undertook an iterative consensus process, followed by peer review, from April to December 2014. The panel developed a mission statement and identified six domains for family medicine global health fellowships: patient care, medical knowledge, professionalism, communication and leadership, teaching, and scholarship. Each domain includes a set of core and program-specific competencies. The family medicine global health competencies are intended to serve as an educational framework for the design, implementation, and evaluation of individual family medicine global health fellowship programs.

Application of the Delphi technique in healthcare maintenance.

PubMed

Njuangang, Stanley; Liyanage, Champika; Akintoye, Akintola

2017-10-09

Purpose The purpose of this paper is to examine the research design, issues and considerations in the application of the Delphi technique to identify, refine and rate the critical success factors and performance measures in maintenance-associated infections. Design/methodology/approach In-depth literature review through the application of open and axial coding were applied to formulate the interview and research questions. These were used to conduct an exploratory case study of two healthcare maintenance managers, randomly selected from two National Health Service Foundation Trusts in England. The results of exploratory case study provided the rationale for the application of the Delphi technique in this research. The different processes in the application of the Delphi technique in healthcare research are examined thoroughly. Findings This research demonstrates the need to apply and integrate different research methods to enhance the validity of the Delphi technique. The rationale for the application of the Delphi technique in this research is because some healthcare maintenance managers lack knowledge about basic infection control (IC) principles to make hospitals safe for patient care. The result of first round of the Delphi exercise is a useful contribution in its own rights. It identified a number of salient issues and differences in the opinions of the Delphi participants, noticeably between healthcare maintenance managers and members of the infection control team. It also resulted in useful suggestions and comments to improve the quality and presentation of the second- and third-round Delphi instruments. Practical implications This research provides a research methodology that can be adopted by researchers investigating new and emerging issues in the healthcare sector. As this research demonstrates, the Delphi technique is relevant in soliciting expert knowledge and opinion to identify performance measures to control maintenance-associated infections in hospitals. The methodology provided here could be applied by other researchers elsewhere to probe, investigate and generate rich information about new and emerging healthcare research topics. Originality/value The authors demonstrate how different research methods can be integrated to enhance the validity of the Delphi technique. For example, the results of an exploratory case study provided the rationale for the application of the Delphi technique investigating the key performance measures in maintenance-associated infections. The different processes involved in the application of the Delphi technique are also carefully explored and discussed in depth.

Constructing post-surgical discharge instructions through a Delphi consensus methodology.

PubMed

Scott, Aaron R; Sanderson, Cody J; Rush, Augustus J; Alore, Elizabeth A; Naik, Aanand D; Berger, David H; Suliburk, James W

2018-05-01

Patient education materials are a crucial part of physician-patient communication. We hypothesize that available discharge instructions are difficult to read and fail to address necessary topics. Our objective is to evaluate readability and content of surgical discharge instructions using thyroidectomy to develop standardized discharge materials. Thyroidectomy discharge materials were analyzed for readability and assessed for content. Fifteen endocrine surgeons participated in a modified Delphi consensus panel to select necessary topics. Using readability best practices, we created standardized discharge instructions which included all selected topics. The panel evaluated 40 topics, selected 23, deemed 4 inappropriate, consolidated 5, and did not reach consensus on 8 topics after 4 rounds. The evaluated instructions' reading levels ranged from grade 6.5 to 13.2; none contained all consensus topics. Current post surgical thyroidectomy discharge instructions are more difficult to read than recommended by literacy standards and omit consensus warning signs of major complications. Our easy-to-read discharge instructions cover pertinent topics and may enhance patient education. Delphi methodology is useful for developing post-surgical instructions. Patient education materials need appropriate readability levels and content. We recommend the Delphi method to select content using consensus expert opinion whenever higher level data is lacking. Copyright © 2017 Elsevier B.V. All rights reserved.

Experiences and wisdom behind the numbers: qualitative analysis of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force stakeholder survey.

PubMed

Booth, Chelsea L

2014-09-01

The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a stakeholder survey including 716 respondents from 49 U.S. states and 18 foreign countries. To conduct a qualitative analysis on responses from individuals representing four main stakeholder groups: attempt and loss survivors, researchers, providers, and policy/administrators. This article focuses on a qualitative analysis of the early-round, open-ended responses collected in a modified online Delphi process, and, as an illustration of the research method, focuses on analysis of respondents' views of the role of life and emotional skills in suicide prevention. Content analysis was performed using both inductive and deductive code and category development and systematic qualitative methods. After the inductive coding was completed, the same data set was re-coded using the 12 Aspirational Goals (AGs) identified by the Delphi process. Codes and thematic categories produced from the inductive coding process were, in some cases, very similar or identical to the 12 AGs (i.e., those dealing with risk and protective factors, provider training, preventing reattempts, and stigma). Other codes highlighted areas that were not identified as important in the Delphi process (e.g., cultural/social factors of suicide, substance use). Qualitative and mixed-methods research are essential to the future of suicide prevention work. By design, qualitative research is explorative and appropriate for complex, culturally embedded social issues such as suicide. Such research can be used to generate hypotheses for testing and, as in this analysis, illuminate areas that would be missed in an approach that imposed predetermined categories on data. Published by Elsevier Inc.

Experience of Delphi technique in the process of establishing consensus on core competencies.

PubMed

Raghav, Pankaja Ravi; Kumar, Dewesh; Bhardwaj, Pankaj

2016-01-01

The Department of Community Medicine and Family Medicine (CMFM) has been started as a new model for imparting the components of family medicine and delivering health-care services at primary and secondary levels in all six newly established All India Institute of Medical Sciences (AIIMS), but there is no competency-based curriculum for it. The paper aims to share the experience of Delphi method in the process of developing consensus on core competencies of the new model of CMFM in AIIMS for undergraduate medical students in India. The study adopted different approaches and methods, but Delphi was the most critical method used in this research. In Delphi, the experts were contacted by e-mail and their feedback on the same was analyzed. Two rounds of Delphi were conducted in which 150 participants were contacted in Delphi-I but only 46 responded. In Delphi-II, 26 participants responded whose responses were finally considered for analysis. Three of the core competencies namely clinician, primary-care physician, and professionalism were agreed by all the participants, and the least agreement was observed in the competencies of epidemiologist and medical teacher. The experts having more experience were less consistent as responses were changed from agree to disagree in more than 15% of participants and 6% changed from disagree to agree. Within the given constraints, the final list of competencies and skills for the discipline of CMFM compiled after the Delphi process will provide a useful insight into the development of competency-based curriculum of the subject.

Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

PubMed

Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

2016-01-01

Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments. © The Author(s) 2014.

Search for one large extra dimension with the DELPHI detector at LEP

NASA Astrophysics Data System (ADS)

Abdallah, J.; Abreu, P.; Adam, W.; Adzic, P.; Albrecht, T.; Alemany-Fernandez, R.; Allmendinger, T.; Allport, P. P.; Amaldi, U.; Amapane, N.; Amato, S.; Anashkin, E.; Andreazza, A.; Andringa, S.; Anjos, N.; Antilogus, P.; Apel, W.-D.; Arnoud, Y.; Ask, S.; Asman, B.; Augustin, J. E.; Augustinus, A.; Baillon, P.; Ballestrero, A.; Bambade, P.; Barbier, R.; Bardin, D.; Barker, G. J.; Baroncelli, A.; Battaglia, M.; Baubillier, M.; Becks, K.-H.; Begalli, M.; Behrmann, A.; Ben-Haim, E.; Benekos, N.; Benvenuti, A.; Berat, C.; Berggren, M.; Bertrand, D.; Besancon, M.; Besson, N.; Bloch, D.; Blom, M.; Bluj, M.; Bonesini, M.; Boonekamp, M.; Booth, P. S. L.; Borisov, G.; Botner, O.; Bouquet, B.; Bowcock, T. J. V.; Boyko, I.; Bracko, M.; Brenner, R.; Brodet, E.; Bruckman, P.; Brunet, J. M.; Buschbeck, B.; Buschmann, P.; Calvi, M.; Camporesi, T.; Canale, V.; Carena, F.; Castro, N.; Cavallo, F.; Chapkin, M.; Charpentier, Ph.; Checchia, P.; Chierici, R.; Chliapnikov, P.; Chudoba, J.; Chung, S. U.; Cieslik, K.; Collins, P.; Contri, R.; Cosme, G.; Cossutti, F.; Costa, M. J.; Crennell, D.; Cuevas, J.; D'Hondt, J.; da Silva, T.; da Silva, W.; Della Ricca, G.; de Angelis, A.; de Boer, W.; de Clercq, C.; de Lotto, B.; de Maria, N.; de Min, A.; de Paula, L.; di Ciaccio, L.; di Simone, A.; Doroba, K.; Drees, J.; Eigen, G.; Ekelof, T.; Ellert, M.; Elsing, M.; Espirito Santo, M. C.; Fanourakis, G.; Fassouliotis, D.; Feindt, M.; Fernandez, J.; Ferrer, A.; Ferro, F.; Flagmeyer, U.; Foeth, H.; Fokitis, E.; Fulda-Quenzer, F.; Fuster, J.; Gandelman, M.; Garcia, C.; Gavillet, Ph.; Gazis, E.; Gokieli, R.; Golob, B.; Gomez-Ceballos, G.; Goncalves, P.; Graziani, E.; Grosdidier, G.; Grzelak, K.; Guy, J.; Haag, C.; Hallgren, A.; Hamacher, K.; Hamilton, K.; Haug, S.; Hauler, F.; Hedberg, V.; Hennecke, M.; Hoffman, J.; Holmgren, S.-O.; Holt, P. J.; Houlden, M. A.; Jackson, J. N.; Jarlskog, G.; Jarry, P.; Jeans, D.; Johansson, E. K.; Jonsson, P.; Joram, C.; Jungermann, L.; Kapusta, F.; Katsanevas, S.; Katsoufis, E.; Kernel, G.; Kersevan, B. P.; Kerzel, U.; King, B. T.; Kjaer, N. J.; Kluit, P.; Kokkinias, P.; Kourkoumelis, C.; Kouznetsov, O.; Krumstein, Z.; Kucharczyk, M.; Lamsa, J.; Leder, G.; Ledroit, F.; Leinonen, L.; Leitner, R.; Lemonne, J.; Lepeltier, V.; Lesiak, T.; Liebig, W.; Liko, D.; Lipniacka, A.; Lopes, J. H.; Lopez, J. M.; Loukas, D.; Lutz, P.; Lyons, L.; MacNaughton, J.; Malek, A.; Maltezos, S.; Mandl, F.; Marco, J.; Marco, R.; Marechal, B.; Margoni, M.; Marin, J.-C.; Mariotti, C.; Markou, A.; Martinez-Rivero, C.; Masik, J.; Mastroyiannopoulos, N.; Matorras, F.; Matteuzzi, C.; Mazzucato, F.; Mazzucato, M.; McNulty, R.; Meroni, C.; Migliore, E.; Mitaroff, W.; Mjoernmark, U.; Moa, T.; Moch, M.; Moenig, K.; Monge, R.; Montenegro, J.; Moraes, D.; Moreno, S.; Morettini, P.; Mueller, U.; Muenich, K.; Mulders, M.; Mundim, L.; Murray, W.; Muryn, B.; Myatt, G.; Myklebust, T.; Nassiakou, M.; Navarria, F.; Nawrocki, K.; Nemecek, S.; Nicolaidou, R.; Nikolenko, M.; Oblakowska-Mucha, A.; Obraztsov, V.; Olshevski, A.; Onofre, A.; Orava, R.; Osterberg, K.; Ouraou, A.; Oyanguren, A.; Paganoni, M.; Paiano, S.; Palacios, J. P.; Palka, H.; Papadopoulou, Th. D.; Pape, L.; Parkes, C.; Parodi, F.; Parzefall, U.; Passeri, A.; Passon, O.; Peralta, L.; Perepelitsa, V.; Perrotta, A.; Petrolini, A.; Piedra, J.; Pieri, L.; Pierre, F.; Pimenta, M.; Piotto, E.; Podobnik, T.; Poireau, V.; Pol, M. E.; Polok, G.; Pozdniakov, V.; Pukhaeva, N.; Pullia, A.; Radojicic, D.; Rebecchi, P.; Rehn, J.; Reid, D.; Reinhardt, R.; Renton, P.; Richard, F.; Ridky, J.; Rivero, M.; Rodriguez, D.; Romero, A.; Ronchese, P.; Roudeau, P.; Rovelli, T.; Ruhlmann-Kleider, V.; Ryabtchikov, D.; Sadovsky, A.; Salmi, L.; Salt, J.; Sander, C.; Savoy-Navarro, A.; Schwickerath, U.; Sekulin, R.; Siebel, M.; Sisakian, A.; Smadja, G.; Smirnova, O.; Sokolov, A.; Sopczak, A.; Sosnowski, R.; Spassov, T.; Stanitzki, M.; Stocchi, A.; Strauss, J.; Stugu, B.; Szczekowski, M.; Szeptycka, M.; Szumlak, T.; Tabarelli, T.; Tegenfeldt, F.; Timmermans, J.; Tkatchev, L.; Tobin, M.; Todorovova, S.; Tome, B.; Tonazzo, A.; Tortosa, P.; Travnicek, P.; Treille, D.; Tristram, G.; Trochimczuk, M.; Troncon, C.; Turluer, M.-L.; Tyapkin, I. A.; Tyapkin, P.; Tzamarias, S.; Uvarov, V.; Valenti, G.; van Dam, P.; van Eldik, J.; van Remortel, N.; van Vulpen, I.; Vegni, G.; Veloso, F.; Venus, W.; Verdier, P.; Verzi, V.; Vilanova, D.; Vitale, L.; Vrba, V.; Wahlen, H.; Washbrook, A. J.; Weiser, C.; Wicke, D.; Wickens, J.; Wilkinson, G.; Winter, M.; Witek, M.; Yushchenko, O.; Zalewska, A.; Zalewski, P.; Zavrtanik, D.; Zhuravlov, V.; Zimin, N. I.; Zintchenko, A.; Zupan, M.

2009-03-01

Single photons detected by the DELPHI experiment at LEP2 in the years 1997-2000 are reanalysed to investigate the existence of a single extra dimension in a modified ADD scenario with slightly warped large extra dimensions. The data collected at centre-of-mass energies between 180 and 209 GeV for an integrated luminosity of ˜650 pb-1 agree with the predictions of the Standard Model and allow a limit to be set on graviton emission in one large extra dimension. The limit obtained on the fundamental mass scale M D is 1.69 TeV/ c 2 at 95% CL, with an expected limit of 1.71 TeV/ c 2.

Final Report of a Study To Assess the Validity and Reliability of the Standards of Eight Allied Health Professions.

ERIC Educational Resources Information Center

Lyons, Kevin J.; Greening, Shirley; Robeson, Mary

2000-01-01

A modified Delphi procedure assessed the content validity of accreditation standards for cardiovascular technologists, cytotechnologists, medical sonographers, electroneurodiagnostic technologists, medical assistants, perfusionists, physician assistants, and surgical technologists. Although validity and reliability were extremely high, some…

Development of an Adolescent Alcohol Misuse Intervention Based on the Prototype Willingness Model: A Delphi Study

ERIC Educational Resources Information Center

Davies, Emma; Martin, Jilly; Foxcroft, David

2016-01-01

Purpose: The purpose of this paper is to report on the use of the Delphi method to gain expert feedback on the identification of behaviour change techniques (BCTs) and development of a novel intervention to reduce adolescent alcohol misuse, based on the Prototype Willingness Model (PWM) of health risk behaviour. Design/methodology/approach: Four…

Teen problem pregnancies: peer counselors' perceptions about community concerns and solutions. approach and limitations.

PubMed

David, H P; Johnson, R L

1980-01-01

This paper summarizes the methodology and major recommendations of a study of peer counselors' perceptions concerning the determinants of adolescent sexuality, contraceptive use, and pregnancy resolution. 55 adolescent peer counselors were queried by use of a modified Delphi technique in panels of 9 or fewer members about their observations regarding the sexual behavior of Districk of Columbia high school students. Questioning focused on identification of the major determinants of unwanted adolescent pregnancy and of effective countermeasures to reduce the importance of these determinants. On the basis of the Delphi panels and subsequent discussions with peer counselors, the research team made 3 major recommendations. 1st, it was suggested that school sex education programs could be improved by placing greater emphasis on women's needs, assertiveness training, and communication problems with males. The 2nd recommendation was for rap sessions where adolescents can discuss their questions about sex with parents of other teenagers (not their own parents) and where parents can hear the views of teenagers who are not their own children. The 3rd recommendation concerned contraceptive distribution and the development and marketing of a safe, effective nonprescription method acceptable to teenagers. Adolescents are currently denied access to a health care system oriented to their needs, perceptions, and time frames.

Towards development and validation of an intraoperative assessment tool for robot-assisted radical prostatectomy training: results of a Delphi study.

PubMed

Morris, Christopher; Hoogenes, Jen; Shayegan, Bobby; Matsumoto, Edward D

2017-01-01

As urology training shifts toward competency-based frameworks, the need for tools for high stakes assessment of trainees is crucial. Validated assessment metrics are lacking for many robot-assisted radical prostatectomy (RARP). As it is quickly becoming the gold standard for treatment of localized prostate cancer, the development and validation of a RARP assessment tool for training is timely. We recruited 13 expert RARP surgeons from the United States and Canada to serve as our Delphi panel. Using an initial inventory developed via a modified Delphi process with urology residents, fellows, and staff at our institution, panelists iteratively rated each step and sub-step on a 5-point Likert scale of agreement for inclusion in the final assessment tool. Qualitative feedback was elicited for each item to determine proper step placement, wording, and suggestions. Panelist's responses were compiled and the inventory was edited through three iterations, after which 100% consensus was achieved. The initial inventory steps were decreased by 13% and a skip pattern was incorporated. The final RARP stepwise inventory was comprised of 13 critical steps with 52 sub-steps. There was no attrition throughout the Delphi process. Our Delphi study resulted in a comprehensive inventory of intraoperative RARP steps with excellent consensus. This final inventory will be used to develop a valid and psychometrically sound intraoperative assessment tool for use during RARP training and evaluation, with the aim of increasing competency of all trainees. Copyright® by the International Brazilian Journal of Urology.

Towards development and validation of an intraoperative assessment tool for robot-assisted radical prostatectomy training: results of a Delphi study

PubMed Central

Morris, Christopher; Hoogenes, Jen; Shayegan, Bobby; Matsumoto, Edward D.

2017-01-01

ABSTRACT Introduction As urology training shifts toward competency-based frameworks, the need for tools for high stakes assessment of trainees is crucial. Validated assessment metrics are lacking for many robot-assisted radical prostatectomy (RARP). As it is quickly becoming the gold standard for treatment of localized prostate cancer, the development and validation of a RARP assessment tool for training is timely. Materials and methods We recruited 13 expert RARP surgeons from the United States and Canada to serve as our Delphi panel. Using an initial inventory developed via a modified Delphi process with urology residents, fellows, and staff at our institution, panelists iteratively rated each step and sub-step on a 5-point Likert scale of agreement for inclusion in the final assessment tool. Qualitative feedback was elicited for each item to determine proper step placement, wording, and suggestions. Results Panelist’s responses were compiled and the inventory was edited through three iterations, after which 100% consensus was achieved. The initial inventory steps were decreased by 13% and a skip pattern was incorporated. The final RARP stepwise inventory was comprised of 13 critical steps with 52 sub-steps. There was no attrition throughout the Delphi process. Conclusions Our Delphi study resulted in a comprehensive inventory of intraoperative RARP steps with excellent consensus. This final inventory will be used to develop a valid and psychometrically sound intraoperative assessment tool for use during RARP training and evaluation, with the aim of increasing competency of all trainees. PMID:28379668

Quality Indicators for Continuous Monitoring to Improve Maternal and Infant Health in Maternity Departments: A Modified Delphi Survey of an International Multidisciplinary Panel

PubMed Central

Boulkedid, Rym; Sibony, Olivier; Goffinet, François; Fauconnier, Arnaud; Branger, Bernard; Alberti, Corinne

2013-01-01

Objective Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals. Methodology and Main Findings An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators. Conclusion A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units. PMID:23577143

Developing clinical practice guidelines for Chinese herbal treatment of polycystic ovary syndrome: A mixed-methods modified Delphi study.

PubMed

Lai, Lily; Flower, Andrew; Moore, Michael; Lewith, George

2015-06-01

Preliminary evidence suggests Chinese herbal medicine (CHM) could be a viable treatment option for polycystic ovary syndrome (PCOS). Prior to conducting a clinical trial it is important to consider the characteristics of good clinical practice. This study aims to use professional consensus to establish good clinical practice guidelines for the CHM treatment of PCOS. CHM practitioners participated in a mixed-methods modified Delphi study involving three rounds of structured group communication. Round 1 involved qualitative interviews with practitioners to generate statements regarding good clinical practice. In round 2, these statements were distributed online to the same practitioners to rate their agreement using a 7-point Likert scale, where group consensus was defined as a median rating of ≥5. Statements reaching consensus were accepted for consideration onto the guideline whilst those not reaching consensus were re-distributed for consideration in round 3. Statements presented in the guidelines were graded from A (strong consensus) to D (no consensus) determined by median score and interquartile range. 11 CHM practitioners in the UK were recruited. After three Delphi rounds, 91 statement items in total had been considered, of which 89 (97.8%) reached consensus and 2 (2.2%) did not. The concluding set of guidelines consists of 85 items representing key features of CHM prescribing for PCOS. These guidelines can be viewed as an initial framework that captures fundamental principles of good clinical practice for CHM. Copyright © 2015 Elsevier Ltd. All rights reserved.

The National Health Educator Job Analysis 2010: Process and Outcomes

ERIC Educational Resources Information Center

Doyle, Eva I.; Caro, Carla M.; Lysoby, Linda; Auld, M. Elaine; Smith, Becky J.; Muenzen, Patricia M.

2012-01-01

The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience…

Modified Delphi Investigation of Lesson Planning Concepts for Physical Education Teacher Education

ERIC Educational Resources Information Center

Sager, Jack W.

2012-01-01

Improving the methods of instructing future educators, through program evaluation and improvement, should be a goal of all teacher education programs. In physical education, the National Association for Sport & Physical Education created standards for initial preparation of physical education teachers. The six standards for preparation include…

Perceptions of College Students on Social Factors That Influence Student Matriculation

ERIC Educational Resources Information Center

Kelly, Jeremy L.; LaVergne, Douglas D.; Boone, Harry N., Jr.; Boone, Deborah A.

2012-01-01

This study analyzed undergraduate students' (n = 280) attitudes toward selected social factors that would influence and discourage student persistence at a four-year research university. Using a modified Delphi technique to construct the questionnaire, the researchers discovered that family encouragement, positive relationships with professors,…

The Determination of Relevant Goals and Criteria Used to Select an Automated Patient Care Information System

PubMed Central

Chocholik, Joan K.; Bouchard, Susan E.; Tan, Joseph K. H.; Ostrow, David N.

1999-01-01

Objectives: To determine the relevant weighted goals and criteria for use in the selection of an automated patient care information system (PCIS) using a modified Delphi technique to achieve consensus. Design: A three-phase, six-round modified Delphi process was implemented by a ten-member PCIS selection task force. The first phase consisted of an exploratory round. It was followed by the second phase, of two rounds, to determine the selection goals and finally the third phase, of three rounds, to finalize the selection criteria. Results: Consensus on the goals and criteria for selecting a PCIS was measured during the Delphi process by reviewing the mean and standard deviation of the previous round's responses. After the study was completed, the results were analyzed using a limits-of-agreement indicator that showed strong agreement of each individual's responses between each of the goal determination rounds. Further analysis for variability in the group's response showed a significant movement to consensus after the first goal-determination iteration, with consensus reached on all goals by the end of the second iteration. Conclusion: The results indicated that the relevant weighted goals and criteria used to make the final decision for an automated PCIS were developed as a result of strong agreement among members of the PCIS selection task force. It is therefore recognized that the use of the Delphi process was beneficial in achieving consensus among clinical and nonclinical members in a relatively short time while avoiding a decision based on political biases and the “groupthink” of traditional committee meetings. The results suggest that improvements could be made in lessening the number of rounds by having information available through side conversations, by having other statistical indicators besides the mean and standard deviation available between rounds, and by having a content expert address questions between rounds. PMID:10332655

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas

PubMed Central

Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-01-01

Introduction The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. Methods and analysis We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. Ethics and dissemination We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. PMID:28780546

The Desired Learning Outcomes of School-Based Nutrition/Physical Activity Health Education: A Health Literacy Constructed Delphi Survey of Finnish Experts

ERIC Educational Resources Information Center

Ormshaw, Michael James; Kokko, Sami Petteri; Villberg, Jari; Kannas, Lasse

2016-01-01

Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the…

Assessing the Trends and Challenges of Teaching Marketing Abroad: A Delphi Approach

ERIC Educational Resources Information Center

Kelley, Craig A.

2007-01-01

The past 20 years have seen a growth in the teaching of marketing in business schools around the world. This article reports the trends and challenges that will face U.S. marketing educators teaching abroad over the next 10 years. Predictions are from a Delphi panel of U.S. marketing educators experienced in teaching marketing abroad to non-U.S.…

International definition of a point-of-care test in family practice: a modified e-Delphi procedure.

PubMed

Schols, Angel M R; Dinant, Geert-Jan; Hopstaken, Rogier; Price, Christopher P; Kusters, Ron; Cals, Jochen W L

2018-01-29

The use of point-of-care tests (POCTs) in family practice is increasing, and the term POCT is often used in medical literature and clinical practice. Yet, no widely supported definition by several professional fields exists. To reach consensus on an international definition of a POCT in family practice. We performed a modified international e-Delphi procedure of four rounds among expert panel members from different professional backgrounds-family practitioners, laboratory specialists, policymakers, researchers and manufacturers. Of 27 panel members from seven different countries, 26 participated in all rounds. Most panel members were active in POCT research or policymaking and 70% worked in family medicine. After choosing important components, structuring of answers and feedback, the following definition was chosen as the best or second best definition by 81% of panel members: a point-of-care test in family practice is a test to support clinical decision making, which is performed by a qualified member of the practice staff nearby the patient and on any part of the patient's body or its derivatives, during or very close to the time of consultation, to help the patient and physician to decide upon the best suited approach, and of which the results should be known at the time of the clinical decision making. The definition emerging from this study can inform family practitioners, laboratory specialists, policymakers and manufacturers on the most widely supported and recognized definition and could act as a clear starting point for the organization and execution of professional point-of-care testing in family practice worldwide. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE): Construct and Content Validation Using a Modified Delphi Method.

PubMed

Paquette-Warren, Jann; Tyler, Marie; Fournie, Meghan; Harris, Stewart B

2017-06-01

In order to scale-up successful innovations, more evidence is needed to evaluate programs that attempt to address the rising prevalence of diabetes and the associated burdens on patients and the healthcare system. This study aimed to assess the construct and content validity of the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE), a tool developed to guide the evaluation, design and implementation with built-in knowledge translation principles. A modified Delphi method, including 3 individual rounds (questionnaire with 7-point agreement/importance Likert scales and/or open-ended questions) and 1 group round (open discussion) were conducted. Twelve experts in diabetes, research, knowledge translation, evaluation and policy from Canada (Ontario, Quebec and British Columbia) and Australia participated. Quantitative consensus criteria were an interquartile range of ≤1. Qualitative data were analyzed thematically and confirmed by participants. An importance scale was used to determine a priority multi-level indicator set. Items rated very or extremely important by 80% or more of the experts were reviewed in the final group round to build the final set. Participants reached consensus on the content and construct validity of DEFINE, including its title, overall goal, 5-step evaluation approach, medical and nonmedical determinants of health schematics, full list of indicators and associated measurement tools, priority multi-level indicator set and next steps in DEFINE's development. Validated by experts, DEFINE has the right theoretic components to evaluate comprehensively diabetes prevention and management programs and to support acquisition of evidence that could influence the knowledge translation of innovations to reduce the burden of diabetes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise.

PubMed

Rabbani, Fauziah; Jafri, Syed M Wasim; Abbas, Farhat; Shah, Mairaj; Azam, Syed Iqbal; Shaikh, Babar Tasneem; Brommels, Mats; Tomson, Goran

2010-01-01

Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings. Copyright 2010 John Wiley & Sons, Ltd.

Nursing Information Systems Requirements: A Milestone for Patient Outcome and Patient Safety Improvement.

PubMed

Farzandipour, Mehrdad; Meidani, Zahra; Riazi, Hossein; Sadeqi Jabali, Monireh

2016-12-01

Considering the integral role of understanding users' requirements in information system success, this research aimed to determine functional requirements of nursing information systems through a national survey. Delphi technique method was applied to conduct this study through three phases: focus group method modified Delphi technique and classic Delphi technique. A cross-sectional study was conducted to evaluate the proposed requirements within 15 general hospitals in Iran. Forty-three of 76 approved requirements were clinical, and 33 were administrative ones. Nurses' mean agreements for clinical requirements were higher than those of administrative requirements; minimum and maximum means of clinical requirements were 3.3 and 3.88, respectively. Minimum and maximum means of administrative requirements were 3.1 and 3.47, respectively. Research findings indicated that those information system requirements that support nurses in doing tasks including direct care, medicine prescription, patient treatment management, and patient safety have been the target of special attention. As nurses' requirements deal directly with patient outcome and patient safety, nursing information systems requirements should not only address automation but also nurses' tasks and work processes based on work analysis.

Consensus on the management of intracranial germ-cell tumours.

PubMed

Murray, Matthew J; Bartels, Ute; Nishikawa, Ryo; Fangusaro, Jason; Matsutani, Masao; Nicholson, James C

2015-09-01

The management of intracranial germ-cell tumours is complex because of varied clinical presentations, tumour sites, treatments and outcomes, and the need for multidisciplinary input. Participants of the 2013 Third International CNS Germ Cell Tumour Symposium (Cambridge, UK) agreed to undertake a multidisciplinary Delphi process to identify consensus in the clinical management of intracranial germ-cell tumours. 77 delegates from the symposium were selected as suitable experts in the field and were invited to participate in the Delphi survey, of which 64 (83%) responded to the invitation. Invited participants represented multiple disciplines from Asia, Australasia, Europe, and the Americas. 38 consensus statements encompassing aspects of intracranial germ-cell tumour work-up, staging, treatment, and follow-up were prepared. To achieve consensus, statements required at least 70% agreement from at least 60% of respondents. Overall, 34 (89%) of 38 statements met consensus criteria. This international Delphi approach has defined key areas of consensus that will help guide and streamline clinical management of patients with intracranial germ-cell tumours. Additionally, the Delphi approach identified areas of different understanding and clinical practice internationally in the management of these tumours, areas which should be the focus of future collaborative studies. Such efforts should translate into improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Delphi approach to reach consensus on primary care guidelines regarding youth violence prevention.

PubMed

De Vos, Edward; Spivak, Howard; Hatmaker-Flanigan, Elizabeth; Sege, Robert D

2006-10-01

Anticipatory guidance is a cornerstone of modern pediatric practice. In recognition of its importance for child well being, injury prevention counseling is a standard element of that guidance. Over the last 20 years, there has been growing recognition that intentional injury or violence is one of the leading causes of morbidity and mortality among youth. The US Surgeon General identified youth violence as a major public health issue and a top priority. Yet, only recently has the scope of injury prevention counseling been expanded to include violence. Pediatric health care providers agree that youth violence-prevention counseling should be provided, yet the number of topics available, the already lengthy list of other anticipatory guidance topics to be covered, developmental considerations, and the evidence base make the selection of an agreed-on set a considerable challenge. The purpose of this study was to systematically identify and prioritize specific counseling topics in violence prevention that could be integrated into anticipatory guidance best practice. A modified electronic Delphi process was used to gain consensus among 50 national multidisciplinary violence-prevention experts. Participants were unaware of other participants' identities. The process consisted of 4 serial rounds of inquiry beginning with a broad open-ended format for the generation of anticipatory guidance and screening topics across 5 age groups (infant, toddler, school age, adolescent, and all ages). Each subsequent round narrowed the list of topics toward the development of a manageable set of essential topics for screening and counseling about positive youth development and violence prevention. Forty-seven unique topics were identified, spanning birth to age 21 years. Topics cover 4 broad categories (building blocks): physical safety, parent centered, child centered, and community connection. Participants placed topics into their developmentally appropriate visit-based schedule and made suggestions for an appropriate topic reinforcement schedule. The resulting schedule provides topics for introduction and reinforcement at each visit. The Delphi technique proved a useful approach for accessing expert opinion, for analyzing and synthesizing results, for achieving consensus, and for setting priorities among the numerous anticipatory guidance and assessment topics relevant for raising resilient, violence-free youth.

Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study.

PubMed

Michalak, Erin E; Suto, Melinda J; Barnes, Steven J; Hou, Sharon; Lapsley, Sara; Scott, Mike W; Murray, Greg; Austin, Jehannine; Elliott, Nusha Balram; Berk, Lesley; Crest Bd

2016-12-01

Self-management represents an important complement to psychosocial treatments for bipolar disorder (BD), but research is limited. Specifically, little is known about self-management approaches for elevated mood states; this study investigated self-management strategies for: (1) maintaining balance in mood, and (2) stopping progression into hypomania/mania. To identify the common components of BD self-management, Delphi Consensus Consultation methods were combined with a Community-Based Participatory Research (CBPR) approach across five study phases: (1) Qualitative dataset content analysis; (2) Academic/grey literature reviews; (3) Content analysis; (4) Two Delphi rounds (rating strategies on a 5-point Likert scale, Very Unhelpful-Very Helpful), and; (5) Quantitative analysis and interpretation. Participants were people with BD and healthcare providers. Phases 1 and 2 identified 262 and 3940 candidate strategies, respectively; 3709 were discarded as duplicates/unintelligible. The remaining 493 were assessed via Delphi methods in Phase 4: 101 people with BD and 52 healthcare providers participated in Round 1; 83 of the BD panel (82%) and 43 of the healthcare provider panel (83%) participated in Round 2-exploratory factor analysis (EFA) was conducted on Round 2 results. EFA was underpowered and sample was not ethnically diverse, limiting generalizability. High concordance was observed in ratings of strategy effectiveness between the two panels. Future research could usefully investigate the provisional discovery here of underlying factors which link individual strategies. For example, 'maintaining hope' underpinned strategies for maintaining balance, and 'decreasing use of stimulants' underpinned strategies to interrupt hypo/manic ascent. There is merit in combining CBPR and Delphi methods. Copyright © 2016 Elsevier B.V. All rights reserved.

The View of Principals on Standards Based Evaluation Systems and Their Role as Instructional Leaders

ERIC Educational Resources Information Center

Zoll, James Allen

2014-01-01

This study examined the implementation of standards based evaluation systems, specifically Georgia's Teacher Keys Effectiveness System, affects the principals' role of instructional leader. Using a modified Delphi study, principals from a large urban/suburban school system, gave feedback on three questions: how has their role changed; are they…

Identifying Characteristics of Technology and Engineering Teachers Striving for Excellence Using a Modified Delphi

ERIC Educational Resources Information Center

Rose, Mary Annette; Shumway, Steven; Carter, Vinson; Brown, Josh

2015-01-01

Preparing a technology and engineering (TE) teacher who strives for teaching excellence is a fundamental mission of TE teacher education programs in the United States. In 2012, the International Technology and Engineering Educators Association (ITEEA, formerly the International Technology Education Association, ITEA) Council on Technology and…

The Department Chairperson: The Confessions of a Researcher Turned Practitioner.

ERIC Educational Resources Information Center

Murray, John P.

A study was conducted to identify the expectations that faculty have of chairpersons. Previously, a study using a modified Delphi technique had revealed that the 50 participants believed that the chair should be responsible for a multitude of duties. However, the participants had a marked preference for shared or participatory leadership.…

Perceptions of Bachelor-Degree Graduates Regarding General Education Program Quality

ERIC Educational Resources Information Center

Bittinger, Sara-Beth

2017-01-01

This study was directed by a modified Delphi-methodology design to gain perspective of the perceptions of alumni regarding the value and applicability of the general education program. The expert-panel participants were 14 alumni of Frostburg State University from various majors, representative of all three colleges, who graduated between 2006 and…

Designing a Standardized Laparoscopy Curriculum for Gynecology Residents: A Delphi Approach

PubMed Central

Shore, Eliane M.; Lefebvre, Guylaine G.; Husslein, Heinrich; Bjerrum, Flemming; Sorensen, Jette Led; Grantcharov, Teodor P.

2015-01-01

Background Evidence suggests that simulation leads to improved operative skill, shorter operating room time, and better patient outcomes. Currently, no standardized laparoscopy curriculum exists for gynecology residents. Objective To design a structured laparoscopy curriculum for gynecology residents using Delphi consensus methodology. Methods This study began with Delphi methodology to determine expert consensus on the components of a gynecology laparoscopic skills curriculum. We generated a list of cognitive content, technical skills, and nontechnical skills for training in laparoscopic surgery, and asked 39 experts in gynecologic education to rate the items on a Likert scale (1–5) for inclusion in the curriculum. Consensus was predefined as Cronbach α of ≥ 0.80. We then conducted another Delphi survey with 9 experienced users of laparoscopic virtual reality simulators to delineate relevant curricular tasks. Finally, a cross-sectional design defined benchmark scores for all identified tasks, with 10 experienced gynecologic surgeons performing the identified tasks at basic, intermediate, and advanced levels. Results Consensus (Cronbach α = 0.85) was achieved in the first round of the curriculum Delphi, and after 2 rounds (Cronbach α = 0.80) in the virtual reality curriculum Delphi. Consensus was reached for cognitive, technical, and nontechnical skills as well as for 6 virtual reality tasks. Median time and economy of movement scores defined benchmarks for all tasks. Conclusions This study used Delphi consensus to develop a comprehensive curriculum for teaching gynecologic laparoscopy. The curriculum conforms to current educational standards of proficiency-based training, and is suggested as a standard in residency programs. PMID:26221434

Multi-Stakeholder Informed Guidelines for Direct Admission of Children to Hospital.

PubMed

Leyenaar, JoAnna K; Shevenell, Megan; Rizzo, Paul A; Hill, Vanessa L; Lindenauer, Peter K

2018-04-25

To develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. We conducted deliberative discussions at 1 children's hospital and 2 community hospitals, engaging parents of hospitalized children and inpatient, outpatient, and emergency department physicians and nurses to identify shared and dissenting perspectives regarding direct admission processes and outcomes. Discussions were audio-recorded, professionally transcribed, and analyzed using a general inductive approach. We then convened a national panel to prioritize guideline components and outcome measures using a RAND/UCLA Modified Delphi approach. Forty-eight stakeholders participated in 6 deliberative discussions. Emergent themes related to effective multistakeholder communication, resources needed for high quality direct admissions, written direct admission guidelines, including criteria to identify children appropriate for and inappropriate for direct admission, and families' needs. Building on these themes, Delphi panelists endorsed 71 guideline components as both appropriate and necessary at children's hospitals and community hospitals and 13 outcomes to evaluate hospital admission systems. Guideline components include (1) pre-admission communication, (2) written guidelines, (3) hospital resources to optimize direct admission processes, (4) special considerations for pediatric populations that may be at particular risk of nosocomial infection and/or stress in emergency departments, (5) communication with families referred for direct admission, and (6) quality reviews to evaluate admission systems. These direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration. Copyright © 2018 Elsevier Inc. All rights reserved.

The Use of the Delphi and Other Consensus Group Methods in Medical Education Research: A Review.

PubMed

Humphrey-Murto, Susan; Varpio, Lara; Wood, Timothy J; Gonsalves, Carol; Ufholz, Lee-Anne; Mascioli, Kelly; Wang, Carol; Foth, Thomas

2017-10-01

Consensus group methods, such as the Delphi method and nominal group technique (NGT), are used to synthesize expert opinions when evidence is lacking. Despite their extensive use, these methods are inconsistently applied. Their use in medical education research has not been well studied. The authors set out to describe the use of consensus methods in medical education research and to assess the reporting quality of these methods and results. Using scoping review methods, the authors searched the Medline, Embase, PsycInfo, PubMed, Scopus, and ERIC databases for 2009-2016. Full-text articles that focused on medical education and the keywords Delphi, RAND, NGT, or other consensus group methods were included. A standardized extraction form was used to collect article demographic data and features reflecting methodological rigor. Of the articles reviewed, 257 met the inclusion criteria. The Modified Delphi (105/257; 40.8%), Delphi (91/257; 35.4%), and NGT (23/257; 8.9%) methods were most often used. The most common study purpose was curriculum development or reform (68/257; 26.5%), assessment tool development (55/257; 21.4%), and defining competencies (43/257; 16.7%). The reporting quality varied, with 70.0% (180/257) of articles reporting a literature review, 27.2% (70/257) reporting what background information was provided to participants, 66.1% (170/257) describing the number of participants, 40.1% (103/257) reporting if private decisions were collected, 37.7% (97/257) reporting if formal feedback of group ratings was shared, and 43.2% (111/257) defining consensus a priori. Consensus methods are poorly standardized and inconsistently used in medical education research. Improved criteria for reporting are needed.

Using the Delphi method to develop nursing-sensitive quality indicators for the NICU.

PubMed

Chen, Lin; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya

2017-02-01

To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China. © 2016 John Wiley & Sons Ltd.

Proposal of quality indicators for cardiac rehabilitation after acute coronary syndrome in Japan: a modified Delphi method and practice test.

PubMed

Ohtera, Shosuke; Kanazawa, Natsuko; Ozasa, Neiko; Ueshima, Kenji; Nakayama, Takeo

2017-01-27

Cardiac rehabilitation is underused and its quality in practice is unclear. A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. 10 professionals in cardiac rehabilitation for the consensus panel. In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). 'Communication with the doctor who referred the patient to cardiac rehabilitation' and 'continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Defining a Research Agenda for Patient-Reported Outcomes in Surgery: A Delphi Survey of Stakeholders

PubMed Central

Pezold, Michael L.; Pusic, Andrea L.; Cohen, Wess A.; Hollenberg, James P.; Butt, Zeeshan; Flum, David R.; Temple, Larissa K.

2016-01-01

Background Identifying timely and important research questions using relevant patient-reported outcomes (PROs) in surgery remains paramount in the current medical climate. The inaugural Patient-Reported Outcomes in Surgery Conference brought together stakeholders in PROs research in surgery, with the aim of creating a research agenda to help determine future directions and advance cross-disciplinary collaboration. Study Design An iterative Web-based interface was used to create a modified Delphi survey. Participation was limited to conference registrants, which included surgeons, PROs researchers, payers, and other stakeholders. In the first round, research items were generated from qualitative review of responses to open-ended prompts. In the second round, items were ranked using a 5-point Likert scale; attendees were also asked to submit any new items. In the final round, the top 30 items and newly submitted items were redistributed for final ranking using a 3-point Likert scale. The top 20 items by mean rating were selected for the research agenda. Results In round one, participants submitted 459 items, which were reduced to 53 distinct items within seven themes of PROs research. A research agenda was formulated after two successive rounds of ranking. The research agenda identified three themes important for future PROs research in surgery: (1) PROs in the decision-making process, (2) integrating PROs into the EHR and, (3) measuring quality in surgery with PROs. Conclusions The PROS Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery. PMID:27437666

A True Delphi Approach: Developing a Tailored Curriculum in Response to Local Agriscience Need

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rubenstein, Eric; Thoron, Andrew; Burleson, Sarah

2012-02-07

The Delphi approach is a structured communication technique, developed as a systematic, interactive forecasting method which relies on a panel of experts. In this specific case experts from Industry, Education and Extension fields addressed needs for educational programs in a traditional agriculturally-based community, environmentally conscious practices in order to restore environmental integrity and multi-disciplinary approach to solve sustainability problems facing the agricultural industry. The experts were divided into two main groups, (A) Secondary and (B) Post-secondary, and answered questionnaires in three rounds: • 1st Round – Participants generated a list of knowledge, skills, and competencies followed • 2nd Round –more » Panelists rated each item • 3rd Round – Panelists were given the opportunity to combine and add additional items As a result, top six items from both groups were not found similar, secondary panelists centralized around employment skills and post-secondary panelists focused on content areas. Implications include a need for content-based curriculum for post-secondary graduates, utilization of true-Delphi technique for future curriculum development research and further examination of students that complete secondary and post-secondary programs in biofuels/sustainable agriculture.« less

The Modified Delphi Method to Analyze the Application of Instructional Design Theory to Online Graduate Education

ERIC Educational Resources Information Center

Zeedick, Danielle Marie

2010-01-01

During the past several decades, the field of instructional design theory has experienced changes in what is mostly applied to traditional, on-ground education. While instructional design theory has been (and still is being) discussed, constructed, and deconstructed, there has been no agreement among prominent instructional design theory…

Service Quality Assessment Scale (SQAS): An Instrument for Evaluating Service Quality of Health-Fitness Clubs

ERIC Educational Resources Information Center

Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.

2005-01-01

This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…

Entry-Level Technical Skills that Agricultural Industry Experts Expected Students to Learn through Their Supervised Agricultural Experiences: A Modified Delphi Study

ERIC Educational Resources Information Center

Ramsey, Jon W.; Edwards, M. Craig

2011-01-01

The National Research Council's (NRC) Report (1988), Understanding Agriculture: New Directions for Education, called on secondary agricultural education to shift its scope and purpose, including students' supervised agricultural experiences (SAEs). The NRC asserted that this shift should create opportunities for students to acquire supervised…

Digital Skills Acquisition: Future Trends among Older Adults

ERIC Educational Resources Information Center

Gilliam, Brian K.

2011-01-01

Purpose: The purpose of this study was to identify future trends and barriers that will either facilitate or impede the narrowing of the digital skills divide among older adults during the next 10 years. Methodology: To address the research questions, this study used a modified version of the Delphi process using a panel of experts who…

Identifying and Verifying Earthquake Engineering Concepts to Create a Knowledge Base in STEM Education: A Modified Delphi Study

ERIC Educational Resources Information Center

Cavlazoglu, Baki; Stuessy, Carol L.

2017-01-01

Stakeholders in STEM education have called for integrating engineering content knowledge into STEM-content classrooms. To answer the call, stakeholders in science education announced a new framework, Next Generation Science Standards, which focuses on the integration of science and engineering in K-12 science education. However, research indicates…

Modified Delphi Investigation of Motor Development and Learning in Physical Education Teacher Education

ERIC Educational Resources Information Center

Ross, Susan; Metcalf, Amanda; Bulger, Sean M.; Housner, Lynn D.

2014-01-01

Purpose: As the scope of motor development and learning knowledge has successfully broadened over the years, there is an increased need to identify the content and learning experiences that are essential in preparing preservice physical educators. The purpose of this study was to generate expert consensus regarding the most critical motor…

Engineering's Grand Challenges: Priorities and Integration Recommendations for Technology Education Curriculum Development

ERIC Educational Resources Information Center

Buelin, Jennifer; Clark, Aaron C.; Ernst, Jeremy V.

2016-01-01

In this study, the 14 Grand Challenges for Engineering in the 21st Century identified by the National Academy of Engineering were examined by a panel of experts in an effort to identify prospective curricular integration opportunities in the field of technology and engineering education. The study utilized a three-round modified Delphi methodology…

A Modified Delphi Study to Define "Ah Ha" Moments in Education Settings

ERIC Educational Resources Information Center

Pilcher, Jobeth

2015-01-01

Ah ha moments are often mentioned in education literature. These moments are suggested to be a powerful aspect of learning, yet limited research is present regarding this topic. Ah ha learning moments have also not been defined in the education literature, resulting in the likelihood that each educator and learner may have differing definitions.…

Measuring assessment standards in undergraduate medical programs: Development and validation of AIM tool.

PubMed

Sajjad, Madiha; Khan, Rehan Ahmed; Yasmeen, Rahila

2018-01-01

To develop a tool to evaluate faculty perceptions of assessment quality in an undergraduate medical program. The Assessment Implementation Measure (AIM) tool was developed by a mixed method approach. A preliminary questionnaire developed through literature review was submitted to a panel of 10 medical education experts for a three-round 'Modified Delphi technique'. Panel agreement of > 75% was considered the criterion for inclusion of items in the questionnaire. Cognitive pre-testing of five faculty members was conducted. Pilot study was done with 30 randomly selected faculty members. Content validity index (CVI) was calculated for individual items (I-CVI) and composite scale (S-CVI). Cronbach's alpha was calculated to determine the internal consistency reliability of the tool. The final AIM tool had 30 items after the Delphi process. S-CVI was 0.98 with the S-CVI/Avg method and 0.86 by S-CVI/UA method, suggesting good content validity. Cut-off value of < 0.9 I-CVI was taken as criterion for item deletion. Cognitive pre-testing revealed good item interpretation. Cronbach's alpha calculated for the AIM was 0.9, whereas Cronbach's alpha for the four domains ranged from 0.67 to 0.80. 'AIM' is a relevant and useful instrument with good content validity and reliability of results, and may be used to evaluate the teachers´ perceptions about assessment quality.

Using Linear Regression To Determine the Number of Factors To Retain in Factor Analysis and the Number of Issues To Retain in Delphi Studies and Other Surveys.

ERIC Educational Resources Information Center

Jurs, Stephen; And Others

The scree test and its linear regression technique are reviewed, and results of its use in factor analysis and Delphi data sets are described. The scree test was originally a visual approach for making judgments about eigenvalues, which considered the relationships of the eigenvalues to one another as well as their actual values. The graph that is…

Diagnostic flexible pharyngo-laryngoscopy: development of a procedure specific assessment tool using a Delphi methodology.

PubMed

Melchiors, Jacob; Henriksen, Mikael Johannes Vuokko; Dikkers, Frederik G; Gavilán, Javier; Noordzij, J Pieter; Fried, Marvin P; Novakovic, Daniel; Fagan, Johannes; Charabi, Birgitte W; Konge, Lars; von Buchwald, Christian

2018-05-01

Proper training and assessment of skill in flexible pharyngo-laryngoscopy are central in the education of otorhinolaryngologists. To facilitate an evidence-based approach to curriculum development in this field, a structured analysis of what constitutes flexible pharyngo-laryngoscopy is necessary. Our aim was to develop an assessment tool based on this analysis. We conducted an international Delphi study involving experts from twelve countries in five continents. Utilizing reiterative assessment, the panel defined the procedure and reached consensus (defined as 80% agreement) on the phrasing of an assessment tool. FIFTY PANELISTS COMPLETED THE DELPHI PROCESS. THE MEDIAN AGE OF THE PANELISTS WAS 44 YEARS (RANGE 33-64 YEARS). MEDIAN EXPERIENCE IN OTORHINOLARYNGOLOGY WAS 15 YEARS (RANGE 6-35 YEARS). TWENTY-FIVE WERE SPECIALIZED IN LARYNGOLOGY, 16 WERE HEAD AND NECK SURGEONS, AND NINE WERE GENERAL OTORHINOLARYNGOLOGISTS. AN ASSESSMENT TOOL WAS CREATED CONSISTING OF TWELVE DISTINCT ITEMS.: Conclusion The gathering of validity evidence for assessment of core procedural skills within Otorhinolaryngology is central to the development of a competence-based education. The use of an international Delphi panel allows for the creation of an assessment tool which is widely applicable and valid. This work allows for an informed approach to technical skills training for flexible pharyngo-laryngoscopy and as further validity evidence is gathered allows for a valid assessment of clinical performance within this important skillset.

Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations.

PubMed

Timmings, Caitlyn; Khan, Sobia; Moore, Julia E; Marquez, Christine; Pyka, Kasha; Straus, Sharon E

2016-02-24

To address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation. A multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability. Nine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78 %) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44 %) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool . Ready, Set, Change! decision support tool is an implementation support that is designed to facilitate the routine incorporation of a readiness assessment as an early step in implementation. Use of this tool in practice may offer time and resource-saving implications for implementation.

Towards an international taxonomy of integrated primary care: a Delphi consensus approach.

PubMed

Valentijn, Pim P; Vrijhoef, Hubertus J M; Ruwaard, Dirk; Boesveld, Inge; Arends, Rosa Y; Bruijnzeels, Marc A

2015-05-22

Developing integrated service models in a primary care setting is considered an essential strategy for establishing a sustainable and affordable health care system. The Rainbow Model of Integrated Care (RMIC) describes the theoretical foundations of integrated primary care. The aim of this study is to refine the RMIC by developing a consensus-based taxonomy of key features. First, the appropriateness of previously identified key features was retested by conducting an international Delphi study that was built on the results of a previous national Delphi study. Second, categorisation of the features among the RMIC integrated care domains was assessed in a second international Delphi study. Finally, a taxonomy was constructed by the researchers based on the results of the three Delphi studies. The final taxonomy consists of 21 key features distributed over eight integration domains which are organised into three main categories: scope (person-focused vs. population-based), type (clinical, professional, organisational and system) and enablers (functional vs. normative) of an integrated primary care service model. The taxonomy provides a crucial differentiation that clarifies and supports implementation, policy formulation and research regarding the organisation of integrated primary care. Further research is needed to develop instruments based on the taxonomy that can reveal the realm of integrated primary care in practice.

Development and face validation of strategies for improving consultation skills.

PubMed

Lefroy, Janet; Thomas, Adam; Harrison, Chris; Williams, Stephen; O'Mahony, Fidelma; Gay, Simon; Kinston, Ruth; McKinley, R K

2014-12-01

While formative workplace based assessment can improve learners' skills, it often does not because the procedures used do not facilitate feedback which is sufficiently specific to scaffold improvement. Provision of pre-formulated strategies to address predicted learning needs has potential to improve the quality and automate the provision of written feedback. To systematically develop, validate and maximise the utility of a comprehensive list of strategies for improvement of consultation skills through a process involving both medical students and their clinical primary and secondary care tutors. Modified Delphi study with tutors, modified nominal group study with students with moderation of outputs by consensus round table discussion by the authors. 35 hospital and 21 GP tutors participated in the Delphi study and contributed 153 new or modified strategies. After review of these and the 205 original strategies, 265 strategies entered the nominal group study to which 46 year four and five students contributed, resulting in the final list of 249 validated strategies. We have developed a valid and comprehensive set of strategies which are considered useful by medical students. This list can be immediately applied by any school which uses the Calgary Cambridge Framework to inform the content of formative feedback on consultation skills. We consider that the list could also be mapped to alternative skills frameworks and so be utilised by schools which do not use the Calgary Cambridge Framework.

Identifying and prioritising systematic review topics with public health stakeholders: A protocol for a modified Delphi study in Switzerland to inform future research agendas.

PubMed

Hoekstra, Dyon; Mütsch, Margot; Kien, Christina; Gerhardus, Ansgar; Lhachimi, Stefan K

2017-08-04

The Cochrane Collaboration aims to produce relevant and top priority evidence that responds to existing evidence gaps. Hence, research priority setting (RPS) is important to identify which potential research gaps are deemed most important. Moreover, RPS supports future health research to conform both health and health evidence needs. However, studies that are prioritising systematic review topics in public health are surprisingly rare. Therefore, to inform the research agenda of Cochrane Public Health Europe (CPHE), we introduce the protocol of a priority setting study on systematic review topics in several European countries, which is conceptualised as pilot. We will conduct a two-round modified Delphi study in Switzerland, incorporating an anonymous web-based questionnaire, to assess which topics should be prioritised for systematic reviews in public health. In the first Delphi round public health stakeholders will suggest relevant assessment criteria and potential priority topics. In the second Delphi round the participants indicate their (dis)agreement to the aggregated results of the first round and rate the potential review topics with the predetermined criteria on a four-point Likert scale. As we invite a wide variety of stakeholders we will compare the results between the different stakeholder groups. We have received ethical approval from the ethical board of the University of Bremen, Germany (principal investigation is conducted at the University of Bremen) and a certificate of non-objection from the Canton of Zurich, Switzerland (fieldwork will be conducted in Switzerland). The results of this study will be further disseminated through peer reviewed publication and will support systematic review author groups (i.a. CPHE) to improve the relevance of the groups´ future review work. Finally, the proposed priority setting study can be used as a framework by other systematic review groups when conducting a priority setting study in a different context. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Research priorities of the Canadian chiropractic profession: a consensus study using a modified Delphi technique.

PubMed

French, Simon D; Beliveau, Peter J H; Bruno, Paul; Passmore, Steven R; Hayden, Jill A; Srbely, John; Kawchuk, Greg N

2017-01-01

Research funds are limited and a healthcare profession that supports research activity should establish research priority areas. The study objective was to identify research priority areas for the Canadian chiropractic profession, and for stakeholders in the chiropractic profession to rank these in order of importance. We conducted a modified Delphi consensus study between August 2015 and May 2017 to determine the views of Canadian chiropractic organisations (e.g. Canadian Chiropractic Association; provincial associations) and stakeholder groups (e.g. chiropractic educational institutions; researchers). Participants completed three online Delphi survey rounds. In Round 1, participants suggested research areas within four broad research themes: 1) Basic science; 2) Clinical; 3) Health services; and 4) Population health. In Round 2, researchers created sub-themes by categorising the areas suggested in Round 1, and participants judged the importance of the research sub-themes. We defined consensus as at least 70% of participants agreeing that a research area was "essential" or "very important". In Round 3, results from Round 2 were presented to the participants to re-evaluate the importance of sub-themes. Finally, participants completed an online pairwise ranking activity to determine the rank order of the list of important research sub-themes. Fifty-seven participants, of 85 people invited, completed Round 1 (response rate 67%). Fifty-six participants completed Round 2, 55 completed Round 3, and 53 completed the ranking activity. After three Delphi rounds and the pairwise ranking activity was completed, the ranked list of research sub-themes considered important were: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services; 4) Effects of chiropractic care; 5) Safety/side effects of chiropractic care; 6) Chiropractic care for older adults; 7) Neurophysiological mechanisms and effects of spinal manipulative therapy; 8) General mechanisms and effects of spinal manipulative therapy. This project identified research priority areas for the Canadian chiropractic profession. The top three priority areas were all in the area of health services research: 1) Integration of chiropractic care into multidisciplinary settings; 2) Costs and cost-effectiveness of chiropractic care; 3) Effect of chiropractic care on reducing medical services.

Nature-based care opportunities and barriers in oncology contexts: a modified international e-Delphi survey.

PubMed

Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope

2017-10-16

To develop recommendations regarding opportunities and barriers for nature-based care in oncology contexts using a structured knowledge generation process involving relevant healthcare and design experts. Four-round modified electronic Delphi study. Oncology patients' nature-based recommendations, uncovered in preceding qualitative investigation, were included in the first round for the expert participants' consideration. Key items (opportunities and barriers) were developed using data aggregation and synthesis, followed by item prioritisation and 10-point Likert scale ranking (1=not important, 10=very important). Descriptive statistics were calculated to assess items of highest importance representing expert recommendations. Online Delphi process constituting an electronic international survey. A purposive sample of 200 potential panellists (recruitment target n=40) comprising healthcare practitioners, managers, designers, architects and researchers were invited to participate; experts were identified via research networks, snowballing and systematic literature review. 38 experts across seven countries (Australia, USA, UK, New Zealand, Canada, Denmark and Sweden) returned questionnaire 1, which determined consent and acceptance for participation. Initial response rate was 19%, and subsequent response rates were 84%, 82% and 84% for rounds 2, 3 and 4, respectively. The Delphi panel developed recommendations consisting of 10 opportunities and 10 barriers. The following opportunities were rated to be of highest importance: window views from clinical areas onto nature; outdoor settings, gardens and courtyards with easy and effortless access; and nature-based physical exercise adapted to patient requirements. Highest-rated barriers for nature-based oncology care included lack of knowledge and awareness about benefits of nature engagement and inaccessibility, not considering access requirements for the very sick and frail. Experts suggested and agreed on a set of recommendations, which represent critical considerations for the safe adoption of nature-based oncology opportunities. These findings fill a gap in understanding about helpful nature-based oncology care and may translate into oncology design and innovation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Framework of behavioral indicators evaluating TB health promotion outcomes: a modified Delphi study of TB policymakers and health workers.

PubMed

Li, Ying; Ehiri, John; Hu, Daiyu; Oren, Eyal; Cao, Jia

2015-12-15

Although TB health promotion directed at policy makers and healthcare workers (HCWs) is considered important to tuberculosis (TB) control, no indicators currently assess the impact of such promotional activities. This article is the second in a series of papers that seek to establish a framework of behavioral indicators for outcome evaluation of TB health promotion, using the Delphi method. In the first article, we sought to establish a framework of behavioral indicators for outcome evaluation of TB health promotion among TB suspects and patients. The objective of this second article is to present an indicator framework that can be used to assess behavioral outcomes of TB health promotion directed at policy makers and HCWs. A two-round, modified Delphi method was used to establish the indicators. Sixteen experts who were knowledgeable and experienced in the field of TB control were consulted in Delphi surveys. A questionnaire was developed following 4 steps, and involved ranking indicators on a five-point Likert scale. The consensus level was 70 %. Median, mode, and Coefficient of variation (CV) were used to describe expert responses. An authority coefficient (Cr) was used to assess the degree of each expert's authority. Consensus was achieved following the two survey rounds and several iterations among the experts. For TB health-promotion activities directed at policymakers, the experts reached consensus on 2 domains ("Resource inputs" and "Policymaking and monitoring behaviors"), 4 subdomains ("Human resources" among others), and 13 indicators ("Human resources per 100,000 person" among others). For TB health-promotion activities directed at HCWs, the experts reached consensus on 5 domains ("Self-protective behaviors" among others), 6 sub-domains ("Preventing infection" among others), and 15 indicators ("Average hours of daily workplace disinfection by ultraviolet radiation" among others). This study identified a conceptual framework of core behavioral indicators to evaluate TB health-promotion activities directed at policymakers and HCWs involved in TB control. Validation in other parts of the world could lead to global consensus on behavioral indicators to evaluate TB health promotion targeted at policymakers and HCWs.

Entry-to-practice public health nursing competencies: A Delphi method and knowledge translation strategy.

PubMed

Schofield, Ruth; Chircop, Andrea; Baker, Cynthia; Dietrich Leurer, Marie; Duncan, Susan; Wotton, Donalda

2018-06-01

Sustaining and strengthening nurses 'contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. The Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. Delphi approach. Nurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. The three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. 242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. This competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public health nursing educators and practitioners world-wide to support the adoption of entry-to-practice public health nursing competencies. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Exploring academics' views on designs, methods, characteristics and outcomes of inclusive health research with people with intellectual disabilities: a modified Delphi study

PubMed Central

Frankena, T K; Naaldenberg, J; Cardol, M; Meijering, J V; Leusink, G; van Schrojenstein Lantman-de Valk, H M J

2016-01-01

Background The British Medical Journal's (BMJ's) patient revolution strives for collaboration with patients in healthcare and health research. This paper studies collaboration with people with intellectual disabilities (ID) in health research, also known as inclusive health research. Currently, transparency and agreement among academics is lacking regarding its main aspects, preventing upscaling of the patient revolution. Objective This study aims to gain agreement among academics on 3 aspects of inclusive health research for people with ID: (1) designs and methods, (2) most important characteristics and (3) outcomes. Design A Delphi study was conducted with academics with experience in inclusive (health) research and on people with ID. The study consisted of 2 sequential questionnaire rounds (n=24; n=17), followed by in-depth interviews (n=10). Results Academics agreed on (1) a collaborative approach to be most suitable to inclusive health research, (2) characteristics regarding the accessibility and facilitation of inclusive health research, and (3) several outcomes of inclusive health research for people with ID and healthcare. Other characteristics agreed on included: atmosphere, relationship, engagement, partnership and power. It was stressed that these characteristics ensure meaningful inclusion. Interviewed academics voiced the need for a tool supporting the facilitation and evaluation of inclusive health research. There was ambiguity as to what this tool should comprise and the extent to which it was possible to capture the complex process of inclusive health research. Discussion and conclusions This study underlines the need for transparency, facilitation and evaluation of inclusive health research. The need for in-depth interviews after 2 Delphi rounds underlines its complexity and context dependence. To increase process transparency, future research should focus on gaining insight into inclusive health research in its context. A tool could be developed to facilitate and evaluate inclusive health research. This tool will be partially applicable to participatory research in general and thereby upscale the patient revolution. PMID:27540101

Barriers Influencing Linkage to Hypertension Care in Kenya: Qualitative Analysis from the LARK Hypertension Study.

PubMed

Naanyu, Violet; Vedanthan, Rajesh; Kamano, Jemima H; Rotich, Jackson K; Lagat, Kennedy K; Kiptoo, Peninah; Kofler, Claire; Mutai, Kennedy K; Bloomfield, Gerald S; Menya, Diana; Kimaiyo, Sylvester; Fuster, Valentin; Horowitz, Carol R; Inui, Thomas S

2016-03-01

Hypertension, the leading global risk factor for mortality, is characterized by low treatment and control rates in low- and middle-income countries. Poor linkage to hypertension care contributes to poor outcomes for patients. However, specific factors influencing linkage to hypertension care are not well known. To evaluate factors influencing linkage to hypertension care in rural western Kenya. Qualitative research study using a modified Health Belief Model that incorporates the impact of emotional and environmental factors on behavior. Mabaraza (traditional community assembly) participants (n = 242) responded to an open invitation to residents in their respective communities. Focus groups, formed by purposive sampling, consisted of hypertensive individuals, at-large community members, and community health workers (n = 169). We performed content analysis of the transcripts with NVivo 10 software, using both deductive and inductive codes. We used a two-round Delphi method to rank the barriers identified in the content analysis. We selected factors using triangulation of frequency of codes and themes from the transcripts, in addition to the results of the Delphi exercise. Sociodemographic characteristics of participants were summarized using descriptive statistics. We identified 27 barriers to linkage to hypertension care, grouped into individual (cognitive and emotional) and environmental factors. Cognitive factors included the asymptomatic nature of hypertension and limited information. Emotional factors included fear of being a burden to the family and fear of being screened for stigmatized diseases such as HIV. Environmental factors were divided into physical (e.g. distance), socioeconomic (e.g. poverty), and health system factors (e.g. popularity of alternative therapies). The Delphi results were generally consistent with the findings from the content analysis. Individual and environmental factors are barriers to linkage to hypertension care in rural western Kenya. Our analysis provides new insights and methodological approaches that may be relevant to other low-resource settings worldwide.

Core Domains for Clinical Research in Acute Respiratory Failure Survivors: An International Modified Delphi Consensus Study.

PubMed

Turnbull, Alison E; Sepulveda, Kristin A; Dinglas, Victor D; Chessare, Caroline M; Bingham, Clifton O; Needham, Dale M

2017-06-01

To identify the "core domains" (i.e., patient outcomes, health-related conditions, or aspects of health) that relevant stakeholders agree are essential to assess in all clinical research studies evaluating the outcomes of acute respiratory failure survivors after hospital discharge. A two-round consensus process, using a modified Delphi methodology, with participants from 16 countries, including patient and caregiver representatives. Prior to voting, participants were asked to review 1) results from surveys of clinical researchers, acute respiratory failure survivors, and caregivers that rated the importance of 19 preliminary outcome domains and 2) results from a qualitative study of acute respiratory failure survivors' outcomes after hospital discharge, as related to the 19 preliminary outcome domains. Participants also were asked to suggest any additional potential domains for evaluation in the first Delphi survey. Web-based surveys of participants representing four stakeholder groups relevant to clinical research evaluating postdischarge outcomes of acute respiratory failure survivors: clinical researchers, clinicians, patients and caregivers, and U.S. federal research funding organizations. None. None. Survey response rates were 97% and 99% in round 1 and round 2, respectively. There were seven domains that met the a priori consensus criteria to be designated as core domains: physical function, cognition, mental health, survival, pulmonary function, pain, and muscle and/or nerve function. This study generated a consensus-based list of core domains that should be assessed in all clinical research studies evaluating acute respiratory failure survivors after hospital discharge. Identifying appropriate measurement instruments to assess these core domains is an important next step toward developing a set of core outcome measures for this field of research.

STOPP/START Medication Criteria Modified for US Nursing Home Setting

PubMed Central

Khodyakov, Dmitry; Ochoa, Aileen; Olivieri-Mui, Brianne L.; Bouwmeester, Carla; Zarowitz, Barbara J.; Patel, Meenakshi; Ching, Diana; Briesacher, Becky

2016-01-01

STRUCTURED ABSTRACT BACKGROUND/OBJECTIVES A barrier to assessing the quality of prescribing in nursing homes (NH) is the lack of explicit criteria for this setting. Our objective was to develop a set of prescribing indicators measurable with available data from electronic nursing home databases by adapting the European-based 2014 STOPP/START criteria of potentially inappropriate and underused medications for the US setting. DESIGN A two-stage expert panel process. In first stage, investigator team reviewed 114 criteria for compatibility and measurability. In second stage, we convened an online modified e-Delphi (OMD) panel to rate the validity of criteria and two webinars to identify criteria with highest relevance to US NHs. PARTICIPANTS Seventeen experts with recognized reputations in NH care participated in the e-Delphi panel and 12 in the webinar. MEASUREMENTS Compatibility and measurability were assessed by comparing criteria to US terminology/setting standards and data elements in NH databases. Validity was rated with a 9-point Likert-type scale (1=not valid at all, 9=highly valid). Mean, median, interpercentile ranges, and agreement were determined for each criterion score. Relevance was determined by ranking the mean panel ratings on criteria that reached agreement; half of the criteria with the highest mean values were reviewed and approved by the webinar participants. RESULTS Fifty-three STOPP/START criteria were deemed as compatible with US setting and measurable using data from electronic NH databases. E-Delphi panelists rated 48 criteria as valid for US NHs. Twenty-four criteria were deemed as most relevant, consisting of 22 measures of potentially inappropriate medications and 2 measures of underused medications. CONCLUSION This study created the first explicit criteria for assessing the quality of prescribing in US NHs. PMID:28008599

Competency-Based Framework and Continuing Education for Preparing a Skilled School Health Workforce for Asthma Care: The Colorado Experience

ERIC Educational Resources Information Center

Cicutto, Lisa; Gleason, Melanie; Haas-Howard, Christy; Jenkins-Nygren, Lynn; Labonde, Susan; Patrick, Kathy

2017-01-01

School health teams commonly address the needs of students with asthma, which requires specific knowledge and skills. To develop a skilled school health team, a competency-based framework for managing asthma in schools was developed. A modified Delphi with 31 panelists was completed. Consensus (=80% agreement) was reached for all 148 items…

What is a Baseline for Effective Information Technology Governance for Higher Education Institutions that are Members of Research University CIO Conclave in United States?

ERIC Educational Resources Information Center

Mohseni, Maryam

2012-01-01

This research study provides the findings of a modified Delphi methodology conducted to define components and baseline for effective information technology governance for higher education institutions member of the Research University CIO Conclave (RUCC) in United States. The participating experts are Chief Information Officers (CIOs) of…

Assessing the Animal Science Technical Skills Needed by Secondary Agricultural Education Graduates for Employment in the Animal Industries: A Modified Delphi Study

ERIC Educational Resources Information Center

Slusher, Wendy L.; Robinson, J. Shane; Edwards, M. Craig

2011-01-01

Career and technical education courses, such as agricultural education, exist, in part, to assist students in acquiring the competencies needed to achieve employability. However, whether the current secondary agricultural education curriculum meets the needs of industry leaders who employ high school graduates of agricultural education programs is…

The challenge of the definition of early symptomatic knee osteoarthritis: a proposal of criteria and red flags from an international initiative promoted by the Italian Society for Rheumatology.

PubMed

Migliore, Alberto; Scirè, Carlo Alberto; Carmona, Loreto; Herrero-Beaumont, Gabriel; Bizzi, Emanuele; Branco, Jaime; Carrara, Greta; Chevalier, Xavier; Collaku, Ledio; Aslanidis, Spiros; Denisov, Lev; Di Matteo, Luigi; Bianchi, Gerolamo; Diracoglu, Demirhan; Frediani, Bruno; Maheu, Emmanuel; Martusevich, Natalia; Bagnato, Gian Filippo; Scarpellini, Magda; Minisola, Giovanni; Akkoc, Nurullah; Ramonda, Roberta; Barskova, Tatiana; Babic-Naglic, Durda; Muelas, Jose Vicente Moreno; Ionescu, Ruxandra; Rashkov, Rasho; Damjanov, Nemanja; Cerinic, Marco Matucci

2017-08-01

The aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained ESKOA definition. A complex methodological approach was followed including: (1) three focus groups (FG), including expert clinicians, researchers and patients; (2) a systematic literature review (SLR); (3) two discussion groups followed by a Delphi survey. FG and SLR were performed in parallel to inform discussion groups in order to identify relevant constructs to be included in the modified Delphi survey. ESKOA is defined in the presence of: (a) two mandatory symptoms (knee pain in the absence of any recent trauma or injury and very short joint stiffness, lasting for less than 10 min, when starting movement) even in the absence of risk factors, or (b) knee pain, and 1 or 2 risk factors or (c) three or more risk factors in the presence of at least one mandatory symptom, with symptoms lasting less than 6 months. These criteria are applicable in the absence of active inflammatory arthritis, generalized pain, Kellgren-Lawrence grade >0, any recent knee trauma or injury, and age lower than 40 years. Knee pain in the absence of any recent trauma lasting for less than 6 months was considered as the referral criterion to the rheumatologist for the suspicion of ESKOA. This consensus process has identified provisional clinical definition of ESKOA and defined potential referral criterion to rheumatologist, in order to test ESKOA obtained definition in prospective validation studies.

Personalising care of adults with asthma from Asia: a modified e-Dephi consensus study to inform management tailored to attitude and control profiles.

PubMed

Chisholm, Alison; Price, David B; Pinnock, Hilary; Lee, Tan Tze; Roa, Camilo; Cho, Sang-Heon; David-Wang, Aileen; Wong, Gary; van der Molen, Thys; Ryan, Dermot; Castillo-Carandang, Nina; Yong, Yee Vern

2017-01-05

REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster's attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal-control clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia.

Development of the Learning Health System Researcher Core Competencies.

PubMed

Forrest, Christopher B; Chesley, Francis D; Tregear, Michelle L; Mistry, Kamila B

2017-08-04

To develop core competencies for learning health system (LHS) researchers to guide the development of training programs. Data were obtained from literature review, expert interviews, a modified Delphi process, and consensus development meetings. The competencies were developed from August to December 2016 using qualitative methods. The literature review formed the basis for the initial draft of a competency domain framework. Key informant semi-structured interviews, a modified Delphi survey, and three expert panel (n = 19 members) consensus development meetings produced the final set of competencies. The iterative development process yielded seven competency domains: (1) systems science; (2) research questions and standards of scientific evidence; (3) research methods; (4) informatics; (5) ethics of research and implementation in health systems; (6) improvement and implementation science; and (7) engagement, leadership, and research management. A total of 33 core competencies were prioritized across these seven domains. The real-world milieu of LHS research, the embeddedness of the researcher within the health system, and engagement of stakeholders are distinguishing characteristics of this emerging field. The LHS researcher core competencies can be used to guide the development of learning objectives, evaluation methods, and curricula for training programs. © Health Research and Educational Trust.

A practical guideline for examining a uterine niche using ultrasonography in non-pregnant women: a modified Delphi method amongst European experts.

PubMed

Jordans, I P M; de Leeuw, R; Stegwee, S I; Amso, N N; Barri-Soldevila, P N; van den Bosch, T; Bourne, T; Brolmann, H A M; Donnez, O; Dueholm, M; Hehenkamp, W J K; Jastrow, N; Jurkovic, D; Mashiach, R; Naji, O; Streuli, I; Timmerman, D; Vd Voet, L F; Huirne, J A F

2018-03-14

To generate a uniform, internationally recognized guideline for detailed uterine niche evaluation by ultrasonography in non-pregnant women using a modified Delphi method amongst international experts. Fifteen international gynecological experts were recruited by their membership of the European niche taskforce group. All experts were physicians with extensive experience in niche evaluation in clinical practice and/or authors of niche studies. Relevant items for niche measurement were determined based on the results of a literature search and recommendations of a focus group. Two online questionnaires were sent to the expert panel and one group meeting was organized. Consensus was predefined as a consensus rate of at least 70%. In total 15 experts participated in this study. Consensus was reached for a total of 42 items on niche evaluation, including definitions, relevance, method of measurement and tips for visualization of the niche. All experts agreed on the proposed guideline for niche evaluation in non-pregnant women as presented in this paper. Consensus between niche experts was achieved on all items regarding ultrasonographic niche measurement. This article is protected by copyright. All rights reserved.

Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop

PubMed Central

2011-01-01

Background Envenomation by crotaline snakes (rattlesnake, cottonmouth, copperhead) is a complex, potentially lethal condition affecting thousands of people in the United States each year. Treatment of crotaline envenomation is not standardized, and significant variation in practice exists. Methods A geographically diverse panel of experts was convened for the purpose of deriving an evidence-informed unified treatment algorithm. Research staff analyzed the extant medical literature and performed targeted analyses of existing databases to inform specific clinical decisions. A trained external facilitator used modified Delphi and structured consensus methodology to achieve consensus on the final treatment algorithm. Results A unified treatment algorithm was produced and endorsed by all nine expert panel members. This algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy. Conclusions Clinical manifestations and ideal treatment of crotaline snakebite differ greatly, and can result in severe complications. Using a modified Delphi method, we provide evidence-informed treatment guidelines in an attempt to reduce variation in care and possibly improve clinical outcomes. PMID:21291549

Case definition and classification of leukodystrophies and leukoencephalopathies.

PubMed

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C; Van Hove, Johan L K; Schmidt, Johanna; Wolf, Nicole I; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S

2015-04-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative consensus building surveys to achieve definition and classification of disorders as leukodystrophies using a modified Delphi approach. A case definition for the leukodystrophies was achieved, and a total of 30 disorders were classified under this definition. In addition, a separate set of disorders with heritable white matter abnormalities but not meeting criteria for leukodystrophy, due to presumed primary neuronal involvement and prominent systemic manifestations, was classified as genetic leukoencephalopathies (gLE). A case definition of leukodystrophies and classification of heritable white matter disorders will permit more detailed epidemiologic studies of these disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

PubMed

Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

2018-05-01

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

High performance interactive graphics for shower reconstruction in HPC, the DELPHI barrel electromagnetic calorimeter

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stanescu, C.

1990-08-01

Complex software for shower reconstruction in DELPHI barrel electromagnetic calorimeter which deals, for each event, with great amounts of information, due to the high spatial resolution of this detector, needs powerful verification tools. An interactive graphics program, running on high performance graphics display system Whizzard 7555 from Megatek, was developed to display the logical steps in showers and their axes reconstruction. The program allows both operations on the image in real-time (rotation, translation and zoom) and the use of non-geometrical criteria to modify it (as the use of energy) thresholds for the representation of the elements that compound the showersmore » (or of the associated lego plots). For this purpose graphics objects associated to user parameters were defined. Instancing and modelling features of the native graphics library were extensively used.« less

Stakeholder involvement in establishing a milk quality sub-index in dairy cow breeding goals: a Delphi approach.

PubMed

Henchion, M; McCarthy, M; Resconi, V C; Berry, D P; McParland, S

2016-05-01

The relative weighting on traits within breeding goals are generally determined by bio-economic models or profit functions. While such methods have generally delivered profitability gains to producers, and are being expanded to consider non-market values, current approaches generally do not consider the numerous and diverse stakeholders that affect, or are affected, by such tools. Based on principles of respondent anonymity, iteration, controlled feedback and statistical aggregation of feedback, a Delphi study was undertaken to gauge stakeholder opinion of the importance of detailed milk quality traits within an overall dairy breeding goal for profit, with the aim of assessing its suitability as a complementary, participatory approach to defining breeding goals. The questionnaires used over two survey rounds asked stakeholders: (a) their opinion on incorporating an explicit sub-index for milk quality into a national breeding goal; (b) the importance they would assign to a pre-determined list of milk quality traits and (c) the (relative) weighting they would give such a milk quality sub-index. Results from the survey highlighted a good degree of consensus among stakeholders on the issues raised. Similarly, revelation of the underlying assumptions and knowledge used by stakeholders to make their judgements illustrated their ability to consider a range of perspectives when evaluating traits, and to reconsider their answers based on the responses and rationales given by others, which demonstrated social learning. Finally, while the relative importance assigned by stakeholders in the Delphi survey (4% to 10%) and the results of calculations based on selection index theory of the relative emphasis that should be placed on milk quality to halt any deterioration (16%) are broadly in line, the difference indicates the benefit of considering more than one approach to determining breeding goals. This study thus illustrates the role of the Delphi technique, as a complementary approach to traditional approaches, to defining breeding goals. This has implications for how breeding goals will be defined and in determining who should be involved in the decision-making process.

Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

PubMed

Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

2015-03-01

The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

Practical state of health estimation of power batteries based on Delphi method and grey relational grade analysis

NASA Astrophysics Data System (ADS)

Sun, Bingxiang; Jiang, Jiuchun; Zheng, Fangdan; Zhao, Wei; Liaw, Bor Yann; Ruan, Haijun; Han, Zhiqiang; Zhang, Weige

2015-05-01

The state of health (SOH) estimation is very critical to battery management system to ensure the safety and reliability of EV battery operation. Here, we used a unique hybrid approach to enable complex SOH estimations. The approach hybridizes the Delphi method known for its simplicity and effectiveness in applying weighting factors for complicated decision-making and the grey relational grade analysis (GRGA) for multi-factor optimization. Six critical factors were used in the consideration for SOH estimation: peak power at 30% state-of-charge (SOC), capacity, the voltage drop at 30% SOC with a C/3 pulse, the temperature rises at the end of discharge and charge at 1C; respectively, and the open circuit voltage at the end of charge after 1-h rest. The weighting of these factors for SOH estimation was scored by the 'experts' in the Delphi method, indicating the influencing power of each factor on SOH. The parameters for these factors expressing the battery state variations are optimized by GRGA. Eight battery cells were used to illustrate the principle and methodology to estimate the SOH by this hybrid approach, and the results were compared with those based on capacity and power capability. The contrast among different SOH estimations is discussed.

Identifying seminal papers in the Australasian Journal on Ageing 1982-2011: a Delphi consensus approach.

PubMed

Parkinson, Lynne; Richardson, Kristy; Sims, Jane; Wells, Yvonne; Naganathan, Vasi; Brooke, Elizabeth; Lindley, Richard

2013-10-01

The aim of this study was to identify seminal Australasian Journal on Ageing papers published over 30 years through a Delphi consensus process. The main data collection was a three-round Delphi consensus study with 38 past and current members of the Australasian Journal on Ageing Editorial Board, Editorial Team and Management Committee. Three papers were agreed as top-ranking. One of the top-ranking articles was also highly cited. One article was published in the 1990 s, two in 2001. While it is difficult to judge how well the top-ranking papers represent seminal papers arising over 30 years, these papers do represent three different research strengths in Australasia, they do span three different disciplines, and they do reflect some of the diversity that characterises ageing research in Australasia over 30 years. © 2013 ACOTA.

Defining Advance Care Planning for Adults: A Consensus Definition from a Multidisciplinary Delphi Panel

PubMed Central

Sudore, Rebecca L.; Lum, Hillary D.; You, John J.; Hanson, Laura C.; Meier, Diane E.; Pantilat, Steven Z.; Matlock, Daniel D.; Rietjens, Judith A. C.; Korfage, Ida J.; Ritchie, Christine S.; Kutner, Jean S.; Teno, Joan M.; Thomas, Judy; McMahan, Ryan D.; Heyland, Daren K.

2017-01-01

Background Despite increasing interest in advance care planning (ACP) and prior ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives. Objective To develop a consensus definition of ACP for adults. Design Delphi Panel Setting/Participants Participants included a multidisciplinary panel of international ACP experts consisting of 52 clinicians, researchers, and policy leaders from 4 countries, and a patient/surrogate advisory committee. Measurements We conducted 10 rounds of a modified Delphi method and qualitatively analyzed panelists’ input. Panelists identified several themes lacking consensus, and iteratively discussed and developed a final consensus definition. Results Panelists identified several tensions concerning ACP concepts such as whether the definition should focus on conversations vs. written advance directives; patients’ values vs. treatment preferences; current shared decision making vs. future medical decisions; and who should be included in the process. The panel achieved a final consensus one-sentence definition and accompanying goals statement: “Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals and preferences during serious and chronic illness.” The panel also described strategies to best support adults in ACP. Conclusions A multidisciplinary Delphi panel developed a consensus definition for ACP for adults that can be used to inform implementation and measurement of ACP clinical, research, and policy initiatives. PMID:28062339

Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel.

PubMed

Sudore, Rebecca L; Lum, Hillary D; You, John J; Hanson, Laura C; Meier, Diane E; Pantilat, Steven Z; Matlock, Daniel D; Rietjens, Judith A C; Korfage, Ida J; Ritchie, Christine S; Kutner, Jean S; Teno, Joan M; Thomas, Judy; McMahan, Ryan D; Heyland, Daren K

2017-05-01

Despite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives. The aim of this study was to develop a consensus definition of ACP for adults. We convened a Delphi panel of multidisciplinary, international ACP experts consisting of 52 clinicians, researchers, and policy leaders from four countries and a patient/surrogate advisory committee. We conducted 10 rounds using a modified Delphi method and qualitatively analyzed panelists' input. Panelists identified several themes lacking consensus and iteratively discussed and developed a final consensus definition. Panelists identified several tensions concerning ACP concepts such as whether the definition should focus on conversations vs. written advance directives; patients' values vs. treatment preferences; current shared decision making vs. future medical decisions; and who should be included in the process. The panel achieved a final consensus one-sentence definition and accompanying goals statement: "Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals and preferences during serious and chronic illness." The panel also described strategies to best support adults in ACP. A multidisciplinary Delphi panel developed a consensus definition for ACP for adults that can be used to inform implementation and measurement of ACP clinical, research, and policy initiatives. Published by Elsevier Inc.

A Delphi study and ranking exercise to support commissioning services: future delivery of Thrombectomy services in England.

PubMed

Halvorsrud, Kristoffer; Flynn, Darren; Ford, Gary A; McMeekin, Peter; Bhalla, Ajay; Balami, Joyce; Craig, Dawn; White, Phil

2018-02-22

Intra-arterial thrombectomy is the gold standard treatment for large artery occlusive stroke. However, the evidence of its benefits is almost entirely based on trials delivered by experienced neurointerventionists working in established teams in neuroscience centres. Those responsible for the design and prospective reconfiguration of services need access to a comprehensive and complementary array of information on which to base their decisions. This will help to ensure the demonstrated effects from trials may be realised in practice and account for regional/local variations in resources and skill-sets. One approach to elucidate the implementation preferences and considerations of key experts is a Delphi survey. In order to support commissioning decisions, we aimed using an electronic Delphi survey to establish consensus on the options for future organisation of thrombectomy services among physicians with clinical experience in managing large artery occlusive stroke. A Delphi survey was developed with 12 options for future organisation of thrombectomy services in England. A purposive sampling strategy established an expert panel of stroke physicians from the British Association of Stroke Physicians (BASP) Clinical Standards and/or Executive Membership that deliver 24/7 intravenous thrombolysis. Options with aggregate scores falling within the lowest quartile were removed from the subsequent Delphi round. Options reaching consensus following the two Delphi rounds were then ranked in a final exercise by both the wider BASP membership and the British Society of Neuroradiologists (BSNR). Eleven stroke physicians from BASP completed the initial two Delphi rounds. Three options achieved consensus, with subsequently wider BASP (97%, n = 43) and BSNR members (86%, n = 21) assigning the highest approval rankings in the final exercise for transferring large artery occlusive stroke patients to nearest neuroscience centre for thrombectomy based on local CT/CT Angiography. The initial Delphi rounds ensured optimal reduction of options by an expert panel of stroke physicians, while subsequent ranking exercises allowed remaining options to be ranked by a wider group of experts within stroke to reach consensus. The preferred implementation option for thrombectomy is investigating suspected acute stroke patients by CT/CT Angiography and secondary transfer of large artery occlusive stroke patients to the nearest neuroscience (thrombectomy) centre.

Feasibility of multi-sector policy measures that create activity-friendly environments for children: results of a Delphi study.

PubMed

Aarts, Marie-Jeanne; Schuit, Albertine J; van de Goor, Ien Am; van Oers, Hans Am

2011-12-15

Although multi-sector policy is a promising strategy to create environments that stimulate physical activity among children, little is known about the feasibility of such a multi-sector policy approach. The aims of this study were: to identify a set of tangible (multi-sector) policy measures at the local level that address environmental characteristics related to physical activity among children; and to assess the feasibility of these measures, as perceived by local policy makers. In four Dutch municipalities, a Delphi study was conducted among local policy makers of different policy sectors (public health, sports, youth and education, spatial planning/public space, traffic and transportation, and safety). In the first Delphi round, respondents generated a list of possible policy measures addressing three environmental correlates of physical activity among children (social cohesion, accessibility of facilities, and traffic safety). In the second Delphi round, policy makers weighted different feasibility aspects (political feasibility, cultural/community acceptability, technical feasibility, cost feasibility, and legal feasibility) and assessed the feasibility of the policy measures derived from the first round. The third Delphi round was aimed at reaching consensus by feedback of group results. Finally, one overall feasibility score was calculated for each policy measure. Cultural/community acceptability, political feasibility, and cost feasibility were considered most important feasibility aspects. The Delphi studies yielded 16 feasible policy measures aimed at physical and social environmental correlates of physical activity among children. Less drastic policy measures were considered more feasible, whereas environmental policy measures were considered less feasible. This study showed that the Delphi technique can be a useful tool in reaching consensus about feasible multi-sector policy measures. The study yielded several feasible policy measures aimed at physical and social environmental correlates of physical activity among children and can assist local policy makers in designing multi-sector policies aimed at an activity-friendly environment for children.

A modified Delphi study towards developing a guideline to inform policy on fetal alcohol spectrum disorders in South Africa: a study protocol

PubMed Central

Mukumbang, Ferdinand C; Okop, Kufre J; Beytell, Anna-Marie

2018-01-01

Introduction Maternal alcohol consumption during pregnancy can result in mental and physical birth defects in individuals. These birth defects are usually described as fetal alcohol spectrum disorders (FASDs). With an estimated 183–259 per 1000 children born with FASDs, South Africa is identified to have the highest prevalence of FASDs in the world. Nevertheless, there is a lack of appropriate policies, guidelines and interventions addressing the issues around FASDs. This protocol outlines a proposed process for developing a guideline to inform policies on FASDs. Methods and analysis This process will have three phases. Phase I will be carried out in three steps; we plan to conduct a document review of available policies on the prevention and management of FASDs and update the existing systematic review on FASDs interventions. The aim of the two reviews is to explore the availability and content of existing policies and global interventions on FASDs. In addition, we will conduct two exploratory qualitative studies to obtain the perspectives of various stakeholders on the existing or possible guidelines and policies for the management of FASDs and available interventions and services. In phase II, we will aggregate the findings of the previous phase to develop a prototype guideline. In phase III, using the developed prototype, we will apply the Delphi approach with experts on FASDs, soliciting their opinions on the nature and content of the proposed guidelines for policies. The information gathered will be used to modify the prototype to formulate a policy guideline on FASDs. The data will be analysed using thematic analysis and narrative synthesis. Ethics and dissemination Ethical clearance has been obtained from the ethics committee of the university and governmental departments. The findings will be disseminated through publications and the guideline will be submitted to relevant departments. PMID:29703853

Improving care standards for patients with spinal trauma combining a modified e-Delphi process and stakeholder interviews: a study protocol.

PubMed

Sharwood, Lisa N; Stanford, Ralph; Middleton, James W; Burns, Brian; Joseph, Anthony; Flower, Oliver; Rigby, Oran; Ball, Jonathon; Dhaliwal, Shelly

2017-01-19

Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients. A modified e-Delphi process will be used to gain consensus for best practice across specific clinical early care areas for the patient with TSCI; invited participants will include clinicians across Australia with relevant and significant expertise. A rapid literature review will identify available evidence, including any current guidelines from 2005 to 2015. Level and strength of evidence identified, including areas of contention, will be used to formulate the first round survey questions and statements. Participants will undertake 2-3 online survey rounds, responding anonymously to questionnaires regarding care practices and indicating their agreement or otherwise with practice standard statements. Relevant key stakeholders, including patients, will also be interviewed face to face. Ethics approval for this study was obtained by the NSW Population & Health Services Research Ethics Committee on 14 January 2016 (HREC/12/CIPHS/74). Seeking comprehensive understanding of how the variation in early care pathways and treatment can be addressed to achieve optimal patient outcomes and economic costs; the overall aim is the agreement to a consistent approach to the triage, treatment, transport and definitive care of acute TSCI victims. The agreed practice standards of care will inform the development of a Clinical Pathway with practice change strategies for implementation. These standards will offer a benchmark for state-wide and potentially national policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Developing a primary care patient measure of safety (PC PMOS): a modified Delphi process and face validity testing.

PubMed

Hernan, Andrea L; Giles, Sally J; O'Hara, Jane K; Fuller, Jeffrey; Johnson, Julie K; Dunbar, James A

2016-04-01

Patients are a valuable source of information about ways to prevent harm in primary care and are in a unique position to provide feedback about the factors that contribute to safety incidents. Unlike in the hospital setting, there are currently no tools that allow the systematic capture of this information from patients. The aim of this study was to develop a quantitative primary care patient measure of safety (PC PMOS). A two-stage approach was undertaken to develop questionnaire domains and items. Stage 1 involved a modified Delphi process. An expert panel reached consensus on domains and items based on three sources of information (validated hospital PMOS, previous research conducted by our study team and literature on threats to patient safety). Stage 2 involved testing the face validity of the questionnaire developed during stage 1 with patients and primary care staff using the 'think aloud' method. Following this process, the questionnaire was revised accordingly. The PC PMOS was received positively by both patients and staff during face validity testing. Barriers to completion included the length, relevance and clarity of questions. The final PC PMOS consisted of 50 items across 15 domains. The contributory factors to safety incidents centred on communication, access to care, patient-related factors, organisation and care planning, task performance and information flow. This is the first tool specifically designed for primary care settings, which allows patients to provide feedback about factors contributing to potential safety incidents. The PC PMOS provides a way for primary care organisations to learn about safety from the patient perspective and make service improvements with the aim of reducing harm in this setting. Future research will explore the reliability and construct validity of the PC PMOS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Developing a Consensus-Driven, Core Competency Model to Shape Future Audio Engineering Technology Curriculum: A Web-Based Modified Delphi Study

ERIC Educational Resources Information Center

Tough, David T.

2009-01-01

The purpose of this online study was to create a ranking of essential core competencies and technologies required by AET (audio engineering technology) programs 10 years in the future. The study was designed to facilitate curriculum development and improvement in the rapidly expanding number of small to medium sized audio engineering technology…

Competencies and Experiences Needed by Pre-Service Agricultural Educators to Teach Globalized Curricula: A Modified Delphi Study

ERIC Educational Resources Information Center

Conner, Nathan; Roberts, T. Grady

2013-01-01

The 21st century graduate must be able to interact with people from all over the world and must also be knowledgeable about the world (Longview Foundation, 2008). In order to produce graduates that are globally competent, The National Council for the Accreditation of Teachers (NCATE, 1982) has mandated that multi-cultural education be incorporated…

Indian Society of Gastroenterology consensus statements on Crohn's disease in India.

PubMed

Ramakrishna, Balakrishnan S; Makharia, Govind K; Ahuja, Vineet; Ghoshal, Uday C; Jayanthi, Venkataraman; Perakath, Benjamin; Abraham, Philip; Bhasin, Deepak K; Bhatia, Shobna J; Choudhuri, Gourdas; Dadhich, Sunil; Desai, Devendra; Goswami, Bhaba Dev; Issar, Sanjeev K; Jain, Ajay K; Kochhar, Rakesh; Loganathan, Goundappa; Misra, Sri Prakash; Ganesh Pai, C; Pal, Sujoy; Philip, Mathew; Pulimood, Anna; Puri, Amarender S; Ray, Gautam; Singh, Shivaram P; Sood, Ajit; Subramanian, Venkatraman

2015-01-01

In 2012, the Indian Society of Gastroenterology's Task Force on Inflammatory Bowel Diseases undertook an exercise to produce consensus statements on Crohn's disease (CD). This consensus, produced through a modified Delphi process, reflects our current recommendations for the diagnosis and management of CD in India. The consensus statements are intended to serve as a reference point for teaching, clinical practice, and research in India.

Technical College Instructors' Perceptions of the Impact of Online Readiness and of Student Support Services on Student Success in Online Courses

ERIC Educational Resources Information Center

Dowd, Nathan

2012-01-01

The purpose of this study is to determine how Wisconsin Technical College (WTCS) administrators and online instructors perceive the impact of online learner readiness and student support services to be on student success in online courses. The study used a modified three-round Delphi technique to determine to collect data. The results indicated…

Foreword: Proceedings From the First Annual Lumbar Total Disc Replacement Summit.

PubMed

Blumenthal, Scott; Buttermann, Glenn; Garcia, Rolando; Gornet, Matthew; Grunch, Betsy; Guyer, Richard; Janssen, Michael; Kimball, Brent; Lewis, Adam; Mesiwala, Ali; Miller, Lynn; Morreale, Joseph; Reed, William; Sandhu, Faheem; Shackleford, Ian; Yue, James; Zigler, Jack; OConnell, Brent; Ferko, Nicole; Hollmann, Sarah

2017-12-15

: This publication focuses on proceedings from the First Annual Lumbar Total Disc Replacement Summit, held October 25, 2016 in Boston, MA. The Summit brought together 17 thought leading surgeons who employed a modified-Delphi method to determine where consensus existed pertaining to the utilization of lumbar total disc replacement as a standard of care for a subpopulation of patients suffering from degenerative disc disease.

Curated Collections for Educators: Five Key Papers about Residents as Teachers Curriculum Development.

PubMed

Krzyzaniak, Sara M; Cherney, Alan; Messman, Anne; Natesan, Sreeja; Overbeck, Michael; Schnapp, Benjamin; Boysen-Osborn, Megan

2018-02-04

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to prepare residents to teach and assess medical students and other learners. In order to achieve this, many programs develop formal residents as teachers (RAT) curricula. Medical educators may seek the guidance of previously published literature during the development of RAT programs at their institutions. The authors sought to identify key articles published on the subject of RAT programs over the last 10 years. The authors utilized a formal literature search with the help of a medical librarian and identified additional articles from virtual discussions among the author group and an open call for articles on Twitter using the hashtag #MedEd. Virtual discussions occurred within an online community of practice, the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. The lead author conducted a four-round modified Delphi process among the author group in order to narrow the broad article list to five key articles on RAT programs. The authors summarize each article and provide considerations for junior faculty as well as faculty developers. Curriculum development and program evaluation should utilize established frameworks and evidence-based approaches. The papers identified by this Delphi process will help faculty use best practices when creating or revising new RAT curriculum. In addition, faculty tasked with guiding junior faculty in this process or creating faculty development programs around curriculum development will find these articles to be a great resource for building content.

A comparison of three methods for estimating the requirements for medical specialists: the case of otolaryngologists.

PubMed Central

Anderson, G F; Han, K C; Miller, R H; Johns, M E

1997-01-01

OBJECTIVE: To compare three methods of computing the national requirements for otolaryngologists in 1994 and 2010. DATA SOURCES: Three large HMOs, a Delphi panel, the Bureau of Health Professions (BHPr), and published sources. STUDY DESIGN: Three established methods of computing requirements for otolaryngologists were compared: managed care, demand-utilization, and adjusted needs assessment. Under the managed care model, a published method based on reviewing staffing patterns in HMOs was modified to estimate the number of otolaryngologists. We obtained from BHPr estimates of work force projections from their demand model. To estimate the adjusted needs model, we convened a Delphi panel of otolaryngologists using the methodology developed by the Graduate Medical Education National Advisory Committee (GMENAC). DATA COLLECTION/EXTRACTION METHODS: Not applicable. PRINCIPAL FINDINGS: Wide variation in the estimated number of otolaryngologists required occurred across the three methods. Within each model it was possible to alter the requirements for otolaryngologists significantly by changing one or more of the key assumptions. The managed care model has a potential to obtain the most reliable estimates because it reflects actual staffing patterns in institutions that are attempting to use physicians efficiently. CONCLUSIONS: Estimates of work force requirements can vary considerably if one or more assumptions are changed. In order for the managed care approach to be useful for actual decision making concerning the appropriate number of otolaryngologists required, additional research on the methodology used to extrapolate the results to the general population is necessary. PMID:9180613

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

PubMed

Upham, Susan J; Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT). A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014. Tools and resources were reviewed in three rounds using a standard pre-tested assessment form. Recommendations, scores and reasons for recommending or rejecting each tool or resource were analysed to determine the final suite of tools and resources. The evaluation was conducted from November 2014 to August 2015. Recommended tools and resources scored highly (mean score, 16/20) in Rounds 1 and 2 of review (n = 25). These tools and resources were perceived to be easily used, useful to the practice and supportive of the PC-PIT. Rejected resources scored considerably lower (mean score, 5/20) and were noted to have limitations such as having no value to the practice and poor utility (n = 6). A final review (Round 3) of 28 resources resulted in a suite of 21 to support the elements of the PC-PIT. This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform.

Curated Collections for Educators: Five Key Papers about Residents as Teachers Curriculum Development

PubMed Central

Cherney, Alan; Messman, Anne; Natesan, Sreeja; Overbeck, Michael; Schnapp, Benjamin; Boysen-Osborn, Megan

2018-01-01

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to prepare residents to teach and assess medical students and other learners. In order to achieve this, many programs develop formal residents as teachers (RAT) curricula. Medical educators may seek the guidance of previously published literature during the development of RAT programs at their institutions. The authors sought to identify key articles published on the subject of RAT programs over the last 10 years. The authors utilized a formal literature search with the help of a medical librarian and identified additional articles from virtual discussions among the author group and an open call for articles on Twitter using the hashtag #MedEd. Virtual discussions occurred within an online community of practice, the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator. The lead author conducted a four-round modified Delphi process among the author group in order to narrow the broad article list to five key articles on RAT programs. The authors summarize each article and provide considerations for junior faculty as well as faculty developers. Curriculum development and program evaluation should utilize established frameworks and evidence-based approaches. The papers identified by this Delphi process will help faculty use best practices when creating or revising new RAT curriculum. In addition, faculty tasked with guiding junior faculty in this process or creating faculty development programs around curriculum development will find these articles to be a great resource for building content. PMID:29637035

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

PubMed

Kaplan, Stephen J; Seabott, Heather M; Cunningham, Erika B; Helman, James D; Calderon, Alvin; Thirlby, Richard C; Schenarts, Kimberly D

The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

75 FR 16513 - Delphi Packard Electrical/Electronic Architecture, a Subsidiary of Delphi Corporation, Including...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

.../Electronic Architecture, a Subsidiary of Delphi Corporation, Including On-Site Leased Workers From Bartech... Assistance on December 8th, 2009, applicable to workers of Delphi Packard Electrical/Electronic Architecture... location of Delphi Packard Electrical/Electronic Architecture, a subsidiary of Delphi Corporation. The...

The Anatomical Society core regional anatomy syllabus for undergraduate medicine.

PubMed

Smith, C F; Finn, G M; Stewart, J; Atkinson, M A; Davies, D C; Dyball, R; Morris, J; Ockleford, C; Parkin, I; Standring, S; Whiten, S; Wilton, J; McHanwell, S

2016-01-01

The Anatomical Society's core syllabus for anatomy (2003 and later refined in 2007) set out a series of learning outcomes that an individual medical student should achieve on graduation. The core syllabus, with 182 learning outcomes grouped in body regions, referenced in the General Medical Council's Teaching Tomorrow's Doctors, was open to criticism on the grounds that the learning outcomes were generated by a relatively small group of anatomists, albeit some of whom were clinically qualified. We have therefore used a modified Delphi technique to seek a wider consensus. A Delphi panel was constructed involving 'experts' (n = 39). The revised core syllabus of 156 learning outcomes presented here is applicable to all medical programmes and may be used by curriculum planners, teachers and students alike in addressing the perennial question: 'What do I need to know ?' © 2015 Anatomical Society.

National Delphi study to determine competencies for nursing leadership in public health.

PubMed

Misener, T R; Alexander, J W; Blaha, A J; Clarke, P N; Cover, C M; Felton, G M; Fuller, S G; Herman, J; Rodes, M M; Sharp, H F

1997-01-01

To identify competencies needed by nurse leaders in public health programs. Five-round national Delphi. Convenience sample of members of major public health nursing associations and nurse and non-nurse public health leaders in the USA. Mailed survey in 1994-1995 using a modified snowball technique based on a modification of the Pew Foundation health professions' competencies for Round 1. Four additional rounds produced consensus. Initially, 62 competencies were identified. Factor analysis resulted in four factors: political competencies, business acumen, program leadership, and management capabilities; 57 competencies were clustered in the four groupings and accounted for 91.4% of the variance. Graduate schools in nursing and public health must prepare students with broad-based competencies from a variety of disciplines. Findings of this national survey provide a database for curriculum development and evaluation of programs to prepare nurse leaders for roles in public health-based delivery systems.

Evidence-based algorithm for diagnosis and assessment in psoriatic arthritis: results by Italian DElphi in psoriatic Arthritis (IDEA).

PubMed

Lapadula, G; Marchesoni, A; Salaffi, F; Ramonda, R; Salvarani, C; Punzi, L; Costa, L; Caso, F; Simone, D; Baiocchi, G; Scioscia, C; Di Carlo, M; Scarpa, R; Ferraccioli, G

2016-12-16

Psoriatic arthritis (PsA) is a chronic inflammatory disease involving skin, peripheral joints, entheses, and axial skeleton. The disease is frequently associated with extrarticular manifestations (EAMs) and comorbidities. In order to create a protocol for PsA diagnosis and global assessment of patients with an algorithm based on anamnestic, clinical, laboratory and imaging procedures, we established a DElphi study on a national scale, named Italian DElphi in psoriatic Arthritis (IDEA). After a literature search, a Delphi poll, involving 52 rheumatologists, was performed. On the basis of the literature search, 202 potential items were identified. The steering committee planned at least two Delphi rounds. In the first Delphi round, the experts judged each of the 202 items using a score ranging from 1 to 9 based on its increasing clinical relevance. The questions posed to experts were How relevant is this procedure/observation/sign/symptom for assessment of a psoriatic arthritis patient? Proposals of additional items, not included in the questionnaire, were also encouraged. The results of the poll were discussed by the Steering Committee, which evaluated the necessity for removing selected procedures or adding additional ones, according to criteria of clinical appropriateness and sustainability. A total of 43 recommended diagnosis and assessment procedures, recognized as items, were derived by combination of the Delphi survey and two National Expert Meetings, and grouped in different areas. Favourable opinion was reached in 100% of cases for several aspects covering the following areas: medical (familial and personal) history, physical evaluation, imaging tool, second level laboratory tests, disease activity measurement and extrarticular manifestations. After performing PsA diagnosis, identification of specific disease activity scores and clinimetric approaches were suggested for assessing the different clinical subsets. Further, results showed the need for investigation on the presence of several EAMs and risk factors. In the context of any area, a rank was assigned for each item by Expert Committee members, in order to create the logical sequence of the algorithm. The final list of recommended diagnosis and assessment procedures, by the Delphi survey and the two National Expert Meetings, was also reported as an algorithm. This study shows results obtained by the combination of a DElphi survey of a group of Italian rheumatologists and two National Expert Meetings, created with the aim of establishing a clinical procedure and algorithm for the diagnosis and the assessment of PsA patients. In order to find accurate and practical diagnostic and assessment items in clinical practice, we have focused our attention on evaluating the different PsA domains. Hence, we conceived the IDEA algorithm in order to address PsA diagnosis and assessment in the context of daily clinical practice. The IDEA algorithm might eventually lead to a multidimensional approach and could represent a useful and practical tool for addressing diagnosis and for assessing the disease appropriately. However, the elaborated algorithm needs to be further investigated in daily practice, for evidencing and proving its eventual efficacy in detecting and staging PsA and its heterogeneous spectrum appropriately.

Improving Patient Safety in Public Hospitals: Developing Standard Measures to Track Medical Errors and Process Breakdowns.

PubMed

Ackerman, Sara L; Gourley, Gato; Le, Gem; Williams, Pamela; Yazdany, Jinoos; Sarkar, Urmimala

2018-03-14

The aim of the study was to develop standards for tracking patient safety gaps in ambulatory care in safety net health systems. Leaders from five California safety net health systems were invited to participate in a modified Delphi process sponsored by the Safety Promotion Action Research and Knowledge Network (SPARKNet) and the California Safety Net Institute in 2016. During each of the three Delphi rounds, the feasibility and validity of 13 proposed patient safety measures were discussed and prioritized. Surveys and transcripts from the meetings were analyzed to understand the decision-making process. The Delphi process included eight panelists. Consensus was reached to adopt 9 of 13 proposed measures. All 9 measures were unanimously considered valid, but concern was expressed about the feasibility of implementing several of the measures. Although safety net health systems face high barriers to standardized measurement, our study demonstrates that consensus can be reached on acceptable and feasible methods for tracking patient safety gaps in safety net health systems. If accompanied by the active participation key stakeholder groups, including patients, clinicians, staff, data system professionals, and health system leaders, the consensus measures reported here represent one step toward improving ambulatory patient safety in safety net health systems.

How to Choose? Using the Delphi Method to Develop Consensus Triggers and Indicators for Disaster Response.

PubMed

Lis, Rebecca; Sakata, Vicki; Lien, Onora

2017-08-01

To identify key decisions along the continuum of care (conventional, contingency, and crisis) and the critical triggers and data elements used to inform those decisions concerning public health and health care response during an emergency. A classic Delphi method, a consensus-building survey technique, was used with clinicians around Washington State to identify regional triggers and indicators. Additionally, using a modified Delphi method, we combined a workshop and single-round survey with panelists from public health (state and local) and health care coalitions to identify consensus state-level triggers and indicators. In the clinical survey, 122 of 223 proposed triggers or indicators (43.7%) reached consensus and were deemed important in regional decision-making during a disaster. In the state-level survey, 110 of 140 proposed triggers or indicators (78.6%) reached consensus and were deemed important in state-level decision-making during a disaster. The identification of consensus triggers and indicators for health care emergency response is crucial in supporting a comprehensive health care situational awareness process. This can inform the creation of standardized questions to ask health care, public health, and other partners to support decision-making during a response. (Disaster Med Public Health Preparedness. 2017;11:467-472).

Strategy Formulation in Small Enterprises: A Developmental Approach.

ERIC Educational Resources Information Center

Paton, Robert; Brownlie, Douglas

1991-01-01

The Small Company European Analysis Technique is a diagnostic tool that small businesses can use to analyze market opportunities in preparation for 1992. The approach uses small group consensus building as in the Delphi technique and brainstorming to formulate a strategic plan. (SK)

USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

PubMed

Vantamay, Nottakrit

2015-09-01

This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth.

Highly efficient and exact method for parallelization of grid-based algorithms and its implementation in DelPhi

PubMed Central

Li, Chuan; Li, Lin; Zhang, Jie; Alexov, Emil

2012-01-01

The Gauss-Seidel method is a standard iterative numerical method widely used to solve a system of equations and, in general, is more efficient comparing to other iterative methods, such as the Jacobi method. However, standard implementation of the Gauss-Seidel method restricts its utilization in parallel computing due to its requirement of using updated neighboring values (i.e., in current iteration) as soon as they are available. Here we report an efficient and exact (not requiring assumptions) method to parallelize iterations and to reduce the computational time as a linear/nearly linear function of the number of CPUs. In contrast to other existing solutions, our method does not require any assumptions and is equally applicable for solving linear and nonlinear equations. This approach is implemented in the DelPhi program, which is a finite difference Poisson-Boltzmann equation solver to model electrostatics in molecular biology. This development makes the iterative procedure on obtaining the electrostatic potential distribution in the parallelized DelPhi several folds faster than that in the serial code. Further we demonstrate the advantages of the new parallelized DelPhi by computing the electrostatic potential and the corresponding energies of large supramolecular structures. PMID:22674480

Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings

PubMed Central

Anderson, Deverick J.; Cochran, Ronda L.; Hicks, Lauri A.; Srinivasan, Arjun; Dodds Ashley, Elizabeth S.

2017-01-01

Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated >6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated >6 in all criteria except feasibility were identified as targets for future development. PMID:27927866

Validation of the new diagnosis grouping system for pediatric emergency department visits using the International Classification of Diseases, 10th Revision.

PubMed

Lee, Jin Hee; Hong, Ki Jeong; Kim, Do Kyun; Kwak, Young Ho; Jang, Hye Young; Kim, Hahn Bom; Noh, Hyun; Park, Jungho; Song, Bongkyu; Jung, Jae Yun

2013-12-01

A clinically sensible diagnosis grouping system (DGS) is needed for describing pediatric emergency diagnoses for research, medical resource preparedness, and making national policy for pediatric emergency medical care. The Pediatric Emergency Care Applied Research Network (PECARN) developed the DGS successfully. We developed the modified PECARN DGS based on the different pediatric population of South Korea and validated the system to obtain the accurate and comparable epidemiologic data of pediatric emergent conditions of the selected population. The data source used to develop and validate the modified PECARN DGS was the National Emergency Department Information System of South Korea, which was coded by the International Classification of Diseases, 10th Revision (ICD-10) code system. To develop the modified DGS based on ICD-10 code, we matched the selected ICD-10 codes with those of the PECARN DGS by the General Equivalence Mappings (GEMs). After converting ICD-10 codes to ICD-9 codes by GEMs, we matched ICD-9 codes into PECARN DGS categories using the matrix developed by PECARN group. Lastly, we conducted the expert panel survey using Delphi method for the remaining diagnosis codes that were not matched. A total of 1879 ICD-10 codes were used in development of the modified DGS. After 1078 (57.4%) of 1879 ICD-10 codes were assigned to the modified DGS by GEM and PECARN conversion tools, investigators assigned each of the remaining 801 codes (42.6%) to DGS subgroups by 2 rounds of electronic Delphi surveys. And we assigned the remaining 29 codes (4%) into the modified DGS at the second expert consensus meeting. The modified DGS accounts for 98.7% and 95.2% of diagnoses of the 2008 and 2009 National Emergency Department Information System data set. This modified DGS also exhibited strong construct validity using the concepts of age, sex, site of care, and seasons. This also reflected the 2009 outbreak of H1N1 influenza in Korea. We developed and validated clinically feasible and sensible DGS system for describing pediatric emergent conditions in Korea. The modified PECARN DGS showed good comprehensiveness and demonstrated reliable construct validity. This modified DGS based on PECARN DGS framework may be effectively implemented for research, reporting, and resource planning in pediatric emergency system of South Korea.

Building Face, Construct, and Content Validity through Use of a Modified Delphi: Adapting Grounded Theory to Build an Environmental Field Days Observation Tool

ERIC Educational Resources Information Center

Heimlich, Joe E.; Carlson, Stephan P.; Storksdieck, Martin

2011-01-01

Environmental field days offer a distinct opportunity to connect students with science and the environment. The literature on field days, informed by research on field trips, provides a framework for best practices. If there are best practices, however, then presence or lack of the practice should have a discernible impact on the outcomes of the…

Developing a Physiotherapy-Specific Preliminary Clinical Decision-Making Tool for Oxygen Titration: A Modified Delphi Study

PubMed Central

Duong, Michelle; Bertin, Kendra; Henry, Renee; Singh, Deepti; Timmins, Nolla; Brooks, Dina; Mathur, Sunita

2014-01-01

ABSTRACT Purpose: To develop and evaluate a preliminary clinical decision-making tool (CDMT) to assist physiotherapists in titrating oxygen for acutely ill adults in Ontario. Methods: A panel of 14 experienced cardiorespiratory physiotherapists was recruited. Factors relating to oxygen titration were identified using a modified Delphi technique. Four rounds of questionnaires were conducted, during which the goals were to (1) generate factors, (2) reduce factors and debate contentious factors, (3) finalize factors and develop the preliminary CDMT, and (4) evaluate the usability of the tool in a clinical context. Results: The panel reached consensus on a total of 89 factors, which were compiled to create the preliminary CDMT. The global tool reached consensus for sensibility, receiving a mean score of 6/7 on a 7-point Likert-type scale (1=unacceptable; 7=excellent). Five of the nine individual components of evaluation of the tool achieved scores ≥6.0; the remaining four had mean scores between 5.4 and 5.9. Conclusion: This study produced a preliminary CDMT for oxygen titration, which the panel agreed was highly comprehensible and globally sensible. Further research is necessary to evaluate the sensibility and applicability of the tool in a clinical setting. PMID:25125782

The competencies of Registered Nurses working in care homes: a modified Delphi study.

PubMed

Stanyon, Miriam Ruth; Goldberg, Sarah Elizabeth; Astle, Anita; Griffiths, Amanda; Gordon, Adam Lee

2017-07-01

registered Nurses (RNs) working in UK care homes receive most of their training in acute hospitals. At present the role of care home nursing is underdeveloped and it is seen as a low status career. We describe here research to define core competencies for RNs working in UK care homes. a two-stage process was adopted. A systematic literature review and focus groups with stakeholders provided an initial list of competencies. The competency list was modified over three rounds of a Delphi process with a multi-disciplinary expert panel of 28 members. twenty-two competencies entered the consensus process, all competencies were amended and six split. Thirty-one competencies were scored in round two, eight were agreed as essential, one competency was split into two. Twenty-four competencies were submitted for scoring in round three. In total, 22 competencies were agreed as essential for RNs working in care homes. A further 10 competencies did not reach consensus. the output of this study is an expert-consensus list of competencies for RNs working in care homes. This would be a firm basis on which to build a curriculum for this staff group. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

Quality indicators for blogs and podcasts used in medical education: modified Delphi consensus recommendations by an international cohort of health professions educators.

PubMed

Lin, Michelle; Thoma, Brent; Trueger, N Seth; Ankel, Felix; Sherbino, Jonathan; Chan, Teresa

2015-10-01

Quality assurance concerns about social media platforms used for education have arisen within the medical education community. As more trainees and clinicians use resources such as blogs and podcasts for learning, we aimed to identify quality indicators for these resources. A previous study identified 151 potentially relevant quality indicators for these social media resources. To identify quality markers for blogs and podcasts using an international cohort of health professions educators. A self-selected group of 44 health professions educators at the 2014 International Conference on Residency Education participated in a Social Media Summit during which a modified Delphi consensus study was conducted to determine which of the 151 quality indicators met the a priori ≥90% inclusion threshold. Thirteen quality indicators classified into the domains of credibility (n=8), content (n=4) and design (n=1) met the inclusion threshold. The quality indicators that were identified may serve as a foundation for further research on quality indicators of social media-based medical education resources and prompt discussion of their legitimacy as a form of educational scholarship. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Quality indicators for the detection and management of chronic kidney disease in primary care in Canada derived from a modified Delphi panel approach.

PubMed

Tu, Karen; Bevan, Lindsay; Hunter, Katie; Rogers, Jess; Young, Jacqueline; Nesrallah, Gihad

2017-01-01

The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist). Indicators identified from peer-reviewed and grey literature sources were subjected to 3 rounds of voting to develop a set of quality indicators for the detection and management of chronic kidney disease in the primary care setting. The final indicators were applied to primary care electronic medical records in the Electronic Medical Record Administrative data Linked Database (EMRALD) to assess the current state of primary care detection and management of chronic kidney disease in Ontario. Seventeen indicators made up the final list, with 1 under the category Prevalence, Incidence and Mortality; 4 under Screening, Diagnosis and Risk Factors; 11 under Management; and 1 under Referral to a Specialist. In a sample of 139 993 adult patients not on dialysis, 6848 (4.9%) had stage 3 or higher chronic kidney disease, with the average age of patients being 76.1 years (standard deviation [SD] 11.0); 62.9% of patients were female. Diagnosis and screening for chronic kidney disease were poorly performed. Only 27.1% of patients with stage 3 or higher disease had their diagnosis documented in their cumulative patient profile. Albumin-creatinine ratio testing was only performed for 16.3% of patients with a low estimated glomerular filtration rate (eGFR) and for 28.5% of patients with risk factors for chronic kidney disease. Family physicians performed relatively better with the management of chronic kidney disease, with 90.4% of patients with stage 3 or higher disease having an eGFR performed in the previous 18 months and 83.1% having a blood pressure recorded in the previous 9 months. We propose a set of measurable indicators to evaluate the quality of the management of chronic kidney disease in primary care. These indicators may be used to identify opportunities to improve current practice in Canada.

75 FR 28655 - Delphi Packard Electrical/Electronic Architecture, a Subsidiary of Delphi Corporation, Including...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

.../Electronic Architecture, a Subsidiary of Delphi Corporation, Including On-Site Leased Workers From Bartech... Assistance on December 8, 2009, applicable to workers of Delphi Packard Electrical/Electronic Architecture, a.../Electronic Architecture, a subsidiary of Delphi Corporation, including on-site leased [[Page 28656

Cross-cultural adaptation of the delphi definitions of low back pain prevalence (German DOLBaPP).

PubMed

Leonhardt, Marja; Liebers, Falk; Dionne, Clermont E; Latza, Ute

2014-11-25

Assessed dimensions of low back pain (LBP) vary in prevalence studies. This may explain the heterogeneity in frequency estimates. To standardize definitions of LBP, an English consensus with 28 experts from 12 countries developed the "Delphi Definitions of Low Back Pain Prevalence" (DOLBaPP). The optimal definition and the shorter minimal definition with the related questionnaires for online, paper, and face-to-face use and telephone surveys are suitable for population-based studies. The definitions have to be adapted to different languages and cultures to provide comparable frequency estimates. The objective was to culturally adapt and pre-test the English definitions and corresponding Delphi DOLBaPP questionnaire forms into German. The German DOLBaPP adaptation was conducted using the systematic approach suggested by Beaton et al. A pre-test of the Delphi DOLBaPP optimal paper questionnaire including an additional evaluation form was conducted in a sample of 121 employees (mainly office workers). In order to evaluate the comprehensibility, usability, applicability, and completeness of the adapted questionnaire, response to the questionnaire and 6 closed evaluation questions were analyzed descriptively. Qualitative methods were used for the 3 open questions of the evaluation form. The cultural adaptation of the DOLBaPP for a German-speaking audience required little linguistic adaptation. Conceptual equivalence was difficult for the expression "low back pain". The expert committee considered the face validity of the pre-final version of the related Delphi DOLBaPP questionnaires as good. In the pre-test, most participants (95%) needed less than 5 minutes to fill in the optimal Delphi DOLBaPP questionnaire. They were generally positive regarding length, wording, diagram, and composition. All subjects with LBP (n=61 out of 121 - 50.4%) answered the questions on functional limitation, sciatic pain, frequency and duration of symptoms as well as pain severity. The results indicate that the cross-cultural German adaptation of the DOLBaPP Definitions and the corresponding questionnaires was successful. The definitions can be used in epidemiological studies to measure the prevalence of LBP. Some critical issues were raised regarding the general features of the Delphi DOLBaPP questionnaires. Future research is needed to evaluate these instruments.

Threshold Concepts in Entrepreneurship--The Entrepreneurs' Perspective

ERIC Educational Resources Information Center

Hatt, Lucy

2018-01-01

Purpose: The purpose of this paper is to present research into the entrepreneurs' perspective of concepts critical to thinking as an entrepreneur, in order to inform enterprise and entrepreneurship course design in higher education. Design/methodology/approach: Taking a social constructivist approach, using a Delphi-style method, semi-structured…

A core outcome set for evaluating self-management interventions in people with comorbid diabetes and severe mental illness: study protocol for a modified Delphi study and systematic review.

PubMed

Taylor, Johanna; Böhnke, Jan R; Wright, Judy; Kellar, Ian; Alderson, Sarah L; Hughes, Tom; Holt, Richard I G; Siddiqi, Najma

2017-02-14

People with diabetes and comorbid severe mental illness (SMI) form a growing population at risk of increased mortality and morbidity compared to those with diabetes or SMI alone. There is increasing interest in interventions that target diabetes in SMI in order to help to improve physical health and reduce the associated health inequalities. However, there is a lack of consensus about which outcomes are important for this comorbid population, with trials differing in their focus on physical and mental health. A core outcome set, which includes outcomes across both conditions that are relevant to patients and other key stakeholders, is needed. This study protocol describes methods to develop a core outcome set for use in effectiveness trials of self-management interventions for adults with comorbid type-2 diabetes and SMI. We will use a modified Delphi method to identify, rank, and agree core outcomes. This will comprise a two-round online survey and multistakeholder workshops involving patients and carers, health and social care professionals, health care commissioners, and other experts (e.g. academic researchers and third sector organisations). We will also select appropriate measurement tools for each outcome in the proposed core set and identify gaps in measures, where these exist. The proposed core outcome set will provide clear guidance about what outcomes should be measured, as a minimum, in trials of interventions for people with coexisting type-2 diabetes and SMI, and improve future synthesis of trial evidence in this area. We will also explore the challenges of using online Delphi methods for this hard-to-reach population, and examine differences in opinion about which outcomes matter to diverse stakeholder groups. COMET registration: http://www.comet-initiative.org/studies/details/911 . Registered on 1 July 2016.

Evaluation of the Walking Index for Spinal Cord Injury II (WISCI-II) in children with Spinal Cord Injury (SCI).

PubMed

Calhoun Thielen, C; Sadowsky, C; Vogel, L C; Taylor, H; Davidson, L; Bultman, J; Gaughan, J; Mulcahey, M J

2017-05-01

Mixed methods were used in this study. The appropriateness of the levels of the Walking Index for Spinal Cord Injury II (WISCI-II) for application in children was critically reviewed by physical therapists using the Modified Delphi Technique, and the inter- and intra-rater reliability of the WISCI-II in children was evaluated. To examine the construct validity, and to establish reliability of the WISCI-II related to its use in children with spinal cord injury (SCI). United States of America. Using a Modified Delphi Technique, physical therapists critically reviewed the WISCI-II levels for pediatric utilization. Concurrently, ambulatory children under age 18 years with SCI were evaluated using the WISCI-II on two occasions by the same therapist to establish intra-rater reliability. One trial was photographed and de-identified. Each photograph was reviewed by four different physical therapists who gave WISCI-II scores to establish inter-rater reliability. Summary and descriptive statistics were used to calculate the frequency of yes/no responses for each WISCI-II level question and to determine the percent agreement for each question. Inter- and intra-rater reliability was calculated using interclass correlation coefficients (ICCs) with 95% confidence intervals (CI). Construct validity was confirmed after one Delphi round during which at least 80% agreement was established by 51 physical therapists on the appropriateness of the WISCI-II levels for children. Fifty-two children with SCI aged 2-17 years completed repeated WISCI-II assessments and 40 de-identified photographs were scored by four physical therapists. Intra- and inter-rater reliability was high (ICC=0.997, CI=0.995-0.998 and ICC=0.97, CI=0.95-0.98, respectively). This study demonstrates support for the use of the WISCI-II in ambulatory children with SCI. This study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI).

Economic instruments for obesity prevention: results of a scoping review and modified Delphi survey.

PubMed

Faulkner, Guy E J; Grootendorst, Paul; Nguyen, Van Hai; Andreyeva, Tatiana; Arbour-Nicitopoulos, Kelly; Auld, M Christopher; Cash, Sean B; Cawley, John; Donnelly, Peter; Drewnowski, Adam; Dubé, Laurette; Ferrence, Roberta; Janssen, Ian; Lafrance, Jeffrey; Lakdawalla, Darius; Mendelsen, Rena; Powell, Lisa M; Traill, W Bruce; Windmeijer, Frank

2011-10-06

Comprehensive, multi-level approaches are required to address obesity. One important target for intervention is the economic domain. The purpose of this study was to synthesize existing evidence regarding the impact of economic policies targeting obesity and its causal behaviours (diet, physical activity), and to make specific recommendations for the Canadian context. Arksey and O'Malley's (2005) methodological framework for conducting scoping reviews was adopted for this study and this consisted of two phases: 1) a structured literature search and review, and 2) consultation with experts in the research field through a Delphi survey and an in-person expert panel meeting in April 2010. Two key findings from the scoping review included 1) consistent evidence that weight outcomes are responsive to food and beverage prices. The debate on the use of food taxes and subsidies to address obesity should now shift to how best to address practical issues in designing such policies; and 2) very few studies have examined the impact of economic instruments to promote physical activity and clear policy recommendations cannot be made at this time. Delphi survey findings emphasised the relatively modest impact any specific economic instrument would have on obesity independently. Based on empirical evidence and expert opinion, three recommendations were supported. First, to create and implement an effective health filter to review new and current agricultural polices to reduce the possibility that such policies have a deleterious impact on population rates of obesity. Second, to implement a caloric sweetened beverage tax. Third, to examine how to implement fruit and vegetable subsidies targeted at children and low income households. In terms of economic interventions, shifting from empirical evidence to policy recommendation remains challenging. Overall, the evidence is not sufficiently strong to provide clear policy direction. Additionally, the nature of the experiments needed to provide definitive evidence supporting certain policy directions is likely to be complex and potentially unfeasible. However, these are not reasons to take no action. It is likely that policies need to be implemented in the face of an incomplete evidence base.

Exploring academics' views on designs, methods, characteristics and outcomes of inclusive health research with people with intellectual disabilities: a modified Delphi study.

PubMed

Frankena, T K; Naaldenberg, J; Cardol, M; Meijering, J V; Leusink, G; van Schrojenstein Lantman-de Valk, H M J

2016-08-18

The British Medical Journal's (BMJ's) patient revolution strives for collaboration with patients in healthcare and health research. This paper studies collaboration with people with intellectual disabilities (ID) in health research, also known as inclusive health research. Currently, transparency and agreement among academics is lacking regarding its main aspects, preventing upscaling of the patient revolution. This study aims to gain agreement among academics on 3 aspects of inclusive health research for people with ID: (1) designs and methods, (2) most important characteristics and (3) outcomes. A Delphi study was conducted with academics with experience in inclusive (health) research and on people with ID. The study consisted of 2 sequential questionnaire rounds (n=24; n=17), followed by in-depth interviews (n=10). Academics agreed on (1) a collaborative approach to be most suitable to inclusive health research, (2) characteristics regarding the accessibility and facilitation of inclusive health research, and (3) several outcomes of inclusive health research for people with ID and healthcare. Other characteristics agreed on included: atmosphere, relationship, engagement, partnership and power. It was stressed that these characteristics ensure meaningful inclusion. Interviewed academics voiced the need for a tool supporting the facilitation and evaluation of inclusive health research. There was ambiguity as to what this tool should comprise and the extent to which it was possible to capture the complex process of inclusive health research. This study underlines the need for transparency, facilitation and evaluation of inclusive health research. The need for in-depth interviews after 2 Delphi rounds underlines its complexity and context dependence. To increase process transparency, future research should focus on gaining insight into inclusive health research in its context. A tool could be developed to facilitate and evaluate inclusive health research. This tool will be partially applicable to participatory research in general and thereby upscale the patient revolution. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Economic instruments for obesity prevention: results of a scoping review and modified delphi survey

PubMed Central

2011-01-01

Background Comprehensive, multi-level approaches are required to address obesity. One important target for intervention is the economic domain. The purpose of this study was to synthesize existing evidence regarding the impact of economic policies targeting obesity and its causal behaviours (diet, physical activity), and to make specific recommendations for the Canadian context. Methods Arksey and O'Malley's (2005) methodological framework for conducting scoping reviews was adopted for this study and this consisted of two phases: 1) a structured literature search and review, and 2) consultation with experts in the research field through a Delphi survey and an in-person expert panel meeting in April 2010. Results Two key findings from the scoping review included 1) consistent evidence that weight outcomes are responsive to food and beverage prices. The debate on the use of food taxes and subsidies to address obesity should now shift to how best to address practical issues in designing such policies; and 2) very few studies have examined the impact of economic instruments to promote physical activity and clear policy recommendations cannot be made at this time. Delphi survey findings emphasised the relatively modest impact any specific economic instrument would have on obesity independently. Based on empirical evidence and expert opinion, three recommendations were supported. First, to create and implement an effective health filter to review new and current agricultural polices to reduce the possibility that such policies have a deleterious impact on population rates of obesity. Second, to implement a caloric sweetened beverage tax. Third, to examine how to implement fruit and vegetable subsidies targeted at children and low income households. Conclusions In terms of economic interventions, shifting from empirical evidence to policy recommendation remains challenging. Overall, the evidence is not sufficiently strong to provide clear policy direction. Additionally, the nature of the experiments needed to provide definitive evidence supporting certain policy directions is likely to be complex and potentially unfeasible. However, these are not reasons to take no action. It is likely that policies need to be implemented in the face of an incomplete evidence base. PMID:21978599

Practical Considerations for Conducting Delphi Studies: The Oracle Enters a New Age.

ERIC Educational Resources Information Center

Eggers, Renee M.; Jones, Charles M.

1998-01-01

In addition to giving an overview of Delphi methodology and describing the methodology used by the researchers in two Delphi studies, the authors provide information about electronic communication in Delphi studies. Also provided are suggestions that can be used in a Delphi study involving any form of communication. (SLD)

ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association.

PubMed

Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M; Patel, Manesh R; Raskin, Ira E; Hendel, Robert C; Bateman, Timothy M; Cerqueira, Manuel D; Gibbons, Raymond J; Gillam, Linda D; Gillespie, John A; Hendel, Robert C; Iskandrian, Ami E; Jerome, Scott D; Krumholz, Harlan M; Messer, Joseph V; Spertus, John A; Stowers, Stephen A

2005-10-18

Under the auspices of the American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC), an appropriateness review was conducted for radionuclide cardiovascular imaging (RNI), specifically gated single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI). The review assessed the risks and benefits of the imaging test for several indications or clinical scenarios and scored them based on a scale of 1 to 9, where the upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The mid range (4 to 6) implies that the test may be generally acceptable and may be a reasonable approach for the indication. The indications for this review were primarily drawn from existing clinical practice guidelines and modified based on discussion by the ACCF Appropriateness Criteria Working Group and the Technical Panel members who rated the indications. The method for this review was based on the RAND/UCLA approach for evaluating appropriateness, which blends scientific evidence and practice experience. A modified Delphi technique was used to obtain first- and second-round ratings of 52 clinical indications. The ratings were done by a Technical Panel with diverse membership, including nuclear cardiologists, referring physicians (including an echocardiographer), health services researchers, and a payer (chief medical officer). These results are expected to have a significant impact on physician decision making and performance, reimbursement policy, and future research directions. Periodic assessment and updating of criteria will be undertaken as needed.

Metadata-driven Delphi rating on the Internet.

PubMed

Deshpande, Aniruddha M; Shiffman, Richard N; Nadkarni, Prakash M

2005-01-01

Paper-based data collection and analysis for consensus development is inefficient and error-prone. Computerized techniques that could improve efficiency, however, have been criticized as costly, inconvenient and difficult to use. We designed and implemented a metadata-driven Web-based Delphi rating and analysis tool, employing the flexible entity-attribute-value schema to create generic, reusable software. The software can be applied to various domains by altering the metadata; the programming code remains intact. This approach greatly reduces the marginal cost of re-using the software. We implemented our software to prepare for the Conference on Guidelines Standardization. Twenty-three invited experts completed the first round of the Delphi rating on the Web. For each participant, the software generated individualized reports that described the median rating and the disagreement index (calculated from the Interpercentile Range Adjusted for Symmetry) as defined by the RAND/UCLA Appropriateness Method. We evaluated the software with a satisfaction survey using a five-level Likert scale. The panelists felt that Web data entry was convenient (median 4, interquartile range [IQR] 4.0-5.0), acceptable (median 4.5, IQR 4.0-5.0) and easily accessible (median 5, IQR 4.0-5.0). We conclude that Web-based Delphi rating for consensus development is a convenient and acceptable alternative to the traditional paper-based method.

Paratonia: a Delphi procedure for consensus definition.

PubMed

Hobbelen, Johannes S M; Koopmans, Raymond T C M; Verhey, Frans R J; Van Peppen, Roland P S; de Bie, Rob A

2006-01-01

Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia. The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia. Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon. The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.

Identifying the features of an exercise addiction: A Delphi study

PubMed Central

Macfarlane, Lucy; Owens, Glynn; Cruz, Borja del Pozo

2016-01-01

Objectives There remains limited consensus regarding the definition and conceptual basis of exercise addiction. An understanding of the factors motivating maintenance of addictive exercise behavior is important for appropriately targeting intervention. The aims of this study were twofold: first, to establish consensus on features of an exercise addiction using Delphi methodology and second, to identify whether these features are congruous with a conceptual model of exercise addiction adapted from the Work Craving Model. Methods A three-round Delphi process explored the views of participants regarding the features of an exercise addiction. The participants were selected from sport and exercise relevant domains, including physicians, physiotherapists, coaches, trainers, and athletes. Suggestions meeting consensus were considered with regard to the proposed conceptual model. Results and discussion Sixty-three items reached consensus. There was concordance of opinion that exercising excessively is an addiction, and therefore it was appropriate to consider the suggestions in light of the addiction-based conceptual model. Statements reaching consensus were consistent with all three components of the model: learned (negative perfectionism), behavioral (obsessive–compulsive drive), and hedonic (self-worth compensation and reduction of negative affect and withdrawal). Conclusions Delphi methodology allowed consensus to be reached regarding the features of an exercise addiction, and these features were consistent with our hypothesized conceptual model of exercise addiction. This study is the first to have applied Delphi methodology to the exercise addiction field, and therefore introduces a novel approach to exercise addiction research that can be used as a template to stimulate future examination using this technique. PMID:27554504

Frontline over ivory tower: key competencies in community-based curricula.

PubMed

Millar, Adam; Malcolm, Janine; Cheng, Alice; Fine, Rebecca; Wong, Rene

2015-01-01

The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties. Presently there is wide variability in community endocrine experiences across Canadian training programs. This is complicated by the paucity of literature providing guidance on what constitutes a 'community' rotation. A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round. The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates. Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum. The experts considered the "Manager" role best taught in the community, while they considered the community least suitable to learn the "Medical Expert" competency. To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada. These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role. The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs.

[Handover between home and respite care facilities : Delphi survey within the context of continuity of care for people with dementia].

PubMed

Kuske, S; Roes, M; Bartholomeyczik, S

2016-07-01

Criteria for the handover between healthcare settings were identified based on a review and on results of empirical data. This study was carried out to select the most relevant criteria for defining the quality of continuity of care of people with dementia (PwD) in the context of the handover between care at home and respite care facilities. A modified classical two-step Delphi design was used in combination with a group Delphi design. A total of 28 core criteria with a consensus strength of > 60 % are presented. Safety-relevant information, especially the personal habits of PwD and the role of informal caregivers in the handover between care settings are important. Furthermore, the following general principles to ensure the quality of continuity of the care of PwD were deduced: completeness, verification, multipath communication, timeliness and topicality, accessibility and defined responsibilities, roles and standardization. A successful transition of PwD to respite care facilities relies on the provision of relevant information, considering personal habits, before the day of transition. Furthermore, a timely preparation for discharge is important. The individual needs of the informal caregivers with regard to their support should be considered. Professionals who are responsible in handover processes should have solid communication competence in order to collect relevant information from informal caregivers, who have a strong individual care experience with the PwD.

Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study

PubMed Central

Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie

2015-01-01

Objectives To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. Methods A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. Results In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Conclusions Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. PMID:24670554

Defining Malaysian Knowledge Society: Results from the Delphi Technique

NASA Astrophysics Data System (ADS)

Hamid, Norsiah Abdul; Zaman, Halimah Badioze

This paper outlines the findings of research where the central idea is to define the term Knowledge Society (KS) in Malaysian context. The research focuses on three important dimensions, namely knowledge, ICT and human capital. This study adopts a modified Delphi technique to seek the important dimensions that can contribute to the development of Malaysian's KS. The Delphi technique involved ten experts in a five-round iterative and controlled feedback procedure to obtain consensus on the important dimensions and to verify the proposed definition of KS. The finding shows that all three dimensions proposed initially scored high and moderate consensus. Round One (R1) proposed an initial definition of KS and required comments and inputs from the panel. These inputs were then used to develop items for a R2 questionnaire. In R2, 56 out of 73 items scored high consensus and in R3, 63 out of 90 items scored high. R4 was conducted to re-rate the new items, in which 8 out of 17 items scored high. Other items scored moderate consensus and no item scored low or no consensus in all rounds. The final round (R5) was employed to verify the final definition of KS. Findings and discovery of this study are significant to the definition of KS and the development of a framework in the Malaysian context.

Development of quality indicators to evaluate antibiotic treatment of patients with community-acquired pneumonia in Indonesia.

PubMed

Farida, Helmia; Rondags, Angelique; Gasem, M Hussein; Leong, Katharina; Adityana, A; van den Broek, Peterhans J; Keuter, Monique; Natsch, Stephanie

2015-04-01

To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia (CAP) applicable in a middle-income developing country. A previous study and Indonesian guidelines were reviewed to derive potential quality of care indicators (QIs). An expert panel performed a two-round Delphi consensus procedure on the QI's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in Semarang, Indonesia. Fifteen QIs were selected by the consensus procedure. Five QIs did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QIs provided minor opportunity for improvement. Two QIs contradicted each other; one of these was considered not valid and excluded. A final set of six QIs was defined for use in the Indonesian setting. Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting. © 2014 John Wiley & Sons Ltd.

Medication dispensing errors in Palestinian community pharmacy practice: a formal consensus using the Delphi technique.

PubMed

Shawahna, Ramzi; Haddad, Aseel; Khawaja, Baraa; Raie, Rand; Zaneen, Sireen; Edais, Tasneem

2016-10-01

Background Medication dispensing errors (MDEs) are frequent in community pharmacy practice. A definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice were not previously approached using formal consensus techniques. Objective This study was conducted to achieve consensus on a definition of MDEs and a wide range of scenarios that should or should not be considered as MDEs in Palestinian community pharmacy practice by a panel of community pharmacists. Setting Community pharmacy practice in Palestine. Method This was a descriptive study using the Delphi technique. A panel of fifty community pharmacists was recruited from different geographical locations of the West Bank of Palestine. A three round Delphi technique was followed to achieve consensus on a proposed definition of MDEs and 83 different scenarios representing potential MDEs using a nine-point scale. Main outcome measure Agreement or disagreement of a panel of community pharmacists on a proposed definition of MDEs and a series of scenarios representing potential MDEs. Results In the first Delphi round, views of key contact community pharmacists on MDEs were explored and situations representing potential MDEs were collected. In the second Delphi round, consensus was achieved to accept the proposed definition and to include 49 (59 %) of the 83 proposed scenarios as MDEs. In the third Delphi round, consensus was achieved to include further 13 (15.7 %) scenarios as MDEs, exclude 9 (10.8 %) scenarios and the rest of 12 (14.5 %) scenarios were considered equivocal based on the opinions of the panelists. Conclusion Consensus on a definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice was achieved using a formal consensus technique. The use of consensual definitions and scenarios representing MDE situations in community pharmacy practice might minimize methodological variations and their significant effects on the number and rate of MDEs reported in different studies.

Web-based dynamic Delphi: a new survey instrument

NASA Astrophysics Data System (ADS)

Yao, JingTao; Liu, Wei-Ning

2006-04-01

We present a mathematical model for a dynamic Delphi survey method which takes advantages of Web technology. A comparative study on the performance of the conventional Delphi method and the dynamic Delphi instrument is conducted. It is suggested that a dynamic Delphi survey may form a consensus quickly. However, the result may not be robust due to the judgement leaking issues.

Defining palliative care in cystic fibrosis: A Delphi study.

PubMed

Dellon, E P; Goggin, J; Chen, E; Sabadosa, K; Hempstead, S E; Faro, A; Homa, K

2018-05-01

The goal of palliative care is to improve quality of life for people with serious illness. We aimed to create a cystic fibrosis (CF)-specific definition of palliative care. A working group of 36 CF care providers, researchers, palliative care providers, quality improvement experts, individuals with CF, and CF caregivers completed a series of questionnaires to rate the value of each of 22 attributes of palliative care, rank top attributes to construct definitions of palliative care, and then rate proposed definitions. An average of 28 participants completed each of four questionnaires, with consistent distribution of stakeholder roles across questionnaires. Many identified overlaps in routine CF care and palliative care and highlighted the importance of a definition that feels relevant across the lifespan. Modified Delphi methodology was used to define palliative care in CF. The definition will be used as the foundation for development of CF-specific palliative care guidelines. Copyright © 2017 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium.

PubMed

Helsloot, Kaat; Walraevens, Mieke; Besauw, Saskia Van; Van Parys, An-Sofie; Devos, Hanne; Holsbeeck, Ann Van; Roelens, Kristien

2017-05-01

to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Creating a Knowledge Base for Management of Southern Bottomland Hardwood Ecosystems

Treesearch

John C. Bliss; Stephen B. Jones; John A. Stanturf; Christine M. Hamner

1997-01-01

We describe an interdisciplinary approach to forecasting potential impacts of even-aged and uneven-aged silvicultural treatments upon bottomland hardwood ecosystems in the Southern United States. Our approach involves identifying scientists with expertise in key disciplines: utilizing the Delphi technique to develop consensus among these scientists on important system...

Development of an evidence-based protocol for care of pilonidal sinus wounds healing by secondary intent using a modified reactive Delphi procedure. Part one: the literature review*.

PubMed

Harris, Connie L; Holloway, Samantha

2012-04-01

This article is in two parts. The overall aim of this section was to review the literature in relation to pilonidal sinus wounds (PSW) healing by secondary intent for a Master's of Science in Wound Healing and Tissue Repair thesis. The purpose of the literature review was to determine if an evidence-based guideline or consensus document existed for the care of these wounds, and if not, to determine the topics from which to develop items for the first round of a modified reactive Delphi questionnaire. Part two will describe the iterative process, the analysis and the results. The review found no best practice guidelines concerning PSW, and only one clinical pathway. Seventeen areas of interest were identified that may contribute to optimal healing conditions or to delayed healing. These included microbiology of infected PSW, signs and symptoms of localised or deeper (spreading) chronic wound infection, swab for c&s, role of topical antiseptics or antimicrobials, systemic antibiotics, local wound interventions, optimal positioning, wound cleansing, principles of moist wound healing/dressing selection, topical negative pressure (TNP) therapy, peri-wound skin decontamination and depilation, pain control, physical activities, optimal nutrition and patient education. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Multidisciplinary Management of Spondyloarthritis-Related Immune-Mediated Inflammatory Disease.

PubMed

Rizzello, Fernando; Olivieri, Ignazio; Armuzzi, Alessandro; Ayala, Fabio; Bettoli, Vincenzo; Bianchi, Luca; Cimino, Luca; Costanzo, Antonio; Cristaudo, Antonio; D'Angelo, Salvatore; Daperno, Marco; Fostini, Anna Chiara; Galeazzi, Mauro; Gilio, Michele; Gionchetti, Paolo; Gisondi, Paolo; Lubrano, Ennio; Marchesoni, Antonio; Offidani, Annamaria; Orlando, Ambrogio; Pugliese, Daniela; Salvarani, Carlo; Scarpa, Raffaele; Vecchi, Maurizio; Girolomoni, Giampiero

2018-04-01

Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis and uveitis. A Delphi consensus-based approach was used to identify a core set of statements. The process included development of initial questions by a steering committee, an exhaustive search of the literature using complementary approaches to identify potential statements and two Delphi voting rounds for finalization of the statements. Consensus was achieved on the related nature of IMIDs, the existence of a high prevalence of multiple IMIDs in a single patient and the fact that a multidisciplinary approach can result in a more extensive evaluation and comprehensive approach to treatment. The goals of a multidisciplinary team should be to increase diagnosis of concomitant IMIDs, improve the decision-making process, and increase patient satisfaction and adherence. Early referral and diagnosis, early recognition of concomitant IMIDs and optimizing treatment to improve patient quality of life are some of the advantages of using multidisciplinary teams. To be effective, a multidisciplinary team should be equipped with the appropriate tools for diagnosis and follow-up, and at a minimum the multidisciplinary team should include a dermatologist, gastroenterologist and rheumatologist; providing psychologic support via a psychologist and involving an ophthalmologist, general practitioners and nurses in multidisciplinary care is also important. The present Delphi consensus identified a set of overarching principles that may be useful for implementation of a multidisciplinary approach for the management of SpA-related IMIDs. Aristea and Hippocrates.

Identifying the critical financial ratios for stocks evaluation: A fuzzy delphi approach

NASA Astrophysics Data System (ADS)

Mokhtar, Mazura; Shuib, Adibah; Mohamad, Daud

2014-12-01

Stocks evaluation has always been an interesting and challenging problem for both researchers and practitioners. Generally, the evaluation can be made based on a set of financial ratios. Nevertheless, there are a variety of financial ratios that can be considered and if all ratios in the set are placed into the evaluation process, data collection would be more difficult and time consuming. Thus, the objective of this paper is to identify the most important financial ratios upon which to focus in order to evaluate the stock's performance. For this purpose, a survey was carried out using an approach which is based on an expert judgement, namely the Fuzzy Delphi Method (FDM). The results of this study indicated that return on equity, return on assets, net profit margin, operating profit margin, earnings per share and debt to equity are the most important ratios.

Internet-Based Delphi Research: Case Based Discussion

PubMed Central

Donohoe, Holly M.; Stellefson, Michael L.

2013-01-01

The interactive capacity of the Internet offers benefits that are intimately linked with contemporary research innovation in the natural resource and environmental studies domains. However, e-research methodologies, such as the e-Delphi technique, have yet to undergo critical review. This study advances methodological discourse on the e-Delphi technique by critically assessing an e-Delphi case study. The analysis suggests that the benefits of using e-Delphi are noteworthy but the authors acknowledge that researchers are likely to face challenges that could potentially compromise research validity and reliability. To ensure that these issues are sufficiently considered when planning and designing an e-Delphi, important facets of the technique are discussed and recommendations are offered to help the environmental researcher avoid potential pitfalls associated with coordinating e-Delphi research. PMID:23288149

The Delphi Method Online: Medical Expert Consensus Via the Internet

PubMed Central

Cam, Kenneth M.; McKnight, Patrick E.; Doctor, Jason N.

2002-01-01

Delphi is an expert consensus method. The theory behind the Delphi method is that the interaction of experts may lead to a reduction in individual bias. We have developed software that carries out all aspects of the Delphi method via the Internet. The Delphi method online consists of three components: 1) authorship, 2) interactive polling, and 3) reporting/results. We hope that researchers use this tool in future medical expert systems.

Exploring perceived barriers, drivers, impacts and the need for evaluation of public involvement in health and social care research: a modified Delphi study

PubMed Central

Snape, D; Kirkham, J; Britten, N; Froggatt, K; Gradinger, F; Lobban, F; Popay, Jennie; Wyatt, K; Jacoby, Ann

2014-01-01

Objective To explore areas of consensus and conflict in relation to perceived public involvement (PI) barriers and drivers, perceived impacts of PI and ways of evaluating PI approaches in health and social care research. Background Internationally and within the UK the recognition of potential benefits of PI in health and social care research is gathering momentum and PI is increasingly identified by organisations as a prerequisite for funding. However, there is relatively little examination of the impacts of PI and how those impacts might be measured. Design Mixed method, three-phase, modified Delphi technique, conducted as part of a larger MRC multiphase project. Sample Clinical and non-clinical academics, members of the public, research managers, commissioners and funders. Findings This study found high levels of consensus about the most important barriers and drivers to PI. There was acknowledgement that tokenism was common in relation to PI; and strong support for the view that demonstrating the impacts and value of PI was made more difficult by tokenistic practice. PI was seen as having intrinsic value; nonetheless, there was clear support for the importance of evaluating its impact. Research team cohesion and appropriate resources were considered essential to effective PI implementation. Panellists agreed that PI can be challenging, but can be facilitated by clear guidance, together with models of good practice and measurable standards. Conclusions This study is the first to present empirical evidence of the opinions voiced by key stakeholders on areas of consensus and conflict in relation to perceived PI barriers and drivers, perceived impacts of PI and the need to evaluate PI. As such it further contributes to debate around best practice in PI, the potential for tokenism and how best to evaluate the impacts of PI. These findings have been used in the development of the Public Involvement Impact Assessment Framework (PiiAF), an online resource which offers guidance to researchers and members of the public involved in the PI process. PMID:24939808

Development of key indicators of hospital resilience: a modified Delphi study.

PubMed

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2015-04-01

Hospital resilience is an emerging concept, which can be defined as 'a hospital's ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one'. Our aim was to develop a comprehensive framework of key indicators of hospital resilience. A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure. A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4). This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Reaching consensus on the physiotherapeutic management of patients following upper abdominal surgery: a pragmatic approach to interpret equivocal evidence.

PubMed

Hanekom, Susan D; Brooks, Dina; Denehy, Linda; Fagevik-Olsén, Monika; Hardcastle, Timothy C; Manie, Shamila; Louw, Quinette

2012-02-06

Postoperative pulmonary complications remain the most significant cause of morbidity following open upper abdominal surgery despite advances in perioperative care. However, due to the poor quality primary research uncertainty surrounding the value of prophylactic physiotherapy intervention in the management of patients following abdominal surgery persists. The Delphi process has been proposed as a pragmatic methodology to guide clinical practice when evidence is equivocal. The objective was to develop a clinical management algorithm for the post operative management of abdominal surgery patients. Eleven draft algorithm statements extracted from the extant literature by the primary research team were verified and rated by scientist clinicians (n=5) in an electronic three round Delphi process. Algorithm statements which reached a priori defined consensus-semi-interquartile range (SIQR)<0.5-were collated into the algorithm. The five panelists allocated to the abdominal surgery Delphi panel were from Australia, Canada, Sweden, and South Africa. The 11 draft algorithm statements were edited and 5 additional statements were formulated. The panel reached consensus on the rating of all statements. Four statements were rated essential. An expert Delphi panel interpreted the equivocal evidence for the physiotherapeutic management of patients following upper abdominal surgery. Through a process of consensus a clinical management algorithm was formulated. This algorithm can now be used by clinicians to guide clinical practice in this population.

Expert consensus regarding drivers of antimicrobial stewardship in companion animal veterinary practice: a Delphi study.

PubMed

Currie, Kay; King, Caroline; Nuttall, Tim; Smith, Matt; Flowers, Paul

2018-03-23

Antimicrobial resistance (AMR) is a global challenge facing both human and animal healthcare professionals; an effective response to this threat requires a 'One-Health' approach to antimicrobial stewardship (AMS) to preserve important antibiotics for urgent clinical need. However, understanding of barriers and enablers to effective AMS behaviour in companion animal veterinary practice is currently limited. We conducted a Delphi study of 16 nationally recognised experts from UK-based veterinary policymakers, university academics and leaders of professional bodies. This Delphi study sought to identify veterinary behaviours which experts believe contribute to AMR and form vital aspects of AMS. Analysis of Delphi findings indicated a perceived hierarchy of behaviours, the most influential being antibiotic prescribing behaviours and interactions with clients. Other veterinary behaviours perceived as being important related to interactions with veterinary colleagues; infection control practices; and the use of diagnostic tests to confirm infection. Key barriers and enablers to AMS within each of these behavioural domains were identified. Specific interventions to address important barriers and enablers are recommended. To the authors' knowledge, this is the first study to establish expert consensus at a national level about which 'behaviours' (aspects of veterinarian practice) should be targeted in relation to AMR and AMS in companion animal veterinary practice. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Delphi survey of the views of adult male patients with personality disorders on psychoeducation and social problem-solving therapy.

PubMed

McMurran, Mary; Wilmington, Rebekah

2007-01-01

Psychoeducation and social problem-solving therapy are treatment components that work well in tandem for offenders with personality disorders, hence it is worthwhile to maintain and improve their effectiveness. The aim was to seek patients' views of these therapies to contribute to their development. A Delphi survey was conducted with all 12 male inpatients of a personality disorder hospital treatment unit. Round 1 produced 30 statements for psychoeducation and 59 for social problem-solving therapy to be rated in Round 2. There was consensus at a level of 70% for all items. Both psychoeducation and social problem-solving therapies were viewed as useful by these patients. The men also suggested improvements in psychoeducation, including minimizing the delay between assessment and feedback, provision of reference material, preparation for the work and support afterwards. Areas identified for improvement in social problem-solving therapy included more frequent review of progress, greater consistency of delivery, eliciting problems more effectively, providing reference material, supporting patients in group work, and the development of an advanced therapy. A Delphi approach to evaluation of therapies with the people receiving them is not only feasible but seems to offer a practical way of making useful clinical adjustments to the work. Further research with larger samples might usefully focus on whether such an approach enhances treatment compliance. 2007 John Wiley & Sons, Ltd

Working towards consensus on methods used to elicit participant-reported safety data in uncomplicated malaria clinical drug studies: a Delphi technique study.

PubMed

Mandimika, Nyaradzo; Barnes, Karen I; Chandler, Clare I R; Pace, Cheryl; Allen, Elizabeth N

2017-01-28

Eliciting adverse event (AE) and non-study medication data reports from clinical research participants is integral to evaluating drug safety. However, using different methods to question participants yields inconsistent results, compromising the interpretation, comparison and pooling of data across studies. This is particularly important given the widespread use of anti-malarials in vulnerable populations, and their increasing use in healthy, but at-risk individuals, as preventive treatment or to reduce malaria transmission. Experienced and knowledgeable anti-malarial drug clinical researchers were invited to participate in a Delphi technique study, to facilitate consensus on what are considered optimal (relevant, important and feasible) methods, tools, and approaches for detecting participant-reported AE and non-study medication data in uncomplicated malaria treatment studies. Of 72 invited, 25, 16 and 10 panellists responded to the first, second and third rounds of the Delphi, respectively. Overall, 68% (68/100) of all questioning items presented for rating achieved consensus. When asking general questions about health, panellists agreed on the utility of a question/concept about any change in health, taking care to ensure that such questions/concepts do not imply causality. Eighty-nine percent (39/44) of specific signs and symptoms questions were rated as optimal. For non-study medications, a general question and most structured questioning items were considered an optimal approach. The use of mobile phones, patient diaries, rating scales as well as openly engaging with participants to discuss concerns were also considered optimal complementary data-elicitation tools. This study succeeded in reaching consensus within a section of the anti-malarial drug clinical research community about using a general question concept, and structured questions for eliciting data about AEs and non-study medication reports. The concepts and items considered in this Delphi to be relevant, important and feasible should be further investigated for potential inclusion in a harmonized approach to collect participant-elicited anti-malarial drug safety data. This, in turn, should improve understanding of anti-malarial drug safety.

Imaging of the small intestine in Crohn's disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association.

PubMed

Kedia, Saurabh; Sharma, Raju; Makharia, Govind K; Ahuja, Vineet; Desai, Devendra; Kandasamy, Devasenathipathy; Eapen, Anu; Ganesan, Karthik; Ghoshal, Uday C; Kalra, Naveen; Karthikeyan, D; Madhusudhan, Kumble Seetharama; Philip, Mathew; Puri, Amarender Singh; Puri, Sunil; Sinha, Saroj K; Banerjee, Rupa; Bhatia, Shobna; Bhat, Naresh; Dadhich, Sunil; Dhali, G K; Goswami, B D; Issar, S K; Jayanthi, V; Misra, S P; Nijhawan, Sandeep; Puri, Pankaj; Sarkar, Avik; Singh, S P; Srivastava, Anshu; Abraham, Philip; Ramakrishna, B S

2017-11-01

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

Developing the E-Delphi System: A Web-Based Forecasting Tool for Educational Research.

ERIC Educational Resources Information Center

Chou, Chien

2002-01-01

Discusses use of the Delphi technique and describes the development of an electronic version, called e-Delphi, in which questionnaire construction and communication with panel members was accomplished using the Web. Explains system function and interface and discusses evaluation of the e-Delphi system. (Author/LRW)

Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study.

PubMed

Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie

2015-09-01

To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A medical school's organizational readiness for curriculum change (MORC): development and validation of a questionnaire.

PubMed

Jippes, Mariëlle; Driessen, Erik W; Broers, Nick J; Majoor, Gerard D; Gijselaers, Wim H; van der Vleuten, Cees P M

2013-09-01

Because successful change implementation depends on organizational readiness for change, the authors developed and assessed the validity of a questionnaire, based on a theoretical model of organizational readiness for change, designed to measure, specifically, a medical school's organizational readiness for curriculum change (MORC). In 2012, a panel of medical education experts judged and adapted a preliminary MORC questionnaire through a modified Delphi procedure. The authors administered the resulting questionnaire to medical school faculty involved in curriculum change and tested the psychometric properties using exploratory and confirmatory factor analysis, and generalizability analysis. The mean relevance score of the Delphi panel (n = 19) reached 4.2 on a five-point Likert-type scale (1 = not relevant and 5 = highly relevant) in the second round, meeting predefined criteria for completing the Delphi procedure. Faculty (n = 991) from 131 medical schools in 56 countries completed MORC. Exploratory factor analysis yielded three underlying factors-motivation, capability, and external pressure-in 12 subscales with 53 items. The scale structure suggested by exploratory factor analysis was confirmed by confirmatory factor analysis. Cronbach alpha ranged from 0.67 to 0.92 for the subscales. Generalizability analysis showed that the MORC results of 5 to 16 faculty members can reliably evaluate a school's organizational readiness for change. MORC is a valid, reliable questionnaire for measuring organizational readiness for curriculum change in medical schools. It can identify which elements in a change process require special attention so as to increase the chance of successful implementation.

Development of an Index of Engagement in HIV Care: An Adapted Internet-Based Delphi Process

PubMed Central

Koester, Kimberly A; Wood, Troy; Neilands, Torsten B; Pomeranz, Jamie L; Christopoulos, Katerina A

2017-01-01

Background Improving engagement in medical care among persons living with human immunodeficiency virus (HIV) is critical to optimizing clinical outcomes and reducing onward transmission of HIV. However, a clear conceptualization of what it means to be engaged in HIV care is lacking, and thus efforts to measure and enhance engagement in care are limited. Objective This paper describes the use of a modified online Delphi process of consensus building to solicit input from a range of HIV and non-HIV researchers and providers, and to integrate that input with focus group data conducted with HIV-infected patients. The overarching goal was to generate items for a patient-centered measure of engagement in HIV care for use in future research and clinical practice. Methods We recruited 66 expert panelists from around the United States. Starting with six open-ended questions, we used four rounds of online Delphi data collection in tandem with 12 in-person focus groups with patients and cognitive interviews with 25 patients. Results We recruited 66 expert panelists from around the United States and 64 (97%) were retained for four rounds of data collection. Starting with six open-ended questions, we used four rounds of online Delphi data collection in tandem with 12 in-person focus groups with patients and cognitive interviews with 25 patients. The process resulted in an expansion to 120 topics that were subsequently reduced to 13 candidate items for the planned assessment measure. Conclusions The process was an efficient method of soliciting input from geographically separated and busy experts across a range of disciplines and professional roles with the aim of arriving at a coherent definition of engagement in HIV care and a manageable set of survey items to assess it. Next steps are to validate the utility of the new measure in predicting retention in care, adherence to treatment, and clinical outcomes among patients living with HIV. PMID:29208589

ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol

PubMed Central

Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S

2017-01-01

Introduction Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues—including conceptualisation, measurement and data analysis—that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. Methods and analysis This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. Ethics and dissemination An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network and other relevant organisations. PMID:28188154

Expert Opinion Is Necessary: Delphi Panel Methodology Facilitates a Scientific Approach to Consensus.

PubMed

Hohmann, Erik; Brand, Jefferson C; Rossi, Michael J; Lubowitz, James H

2018-02-01

Our current trend and focus on evidence-based medicine is biased in favor of randomized controlled trials, which are ranked highest in the hierarchy of evidence while devaluing expert opinion, which is ranked lowest in the hierarchy. However, randomized controlled trials have weaknesses as well as strengths, and no research method is flawless. Moreover, stringent application of scientific research techniques, such as the Delphi Panel methodology, allows survey of experts in a high quality and scientific manner. Level V evidence (expert opinion) remains a necessary component in the armamentarium used to determine the answer to a clinical question. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Simulation Of Wave Function And Probability Density Of Modified Poschl Teller Potential Derived Using Supersymmetric Quantum Mechanics

NASA Astrophysics Data System (ADS)

Angraini, Lily Maysari; Suparmi, Variani, Viska Inda

2010-12-01

SUSY quantum mechanics can be applied to solve Schrodinger equation for high dimensional system that can be reduced into one dimensional system and represented in lowering and raising operators. Lowering and raising operators can be obtained using relationship between original Hamiltonian equation and the (super) potential equation. In this paper SUSY quantum mechanics is used as a method to obtain the wave function and the energy level of the Modified Poschl Teller potential. The graph of wave function equation and probability density is simulated by using Delphi 7.0 programming language. Finally, the expectation value of quantum mechanics operator could be calculated analytically using integral form or probability density graph resulted by the programming.

Environmental initiative prioritization with a Delphi approach: a case study.

PubMed

Gokhale, A A

2001-08-01

India is fast finding its place in the industrialized world and that is beginning to raise its environmental consciousness. The Delphi technique was used to prioritize specific needs and articulate a sustainable urban improvement strategy for the city of Mumbai (formerly Bombay). The Delphi technique is a means of achieving consensual validity among raters by providing them feedback regarding other raters' responses. Mumbai has several indigenous environmental groups that were tapped for activists and leaders; the study was conducted using ten environmentalists. In the initial phases the responses resulted in a range of possible program alternatives. The last two stages helped to seek out information that generated a consensus on the part of the respondent group. Statistical analysis methods included a hierarchical cluster analysis, mean, median, mode, and percent of agreement calculations using SPSS software. The face-to-face discussion in phase 4 clarified some issues and helped the group as a whole to outline the strategy for putting in place the essential elements of a framework to improve the quality of life in an urban environment.

A cross-validation Delphi method approach to the diagnosis and treatment of personality disorders in older adults.

PubMed

Rosowsky, Erlene; Young, Alexander S; Malloy, Mary C; van Alphen, S P J; Ellison, James M

2018-03-01

The Delphi method is a consensus-building technique using expert opinion to formulate a shared framework for understanding a topic with limited empirical support. This cross-validation study replicates one completed in the Netherlands and Belgium, and explores US experts' views on the diagnosis and treatment of older adults with personality disorders (PD). Twenty-one geriatric PD experts participated in a Delphi survey addressing diagnosis and treatment of older adults with PD. The European survey was translated and administered electronically. First-round consensus was reached for 16 out of 18 items relevant to diagnosis and specific mental health programs for personality disorders in older adults. Experts agreed on the usefulness of establishing criteria for specific types of treatments. The majority of psychologists did not initially agree on the usefulness of pharmacotherapy. Expert consensus was reached following two subsequent rounds after clarification addressing medication use. Study results suggest consensus among regarding psychosocial treatments. Limited acceptance amongst US psychologists about the suitability of pharmacotherapy for late-life PDs contrasted with the views expressed by experts surveyed in Netherlands and Belgium studies.

The use of advanced web-based survey design in Delphi research.

PubMed

Helms, Christopher; Gardner, Anne; McInnes, Elizabeth

2017-12-01

A discussion of the application of metadata, paradata and embedded data in web-based survey research, using two completed Delphi surveys as examples. Metadata, paradata and embedded data use in web-based Delphi surveys has not been described in the literature. The rapid evolution and widespread use of online survey methods imply that paper-based Delphi methods will likely become obsolete. Commercially available web-based survey tools offer a convenient and affordable means of conducting Delphi research. Researchers and ethics committees may be unaware of the benefits and risks of using metadata in web-based surveys. Discussion paper. Two web-based, three-round Delphi surveys were conducted sequentially between August 2014 - January 2015 and April - May 2016. Their aims were to validate the Australian nurse practitioner metaspecialties and their respective clinical practice standards. Our discussion paper is supported by researcher experience and data obtained from conducting both web-based Delphi surveys. Researchers and ethics committees should consider the benefits and risks of metadata use in web-based survey methods. Web-based Delphi research using paradata and embedded data may introduce efficiencies that improve individual participant survey experiences and reduce attrition across iterations. Use of embedded data allows the efficient conduct of multiple simultaneous Delphi surveys across a shorter timeframe than traditional survey methods. The use of metadata, paradata and embedded data appears to improve response rates, identify bias and give possible explanation for apparent outlier responses, providing an efficient method of conducting web-based Delphi surveys. © 2017 John Wiley & Sons Ltd.

A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method.

PubMed

Walker, David A; Liu, JoFen; Kieran, Mark; Jabado, Nada; Picton, Susan; Packer, Roger; St Rose, Christian

2013-04-01

Astrocytic tumors account for 42% of childhood brain tumors, arising in all anatomical regions and associated with neurofibromatosis type 1 (NF1) in 15%. Anatomical site determines the degree and risk of resectability; the more complete resection, the better the survival rates. New biological markers and modern radiotherapy techniques are altering the risk assessments of clinical decisions for tumor resection and biopsy. The increasingly distinct pediatric neuro-oncology multidisciplinary team (PNMDT) is developing a distinct evidence base. A multidisciplinary consensus conference on pediatric neurosurgery was held in February 2011, where 92 invited participants reviewed evidence for clinical management of hypothalamic chiasmatic glioma (HCLGG), diffuse intrinsic pontine glioma (DIPG), and high-grade glioma (HGG). Twenty-seven statements were drafted and subjected to online Delphi consensus voting by participants, seeking >70% agreement from >60% of respondents; where <70% consensus occurred, the statement was modified and resubmitted for voting. Twenty-seven statements meeting consensus criteria are reported. For HCLGG, statements describing overall therapeutic purpose and indications for biopsy, observation, or treatment aimed at limiting the risk of visual damage and the need for on-going clinical trials were made. Primary surgical resection was not recommended. For DIPG, biopsy was recommended to ascertain biological characteristics to enhance understanding and targeting of treatments, especially in clinical trials. For HGG, biopsy is essential, the World Health Organization classification was recommended; selection of surgical strategy to achieve gross total resection in a single or multistep process should be discussed with the PNMDT and integrated with trials based drug strategies for adjuvant therapies.

Multidisciplinary Consensus on the Nonadherence to Clinical Management of Inhaled Therapy in Spanish asthma patients.

PubMed

López-Viña, Antolín; Giner, Jordi; Molina, Jesús; Palicio, Javier; Plaza, Javier; Quintano, José Antonio; Quirce, Santiago; Soria, Cristina; Uréndez, Ana María; Plaza, Vicente

2017-08-01

Rates of nonadherence to asthma treatment in Spain are between 24% and 76%, which results in poor disease control and increased health care costs. The main objective of this multidisciplinary consensus was to investigate the opinions of health professionals and patients regarding adherence to inhaled therapy in Spain. The results will help to identify the causes of nonadherence and to establish strategies to detect and correct the problem. This research was conducted by using a modified Delphi method organized into 2 rounds and involving a panel of 64 physicians, 16 nurses, and 10 community pharmacists. In addition, 70 patients with asthma completed a simplified 1-round survey, based on the Delphi questionnaire. The items proposed to reach a consensus included topics such as impact and causes of nonadherence, as well as strategies to improve adherence to treatment. Expert panelists reached a consensus on ~80% of the items proposed. They agreed that the lack of control in asthma has an important economic impact. The causes of nonadherence with more agreement were the patients' beliefs about treatment and the complexity of the inhalation devices. Panelists agreed that the most important strategies to improve adherence were modification of patients' beliefs, training of professionals in the management of adherence, and personalization of interventions. Most patients only agreed with items that referred to strategies to improve adherence. Although the problems, impact, causes, and interventions regarding nonadherence to asthma treatment are known, adequate monitoring of adherence to treatment is not performed. A multidisciplinary and personalized approach is necessary to control and improve adherence. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

An examination of the research priorities for a hospice service in New Zealand: A Delphi study.

PubMed

de Vries, Kay; Walton, Jo; Nelson, Katherine; Knox, Rhondda

2016-06-01

Palliative care research is relatively diverse and prioritizing research in this field is dependent on multiple factors such as complex ethical decisions in designing and conducting the research; access to participants who may be deemed "vulnerable" and an increasingly medically focused approach to care. The aim of this study was to inform organizational decision-making and policy development regarding future research priorities for a hospice service in New Zealand. A modified three-round Delphi technique was employed. Participants were drawn from one dedicated specialist palliative care service that delivers care in the community, day-care, hospice inpatient, aged residential care, and acute hospital palliative care service. A purposive sample included palliative care staff (n = 10, 18, 9, for rounds 1-3, respectively) volunteers (n = 10, 12, 11); and patients and family carers (n = 6, 8, for rounds 1 and 2). Patients and family carers were not involved in the third round. At final ranking of six research themes encompassing 23 research topics were identified by staff and volunteers. These were: symptom management; aged care; education; community; patient and family; and bereavement support and young people. Patients and family carers agreed on four themes, made up of 10 research topics. These were: decision-making, bereavement and loss, symptom management; and recognition of need and response of service. The study generated a rich set of research themes and specific research topics. The perspectives of staff and volunteers are significantly different from those of patients and family members, in spite of the recognition by all concerned that palliative care services work within a philosophy of patient-centered care. Open discussion of ideas has the potential to engage both staff and patients and carers in quality improvement initiatives, and to reinforce the value of research for patient care.

CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children.

PubMed

Bishop, D V M; Snowling, Margaret J; Thompson, Paul A; Greenhalgh, Trisha

2016-01-01

Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

Global priorities for research and the relative importance of different research outcomes: an international Delphi survey of malaria research experts.

PubMed

Mulligan, Jo-Ann; Conteh, Lesong

2016-12-06

As global research investment increases, attention inevitably turns to assessing and measuring the outcomes and impact from research programmes. Research can have many different outcomes such as producing advances in scientific knowledge, building research capacity and, ultimately, health and broader societal benefits. The aim of this study was to test the use of a Delphi methodology as a way of gathering views from malaria research experts on research priorities and eliciting relative valuations of the different types of health research impact. An international Delphi survey of 60 malaria research experts was used to understand views on research outcomes and priorities within malaria and across global health more widely. The study demonstrated the application of the Delphi technique to eliciting views on malaria specific research priorities, wider global health research priorities and the values assigned to different types of research impact. In terms of the most important past research successes, the development of new anti-malarial drugs and insecticide-treated bed nets were rated as the most important. When asked about research priorities for future funding, respondents ranked tackling emerging drug and insecticide resistance the highest. With respect to research impact, the panel valued research that focuses on health and health sector benefits and informing policy and product development. Contributions to scientific knowledge, although highly valued, came lower down the ranking, suggesting that efforts to move research discoveries to health products and services are valued more highly than pure advances in scientific knowledge. Although the Delphi technique has been used to elicit views on research questions in global health this was the first time it has been used to assess how a group of research experts value or rank different types of research impact. The results suggest it is feasible to inject the views of a key stakeholder group into the research prioritization process and the Delphi approach is a useful tool for eliciting views on the value or importance of research impact. Future work will explore other methods for assessing and valuing research impact and test the feasibility of developing a composite tool for measuring research outcomes weighted by the values of different stakeholders.

Moving Forward Through Consensus: A Modified Delphi Approach to Determine the Top Research Priorities in Orthopaedic Oncology.

PubMed

Schneider, Patricia Jacqueline; Evaniew, Nathan; McKay, Paula; Ghert, Michelle

2017-12-01

Several challenges presently impede the conduct of prospective clinical studies in orthopaedic oncology, including limited financial resources to support their associated costs and inadequate patient volume at most single institutions. This study was conducted to prioritize research questions within the field so that the Musculoskeletal Tumor Society (MSTS), and other relevant professional societies, can direct the limited human and fiscal resources available to address the priorities that the stakeholders involved believe will have the most meaningful impact on orthopaedic oncology patient care. The purpose of this study was to use a formal consensus-based approach involving clinician-scientists and other stakeholders to identify the top priority research questions for future international prospective clinical studies in orthopaedic oncology. A three-step modified Delphi process involving multiple stakeholder groups (including orthopaedic oncologists, research personnel, funding agency representation, and patient representation) was conducted. First, we sent an electronic questionnaire to all participants to solicit clinically relevant research questions (61 participants; 54% of the original 114 individuals invited to participate returned the questionnaires). Then, participants rated the candidate research questions using a 5-point Likert scale for five criteria (60 participants; 53% of the original group participated in this portion of the process). Research questions that met a priori consensus thresholds progressed for consideration to an in-person consensus meeting, which was attended by 44 participants (39% of the original group; 12 countries were represented at this meeting). After the consensus panel's discussion, members individually assigned scores to each question using a 9-point Likert scale. Research questions that met preset criteria advanced to final ranking, and panel members individually ranked their top three priority research questions, resulting in a final overall ranking of research priorities. A total of 73 candidate research questions advanced to the consensus meeting. In the end, the consensus panel identified four research priorities: (1) Does less intensive surveillance of patients with sarcoma affect survival? (2) What are the survival outcomes over time for orthopaedic oncology implants? (3) Does resection versus stabilization improve oncologic and functional outcomes in oligometastatic bone disease? (4) What is the natural history of untreated fibromatosis? The results of this study will assist in developing a long-term research strategy for the MSTS and, possibly, the orthopaedic oncology field as a whole. Furthermore, the results of this study can assist researchers in guiding their research efforts and in providing a justified rationale to funding agencies when requesting the resources necessary to support future collaborative research studies that address the identified orthopaedic oncology priorities.

Climate Change Impacts and Vulnerability Assessment in Industrial Complexes

NASA Astrophysics Data System (ADS)

Lee, H. J.; Lee, D. K.

2016-12-01

Climate change has recently caused frequent natural disasters, such as floods, droughts, and heat waves. Such disasters have also increased industrial damages. We must establish climate change adaptation policies to reduce the industrial damages. It is important to make accurate vulnerability assessment to establish climate change adaptation policies. Thus, this study aims at establishing a new index to assess vulnerability level in industrial complexes. Most vulnerability indices have been developed with subjective approaches, such as the Delphi survey and the Analytic Hierarchy Process(AHP). The subjective approaches rely on the knowledge of a few experts, which provokes the lack of the reliability of the indices. To alleviate the problem, we have designed a vulnerability index incorporating objective approaches. We have investigated 42 industrial complex sites in Republic of Korea (ROK). To calculate weights of variables, we used entropy method as an objective method integrating the Delphi survey as a subjective method. Finally, we found our method integrating both subjective method and objective method could generate result. The integration of the entropy method enables us to assess the vulnerability objectively. Our method will be useful to establish climate change adaptation policies by reducing the uncertainties of the methods based on the subjective approaches.

Competency standards for newly graduated prosthetist/orthotists in Sweden.

PubMed

Ramstrand, Nerrolyn; Ramstrand, Simon

2018-05-01

There are currently no national competency standards upon which to develop educational objectives for prosthetist/orthotists in Sweden. While standards have been developed in other countries, they cannot be applied without confirming their relevance in a Swedish context. To describe and obtain consensus on core competencies required for newly graduated prosthetist/orthotists in Sweden. Modified Delphi process. A modified Delphi technique was carried out. Focus groups were initially used to identify core competency domains. Two consecutive questionnaires, containing a list of potential competency items, were sent to a group of stakeholders with ties to the prosthetic and orthotic profession. Stakeholders were requested to rate their level of agreement with each competency item and provide written comments. Finally, two focus groups were conducted to obtain feedback on the draft competency standards. Forty-four competency items, listed under five key domains of practice, were identified as essential for newly graduated prosthetist/orthotists in Sweden. Many similarities exist in core competency descriptions for prosthetist/orthotists in Sweden when compared to other countries. Regional differences do however exist, and it is important to confirm the relevance of core competency items at a national level before they are applied. Clinical relevance Competency standards developed in this study can be used to guide development of learning objectives within an undergraduate prosthetic and orthotic program, provide a framework for workforce development, assist professional organizations in understanding the needs of their members, and prepare for international accreditation.

Validation of consensus panel diagnosis in dementia.

PubMed

Gabel, Matthew J; Foster, Norman L; Heidebrink, Judith L; Higdon, Roger; Aizenstein, Howard J; Arnold, Steven E; Barbas, Nancy R; Boeve, Bradley F; Burke, James R; Clark, Christopher M; Dekosky, Steven T; Farlow, Martin R; Jagust, William J; Kawas, Claudia H; Koeppe, Robert A; Leverenz, James B; Lipton, Anne M; Peskind, Elaine R; Turner, R Scott; Womack, Kyle B; Zamrini, Edward Y

2010-12-01

The clinical diagnosis of dementing diseases largely depends on the subjective interpretation of patient symptoms. Consensus panels are frequently used in research to determine diagnoses when definitive pathologic findings are unavailable. Nevertheless, research on group decision making indicates that many factors can adversely affect panel performance. To determine conditions that improve consensus panel diagnosis. Comparison of neuropathologic diagnoses with individual and consensus panel diagnoses based on clinical scenarios only, fludeoxyglucose F 18 positron emission tomography images only, and scenarios plus images. Expert and trainee individual and consensus panel deliberations using a modified Delphi method in a pilot research study of the diagnostic utility of fludeoxyglucose F 18 positron emission tomography. Forty-five patients with pathologically confirmed Alzheimer disease or frontotemporal dementia. Statistical measures of diagnostic accuracy, agreement, and confidence for individual raters and panelists before and after consensus deliberations. The consensus protocol using trainees and experts surpassed the accuracy of individual expert diagnoses when clinical information elicited diverse judgments. In these situations, consensus was 3.5 times more likely to produce positive rather than negative changes in the accuracy and diagnostic certainty of individual panelists. A rule that forced group consensus was at least as accurate as majority and unanimity rules. Using a modified Delphi protocol to arrive at a consensus diagnosis is a reasonable substitute for pathologic information. This protocol improves diagnostic accuracy and certainty when panelist judgments differ and is easily adapted to other research and clinical settings while avoiding the potential pitfalls of group decision making.

Use of a modified Delphi panel to identify and weight criteria for prioritization of zoonotic diseases in Switzerland.

PubMed

Stebler, N; Schuepbach-Regula, G; Braam, P; Falzon, L C

2015-09-01

Zoonotic diseases have a significant impact on public health globally. To prevent or reduce future zoonotic outbreaks, there is a constant need to invest in research and surveillance programs while updating risk management strategies. However, given the limited resources available, disease prioritization based on the need for their control and surveillance is important. This study was performed to identify and weight disease criteria for the prioritization of zoonotic diseases in Switzerland using a semi-quantitative research method based on expert opinion. Twenty-eight criteria relevant for disease control and surveillance, classified under five domains, were selected following a thorough literature review, and these were evaluated and weighted by seven experts from the Swiss Federal Veterinary Office using a modified Delphi panel. The median scores assigned to each criterion were then used to rank 16 notifiable and/or emerging zoonoses in Switzerland. The experts weighted the majority of the criteria similarly, and the top three criteria were Severity of disease in humans, incidence and prevalence of the disease in humans and treatment in humans. Based on these weightings, the three highest ranked diseases were Avian Influenza, Bovine Spongiform Encephalitis, and Bovine Tuberculosis. Overall, this study provided a preliminary list of criteria relevant for disease prioritization in Switzerland. These were further evaluated in a companion study which involved a quantitative prioritization method and multiple stakeholders. Copyright © 2015 Elsevier B.V. All rights reserved.

Administration and leadership competencies: establishment of a national consensus for emergency medicine.

PubMed

Thoma, Brent; Poitras, Julien; Penciner, Rick; Sherbino, Jonathan; Holroyd, Brian R; Woods, Robert A

2015-03-01

The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum. A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement. Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion. Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.

A pushing chronic care forward in Abu Dhabi by identifying priorities and addressing barriers: a modified Delphi technique

PubMed Central

Loney, Tom; Lapão, Luis V

2018-01-01

Objective This study aimed to elucidate the top five key priorities and barriers to chronic care in the health system of Abu Dhabi, United Arab Emirates (UAE). Design A modified Delphi study was performed to reach consensus on priority areas and barriers to the development of the Chronic Care Model in the health system of Abu Dhabi. Individual wireless audience response devices (keypads) linked to a computer were used to reduce 28 priorities and 20 barriers to the top five during three iterative rounds over three consecutive days. Setting Chronic care services for patients with diabetes, cardiovascular diseases and cancer, in both private and publicly funded healthcare services in the emirate of Abu Dhabi. Participants A purposive sample of 20 health systems’ experts were recruited. They were front-line healthcare workers from the public and private sector working in the delivery of care for patients with diabetes, cardiovascular diseases and cancer. Results The ‘overall organizational leadership in chronic illness care’ was ranked as the most important priority to address (26.3%) and ‘patient compliance’ was ranked as the most important barrier (36.8%) to the development of the Chronic Care Model. Conclusions This study has identified the current priorities and barriers to improving chronic care within Abu Dhabi’s healthcare system. Our paper addresses the UAE’s 2021 Agenda of achieving a world-class healthcare system, and findings may help inform strategic changes required to achieve this mission. PMID:29866724

Optimizing the assessment of pediatric injury severity in low-resource settings: Consensus generation through a modified Delphi analysis.

PubMed

St-Louis, Etienne; Deckelbaum, Dan Leon; Baird, Robert; Razek, Tarek

2017-06-01

Although a plethora of pediatric injury severity scoring systems is available, many of them present important challenges and limitations in the low resource setting. Our aim is to generate consensus among a group of experts regarding the optimal parameters, outcomes, and methods of estimating injury severity for pediatric trauma patients in low resource settings. A systematic review of the literature was conducted to identify and compare existing injury scores used in pediatric patients. Qualitative data was extracted from the systematic review, including scoring parameters, settings and outcomes. In order to establish consensus regarding which of these elements are most adapted to pediatric patients in low-resource settings, they were subjected to a modified Delphi survey for external validation. The Delphi process is a structured communication technique that relies on a panel of experts to develop a systematic, interactive consensus method. We invited a group of 38 experts, including adult and pediatric surgeons, emergency physicians and anesthesiologists trauma team leaders from a level 1 trauma center in Montreal, Canada, and a pediatric referral trauma hospital in Santiago, Chile to participate in two successive rounds of our survey. Consensus was reached regarding various features of an ideal pediatric trauma score. Specifically, our experts agreed pediatric trauma scoring tool should differ from its adult counterpart, that it can be derived from point of care data available at first assessment, that blood pressure is an important variable to include in a predictive model for pediatric trauma outcomes, that blood pressure is a late but specific marker of shock in pediatric patients, that pulse rate is a more sensitive marker of hemodynamic instability than blood pressure, that an assessment of airway status should be included as a predictive variable for pediatric trauma outcomes, that the AVPU classification of neurologic status is simple and reliable in the acute setting, and more so than GCS at all ages. Therefore, we conclude that an opportunity exists to develop a new pediatric trauma score, combining the above consensus-generating ideas, that would be best adapted for use in low-resource settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Toward an essential ethic for teaching science in the new millennium

NASA Astrophysics Data System (ADS)

Hays, Irene De La Bretonne

The purpose of this study was to identify and explore values and views that might underlie an essential ethic for teaching science in the new millennium. With such an ethic, teachers may be better able to prepare young people to form and fully participate in communities that restore and sustain Earth. Reviewed in the literature for this study were changing philosophies and theories from early indigenous cultures to the present on the nature of nature, the value of nature, and the human relationship with nature. These philosophies and theories were found to influence values that today underlie the work scientists do and the ways young people are educated in science. In the study, two groups of participants--Nature Writers and scientists--revealed the essence and meaning of their relationship with nature. A two-stage, modified Delphi method was used for collecting data. Stage One comprised the first "round" of the Delphi and involved content analysis of writings by a select group of U.S. Nature Writers from the early 1800s to the present. In Stage Two, comprising three rounds of the modified Delphi, perspectives of Nature Writers were imbedded in questionnaires and presented for response to a select group of scientists connected with research and education at National Laboratories across the country. Finally, results from each participant group were brought together in a recursive process, one with the other, to determine findings. Strong Earth-care values, including receptivity, responsibility, interdependence, respect, cooperation, love, and care, were found to be held in common by the Nature Writers and scientists in this study and could form the foundation for an essential ethic for teaching science. The strongest dissonance between Nature Writers and scientists was evident in emotional and spiritual domains--despite that many scientists revealed emotional and spiritual elements in stories told of their experiences with nature. Contrary to what might have been expected from scientists based on theories of science and practices of science education represented in the literature, few scientists revealed negative, utilitarian, or dominionistic affiliations with nature. In contrast, no Nature Writers revealed such affiliations.

Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.

PubMed

McInnes, Matthew D F; Moher, David; Thombs, Brett D; McGrath, Trevor A; Bossuyt, Patrick M; Clifford, Tammy; Cohen, Jérémie F; Deeks, Jonathan J; Gatsonis, Constantine; Hooft, Lotty; Hunt, Harriet A; Hyde, Christopher J; Korevaar, Daniël A; Leeflang, Mariska M G; Macaskill, Petra; Reitsma, Johannes B; Rodin, Rachel; Rutjes, Anne W S; Salameh, Jean-Paul; Stevens, Adrienne; Takwoingi, Yemisi; Tonelli, Marcello; Weeks, Laura; Whiting, Penny; Willis, Brian H

2018-01-23

Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.

Emerging Technologies Program Integration Report. Volume 2. Background, Delphi and Workshop Data. Appendices

DTIC Science & Technology

1987-05-04

FTIILE COP’ AD-A196 840 EMERGING TECHNOLOGIES PROGRAM INTEGRATION REPORT VOLUME II BACKGROUND, DELPHI AND WORKSHOP DATA, APPENDICES . -- PREPARED...Security Classification) Emerging Technologies Program Integration Report Volume II: Background, Delphi and Workshop Data; Appendices (U) 12 PERSONAL...volumes of this integration report assess and synthesize information gathered through a Delphi survey, defense needs prioritization workshops, and

Measuring elimination of podoconiosis, endemicity classifications, case definition and targets: an international Delphi exercise.

PubMed

Deribe, Kebede; Wanji, Samuel; Shafi, Oumer; Muheki Tukahebwa, Edridah; Umulisa, Irenee; Davey, Gail

2015-09-01

Podoconiosis is one of the major causes of lymphoedema in the tropics. Nonetheless, currently there are no endemicity classifications or elimination targets to monitor the effects of interventions. This study aimed at establishing case definitions and indicators that can be used to assess endemicity, elimination and clinical outcomes of podoconiosis. This paper describes the result of a Delphi technique used among 28 experts. A questionnaire outlining possible case definitions, endemicity classifications, elimination targets and clinical outcomes was developed. The questionnaire was distributed to experts working on podoconiosis and other neglected tropical diseases in two rounds. The experts rated the importance of case definitions, endemic classifications, elimination targets and the clinical outcome measures. Median and mode were used to describe the central tendency of expert responses. The coefficient of variation was used to describe the dispersals of expert responses. Consensus on definitions and indicators for assessing endemicity, elimination and clinical outcomes of podoconiosis directed at policy makers and health workers was achieved following the two rounds of Delphi approach among the experts. Based on the two Delphi rounds we discuss potential indicators and endemicity classification of this disabling disease, and the ongoing challenges to its elimination in countries with the highest prevalence. Consensus will help to increase effectiveness of podoconiosis elimination efforts and ensure comparability of outcome data. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

DelPhi Web Server: A comprehensive online suite for electrostatic calculations of biological macromolecules and their complexes

PubMed Central

Sarkar, Subhra; Witham, Shawn; Zhang, Jie; Zhenirovskyy, Maxim; Rocchia, Walter; Alexov, Emil

2011-01-01

Here we report a web server, the DelPhi web server, which utilizes DelPhi program to calculate electrostatic energies and the corresponding electrostatic potential and ionic distributions, and dielectric map. The server provides extra services to fix structural defects, as missing atoms in the structural file and allows for generation of missing hydrogen atoms. The hydrogen placement and the corresponding DelPhi calculations can be done with user selected force field parameters being either Charmm22, Amber98 or OPLS. Upon completion of the calculations, the user is given option to download fixed and protonated structural file, together with the parameter and Delphi output files for further analysis. Utilizing Jmol viewer, the user can see the corresponding structural file, to manipulate it and to change the presentation. In addition, if the potential map is requested to be calculated, the potential can be mapped onto the molecule surface. The DelPhi web server is available from http://compbio.clemson.edu/delphi_webserver. PMID:24683424

Research priorities for multi-institutional collaborative research in surgical education.

PubMed

Stefanidis, Dimitrios; Cochran, Amalia; Sevdalis, Nick; Mellinger, John; Phitayakorn, Roy; Sullivan, Maura; Barney, Linda

2015-01-01

Research in surgical education has seen unprecedented growth but originates from single institutions and remains uncoordinated; this study aimed to generate a list of research priorities in surgical educational topics. The membership of the Association for Surgical Education was asked to submit up to 5 research questions concerned with multi-institutional collaborative surgical education research and to identify challenges faced by surgical education researchers. A modified Delphi methodology was used to create the research agenda based on these responses. Surgical educators responded to 3 survey rounds. Categories of submitted questions included teaching methods and curriculum development; assessment and competency; simulation; medical student preparation and selection; impact of work hour restrictions; and faculty development. Participants cited institutional culture and practice variability and lack of institutional review board coordination as common barriers to collaborative research, while identifying extensive planning, frequent communication, and availability of dedicated research coordinators as the most important facilitators. Using a Delphi methodology, a prioritized agenda for multi-institutional surgical education research was developed that may help advance surgeon education. Copyright © 2015 Elsevier Inc. All rights reserved.

Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

PubMed

Peters, S E; Johnston, V; Ross, M; Coppieters, M W

2017-02-01

This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

Developing an industry-oriented safety curriculum using the Delphi technique.

PubMed

Chen, Der-Fa; Wu, Tsung-Chih; Chen, Chi-Hsiang; Chang, Shu-Hsuan; Yao, Kai-Chao; Liao, Chin-Wen

2016-09-01

In this study, we examined the development of industry-oriented safety degree curricula at a college level. Based on a review of literature on the practices and study of the development of safety curricula, we classified occupational safety and health curricula into the following three domains: safety engineering, health engineering, and safety and health management. We invited 44 safety professionals to complete a four-round survey that was designed using a modified Delphi technique. We used Chi-square statistics to test the panel experts' consensus on the significance of the items in the three domains and employed descriptive statistics to rank the participants' rating of each item. The results showed that the top three items for each of the three domains were Risk Assessment, Dangerous Machinery and Equipment, and Fire and Explosion Prevention for safety engineering; Ergonomics, Industrial Toxicology, and Health Risk Assessment for health engineering; and Industrial Safety and Health Regulations, Accident Investigation and Analysis, and Emergency Response for safety and health management. Only graduates from safety programmes who possess practical industry-oriented abilities can satisfy industry demands and provide value to the existence of college safety programmes.

Development of ethical rules for boundaries of touch in complementary medicine--outcomes of a Delphi process.

PubMed

Schiff, Elad; Ben-Arye, Eran; Shilo, Margalit; Levy, Moti; Schachter, Leora; Weitchner, Na'ama; Golan, Ofra; Stone, Julie

2010-11-01

The practice of complementary medicine (CAM) often involves touch. The unique philosophy of many CAM therapies, and the setting in which treatments are provided create a therapeutic space which may be less clearly defined than in conventional settings - a space in which the boundaries between professional touch and personal/intimate touch may become easily obscured. Thus, complementary therapists need clear definitions and firm boundaries in order to maintain therapeutic efficacy and commitment. The aim of the process described in this article, was to develop ethical guidelines for boundaries of touch that will promote the safety and protection of the public which use CAM. Through a modified Delphi process, a diverse group of CAM practitioners, physicians, ethicists, legal consultants, health policy specialists, and representatives from the public, developed Ethical Rules for Boundaries of Touch in CAM. These guidelines may be implemented in ethical codes of professional CAM organizations, and also serve as a foundation for curriculums in ethics in CAM schools. Copyright © 2010 Elsevier Ltd. All rights reserved.

Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative.

PubMed

Penciner, Rick; Woods, Robert A; McEwen, Jill; Lee, Richard; Langhan, Trevor; Bandiera, Glen

2013-01-01

There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators. We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided. This study established a national consensus defining the core competencies for EM clerkship in Canada.

From control to causation: Validating a 'complex systems model' of running-related injury development and prevention.

PubMed

Hulme, A; Salmon, P M; Nielsen, R O; Read, G J M; Finch, C F

2017-11-01

There is a need for an ecological and complex systems approach for better understanding the development and prevention of running-related injury (RRI). In a previous article, we proposed a prototype model of the Australian recreational distance running system which was based on the Systems Theoretic Accident Mapping and Processes (STAMP) method. That model included the influence of political, organisational, managerial, and sociocultural determinants alongside individual-level factors in relation to RRI development. The purpose of this study was to validate that prototype model by drawing on the expertise of both systems thinking and distance running experts. This study used a modified Delphi technique involving a series of online surveys (December 2016- March 2017). The initial survey was divided into four sections containing a total of seven questions pertaining to different features associated with the prototype model. Consensus in opinion about the validity of the prototype model was reached when the number of experts who agreed or disagreed with survey statement was ≥75% of the total number of respondents. A total of two Delphi rounds was needed to validate the prototype model. Out of a total of 51 experts who were initially contacted, 50.9% (n = 26) completed the first round of the Delphi, and 92.3% (n = 24) of those in the first round participated in the second. Most of the 24 full participants considered themselves to be a running expert (66.7%), and approximately a third indicated their expertise as a systems thinker (33.3%). After the second round, 91.7% of the experts agreed that the prototype model was a valid description of the Australian distance running system. This is the first study to formally examine the development and prevention of RRI from an ecological and complex systems perspective. The validated model of the Australian distance running system facilitates theoretical advancement in terms of identifying practical system-wide opportunities for the implementation of sustainable RRI prevention interventions. This 'big picture' perspective represents the first step required when thinking about the range of contributory causal factors that affect other system elements, as well as runners' behaviours in relation to RRI risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Application of Delphi method in traditional Chinese medicine clinical research].

PubMed

Bi, Ying-fei; Mao, Jing-yuan

2012-03-01

In recent years, Delphi method has been widely applied in traditional Chinese medicine (TCM) clinical research. This article analyzed the present application situation of Delphi method in TCM clinical research, and discussed some problems presented in the choice of evaluation method, classification of observation indexes and selection of survey items. On the basis of present application of Delphi method, the author analyzed the method on questionnaire making, selection of experts, evaluation of observation indexes and selection of survey items. Furthermore, the author summarized the steps of application of Delphi method in TCM clinical research.

The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach.

PubMed

Skela-Savič, Brigita; Macrae, Rhoda; Lillo-Crespo, Manuel; Rooney, Kevin D

2017-06-01

There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and 'change making' should become an intrinsic part of everyone's job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania. A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: 'Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.' The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.

Gadamerian philosophical hermeneutics as a useful methodological framework for the Delphi technique.

PubMed

Guzys, Diana; Dickson-Swift, Virginia; Kenny, Amanda; Threlkeld, Guinever

2015-01-01

In this article we aim to demonstrate how Gadamerian philosophical hermeneutics may provide a sound methodological framework for researchers using the Delphi Technique (Delphi) in studies exploring health and well-being. Reporting of the use of Delphi in health and well-being research is increasing, but less attention has been given to covering its methodological underpinnings. In Delphi, a structured anonymous conversation between participants is facilitated, via an iterative survey process. Participants are specifically selected for their knowledge and experience with the topic of interest. The purpose of structuring conversation in this manner is to cultivate collective opinion and highlight areas of disagreement, using a process that minimizes the influence of group dynamics. The underlying premise is that the opinion of a collective is more useful than that of an individual. In designing our study into health literacy, Delphi aligned well with our research focus and would enable us to capture collective views. However, we were interested in the methodology that would inform our study. As researchers, we believe that methodology provides the framework and principles for a study and is integral to research integrity. In assessing the suitability of Delphi for our research purpose, we found little information about underpinning methodology. The absence of a universally recognized or consistent methodology associated with Delphi was highlighted through a scoping review we undertook to assist us in our methodological thinking. This led us to consider alternative methodologies, which might be congruent with the key principles of Delphi. We identified Gadamerian philosophical hermeneutics as a methodology that could provide a supportive framework and principles. We suggest that this methodology may be useful in health and well-being studies utilizing the Delphi method.

Gadamerian philosophical hermeneutics as a useful methodological framework for the Delphi technique

PubMed Central

Guzys, Diana; Dickson-Swift, Virginia; Kenny, Amanda; Threlkeld, Guinever

2015-01-01

In this article we aim to demonstrate how Gadamerian philosophical hermeneutics may provide a sound methodological framework for researchers using the Delphi Technique (Delphi) in studies exploring health and well-being. Reporting of the use of Delphi in health and well-being research is increasing, but less attention has been given to covering its methodological underpinnings. In Delphi, a structured anonymous conversation between participants is facilitated, via an iterative survey process. Participants are specifically selected for their knowledge and experience with the topic of interest. The purpose of structuring conversation in this manner is to cultivate collective opinion and highlight areas of disagreement, using a process that minimizes the influence of group dynamics. The underlying premise is that the opinion of a collective is more useful than that of an individual. In designing our study into health literacy, Delphi aligned well with our research focus and would enable us to capture collective views. However, we were interested in the methodology that would inform our study. As researchers, we believe that methodology provides the framework and principles for a study and is integral to research integrity. In assessing the suitability of Delphi for our research purpose, we found little information about underpinning methodology. The absence of a universally recognized or consistent methodology associated with Delphi was highlighted through a scoping review we undertook to assist us in our methodological thinking. This led us to consider alternative methodologies, which might be congruent with the key principles of Delphi. We identified Gadamerian philosophical hermeneutics as a methodology that could provide a supportive framework and principles. We suggest that this methodology may be useful in health and well-being studies utilizing the Delphi method. PMID:25948132

A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique.

PubMed

Jacob, Elisabeth; Duffield, Christine; Jacob, Darren

2017-08-01

The aim of this study was to develop an assessment tool to measure the critical thinking ability of nurses. As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognizing changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered Nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently, there is no published tool to assess critical thinking skills which is context specific to Australian nurses. A modified Delphi study will be used for the project. This study will develop a series of unfolding case scenarios using national health data with multiple-choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and Research Ethics Committee approval were obtained in March and November 2016, respectively. Patient outcomes and safety are directly linked to nurses' critical thinking skills. This study will develop an assessment tool to provide a standardized method of measuring nurses' critical thinking skills across Australia. This will provide healthcare providers with greater confidence in the critical thinking level of graduate Registered Nurses. © 2017 John Wiley & Sons Ltd.

Assessing Consensus Between UK Renal Clinicians on Listing for Kidney Transplantation: A Modified Delphi Study.

PubMed

Tonkin-Crine, Sarah; Pruthi, Rishi; Taylor, Dominic M; Leydon, Geraldine M; Calestani, Melania; Oniscu, Gabriel C; Bradley, J Andrew; Tomson, Charles R; Bradley, Clare; Dudley, Christopher; Watson, Christopher J E; Draper, Heather; Johnson, Rachel J; Metcalfe, Wendy; Fogarty, Damian G; Ravanan, Rommel; Roderick, Paul

2018-05-01

It is well recognized that there is significant variation between centers in access to kidney transplantation. In the absence of high-grade evidence, it is unclear whether variation is due to patient case mix, other center factors, or individual clinician decisions. This study sought consensus between UK clinicians on factors that should influence access to kidney transplantation. As part of the Access to Transplantation and Transplant Outcome Measures project, consultant nephrologists and transplant surgeons in 71 centers were invited to participate in a Delphi study involving 2 rounds. During rounds 1 and 2, participants rated their agreement to 29 statements covering 8 topics regarding kidney transplantation. A stakeholder meeting was used to discuss statements of interest after the 2 rounds. In total, 122 nephrologists and 16 transplant surgeons from 45 units participated in rounds 1 and 2. After 2 rounds, 12 of 29 statements reached consensus. Fifty people participated in the stakeholder meeting. After the stakeholder meeting, a further 4 statements reached agreement. Of the 8 topics covered, consensus was reached in 6: use of a transplant protocol, patient age, body mass index, patient compliance with treatment, cardiac workup, and use of multidisciplinary meetings. Consensus was not reached on screening for malignancy and use of peripheral Doppler studies. The Delphi process identified factors upon which clinicians agreed and areas where consensus could not be achieved. The findings should inform national guidelines to support decision making in the absence of high quality evidence and to guide areas that warrant future research.

Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice.

PubMed

Cohn, David E; Havrilesky, Laura J; Osann, Kathryn; Lipscomb, Joseph; Hsieh, Susie; Walker, Joan L; Wright, Alexi A; Alvarez, Ronald D; Karlan, Beth Y; Bristow, Robert E; DiSilvestro, Paul A; Wakabayashi, Mark T; Morgan, Robert; Mukamel, Dana B; Wenzel, Lari

2015-09-01

To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing Consensus Between UK Renal Clinicians on Listing for Kidney Transplantation: A Modified Delphi Study

PubMed Central

Tonkin-Crine, Sarah; Pruthi, Rishi; Taylor, Dominic M.; Leydon, Geraldine M.; Calestani, Melania; Oniscu, Gabriel C.; Bradley, J. Andrew; Tomson, Charles R.; Bradley, Clare; Dudley, Christopher; Watson, Christopher J.E.; Draper, Heather; Johnson, Rachel J.; Metcalfe, Wendy; Fogarty, Damian G.; Ravanan, Rommel; Roderick, Paul

2018-01-01

Background It is well recognized that there is significant variation between centers in access to kidney transplantation. In the absence of high-grade evidence, it is unclear whether variation is due to patient case mix, other center factors, or individual clinician decisions. This study sought consensus between UK clinicians on factors that should influence access to kidney transplantation. Methods As part of the Access to Transplantation and Transplant Outcome Measures project, consultant nephrologists and transplant surgeons in 71 centers were invited to participate in a Delphi study involving 2 rounds. During rounds 1 and 2, participants rated their agreement to 29 statements covering 8 topics regarding kidney transplantation. A stakeholder meeting was used to discuss statements of interest after the 2 rounds. Results In total, 122 nephrologists and 16 transplant surgeons from 45 units participated in rounds 1 and 2. After 2 rounds, 12 of 29 statements reached consensus. Fifty people participated in the stakeholder meeting. After the stakeholder meeting, a further 4 statements reached agreement. Of the 8 topics covered, consensus was reached in 6: use of a transplant protocol, patient age, body mass index, patient compliance with treatment, cardiac workup, and use of multidisciplinary meetings. Consensus was not reached on screening for malignancy and use of peripheral Doppler studies. Conclusions The Delphi process identified factors upon which clinicians agreed and areas where consensus could not be achieved. The findings should inform national guidelines to support decision making in the absence of high quality evidence and to guide areas that warrant future research. PMID:29796414

Development of a tool to support holistic generic assessment of clinical procedure skills.

PubMed

McKinley, Robert K; Strand, Janice; Gray, Tracey; Schuwirth, Lambert; Alun-Jones, Tom; Miller, Helen

2008-06-01

The challenges of maintaining comprehensive banks of valid checklists make context-specific checklists for assessment of clinical procedural skills problematic. This paper reports the development of a tool which supports generic holistic assessment of clinical procedural skills. We carried out a literature review, focus groups and non-participant observation of assessments with interview of participants, participant evaluation of a pilot objective structured clinical examination (OSCE), a national modified Delphi study with prior definitions of consensus and an OSCE. Participants were volunteers from a large acute teaching trust, a teaching primary care trust and a national sample of National Health Service staff. Results In total, 86 students, trainees and staff took part in the focus groups, observation of assessments and pilot OSCE, 252 in the Delphi study and 46 candidates and 50 assessors in the final OSCE. We developed a prototype tool with 5 broad categories amongst which were distributed 38 component competencies. There was > 70% agreement (our prior definition of consensus) at the first round of the Delphi study for inclusion of all categories and themes and no consensus for inclusion of additional categories or themes. Generalisability was 0.76. An OSCE based on the instrument has a predicted reliability of 0.79 with 12 stations and 1 assessor per station or 10 stations and 2 assessors per station. This clinical procedural skills assessment tool enables reliable assessment and has content and face validity for the assessment of clinical procedural skills. We have designated it the Leicester Clinical Procedure Assessment Tool (LCAT).

Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique.

PubMed

Strøm, M; Lönn, L; Bech, B; Schroeder, T V; Konge, L

2017-07-01

To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR). A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200-3000) from vascular surgery (n = 21) and radiology (n = 11) was established. The first Delphi round was based on a review of endovascular skills assessment papers, stent graft instructions for use, and structured interviews. It led to a primary pool of 83 items that were formulated as global rating scale items with tentative anchors. Iterative Delphi rounds were executed. The panellists rated the importance of each item on a 5 point Likert scale. Consensus was defined as 80% of the panel rating an item 4 or 5 in the primary round and 90% in subsequent rounds. Consensus on the final assessment tool was defined as Cronbach's alpha > .8 after a minimum of three rounds. Thirty-two of 35 invited experts participated. Three rounds of surveys were completed with a completion rate of 100% in the first two rounds and 91% in round three. The 83 primary assessment items were supplemented with five items suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable, and superior performance on a 5 point Likert scale. The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), represents key elements in the procedure. EVARATE constitutes an assessment tool for providing structured feedback to endovascular operators in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

The setting of standards for agricultural nitrogen emissions: a case study of the Delphi technique.

PubMed

Angus, A J; Hodge, I D; McNally, S; Sutton, M A

2003-12-01

The Delphi technique is a means of aggregating the judgement of a panel of experts in order to improve the quality of decision-making. This paper provides a case study of the technique by undertaking a three-round Delphi study to determine a package of best available techniques to reduce nitrogen emissions from a poultry unit under the Integrated Pollution Prevention and Control Directive (IPPC). Forms of nitrogen addressed included ammonia (NH3), nitrous oxide (N2O) nitrogen oxides (NOx), dusts and nitrate (NO3-), with the study providing a means to prioritise the pollution concerns on different spatial scales. The priority pollutant issues were the contribution of NH3 to eutrophication, the global cooling effect of NH4+ aerosol, the role of NH4+ as a vector for atmospheric transport of NOx and SO2, the contribution of N2O to global warming, and NO3- leaching. Reduced nitrogen (NHx) was rated as a priority on all scales, while N2O and NO3- were rated as priorities only on global and local scales, respectively. The study indicated the need for abatement techniques at each stage of poultry rearing and waste management, with particular attention to reduce NH3 emissions, reflecting the priority pollutant concerns. Measures identified by the panel include maintenance of dry litter, low emission removal of litter from housing and storage of litter under cover. Once the litter has left the farm, this should either be used as a biofuel for electricity generation or rapidly incorporated into agricultural soils. The amounts and timing of manure application should be tuned to crop needs. Uncertainties in the Delphi technique limit its suitability as a stand-alone decision making tool. However, the Delphi technique proved useful in identifying priority pollutant issues, areas of agreement, disagreement and where information is lacking. This demonstrates its use when dealing with the complex issues of prioritising pollution issues and abatement approaches.

DelPhi web server v2: incorporating atomic-style geometrical figures into the computational protocol.

PubMed

Smith, Nicholas; Witham, Shawn; Sarkar, Subhra; Zhang, Jie; Li, Lin; Li, Chuan; Alexov, Emil

2012-06-15

A new edition of the DelPhi web server, DelPhi web server v2, is released to include atomic presentation of geometrical figures. These geometrical objects can be used to model nano-size objects together with real biological macromolecules. The position and size of the object can be manipulated by the user in real time until desired results are achieved. The server fixes structural defects, adds hydrogen atoms and calculates electrostatic energies and the corresponding electrostatic potential and ionic distributions. The web server follows a client-server architecture built on PHP and HTML and utilizes DelPhi software. The computation is carried out on supercomputer cluster and results are given back to the user via http protocol, including the ability to visualize the structure and corresponding electrostatic potential via Jmol implementation. The DelPhi web server is available from http://compbio.clemson.edu/delphi_webserver.

A Delphi approach to developing a core competency framework for family practice registered nurses in Ontario.

PubMed

Moaveni, Azadeh; Gallinaro, Anna; Conn, Lesley Gotlib; Callahan, Sheilagh; Hammond, Melanie; Oandasan, Ivy

2010-12-01

This paper describes the results of a Delphi panel process to gain consensus on a role description and competency framework for family practice registered nurses (FP-RNs) in Ontario. Based on the findings from interviews and focus groups with family practice registered nurses and their inter-professional colleagues throughout Ontario, a core competency framework for FP-RNs emerged consisting of six distinct roles - Professional, Expert, Communicator, Synergist, Health Educator and Lifelong Learner - with accompanying enabling competency statements. This framework was refined and validated by a panel of experts from various nursing and family medicine associations and organizations through a Delphi consensus process. This core competency framework for FP-RNs was developed as a stepping stone for clarifying this very important and poorly understood role in family practice. As a result of this research, we expect a greater acknowledgement of the contributions and expertise of the FP-RN as well as the need to celebrate and profile this role. This work has already led to the establishment of a network of stakeholders from nursing organizations in Ontario who are considering opportunities to move the development and use of the competency framework forward.

Research Priorities for NCD Prevention and Climate Change: An International Delphi Survey.

PubMed

Colagiuri, Ruth; Boylan, Sinead; Morrice, Emily

2015-10-16

Climate change and non-communicable diseases (NCDs) are arguably the greatest global challenges of the 21st Century. However, the confluence between them remains under-examined and there is little evidence of a comprehensive, systematic approach to identifying research priorities to mitigate their joint impact. Consequently, we: (i) convened a workshop of academics (n = 25) from the Worldwide Universities Network to identify priority areas at the interface between NCDs and climate change; (ii) conducted a Delphi survey of international opinion leaders in public health and relevant other disciplines; and (iii) convened an expert panel to review and advise on final priorities. Three research areas (water security; transport; conceptualising NCD harms to support policy formation) were listed among the top 10 priorities by >90% of Delphi respondents, and ranked among the top 12 priorities by >60% of respondents who ranked the order of priority. A fourth area (reducing the carbon footprint of cities) was ranked highest by the same >60% of respondents. Our results are consistent with existing frameworks on health and climate change, and extends them by focusing specifically on NCDs. Researching these priorities could progress understanding of climate change and NCDs, and inform global and national policy decisions for mitigating associated harms.

Remediation System Evaluation, Delphi Corporation Site in Vandalia, Ohio

EPA Pesticide Factsheets

This RSE pertains to aspects of the corrective action underway at two neighboring plants, the Delphi Energy and Chassis Systems Plant and Delphi Safety and Interior Systems Plant, collectively referred to as the “facility” in this report.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy.

PubMed

Rowe, Michael; Frantz, Jose; Bozalek, Vivienne

2013-04-10

While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond "having" knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills.

A cognitive perspective on health systems integration: results of a Canadian Delphi study.

PubMed

Evans, Jenna M; Baker, G Ross; Berta, Whitney; Barnsley, Jan

2014-05-19

Ongoing challenges to healthcare integration point toward the need to move beyond structural and process issues. While we know what needs to be done to achieve integrated care, there is little that informs us as to how. We need to understand how diverse organizations and professionals develop shared knowledge and beliefs - that is, we need to generate knowledge about normative integration. We present a cognitive perspective on integration, based on shared mental model theory, that may enhance our understanding and ability to measure and influence normative integration. The aim of this paper is to validate and improve the Mental Models of Integrated Care (MMIC) Framework, which outlines important knowledge and beliefs whose convergence or divergence across stakeholder groups may influence inter-professional and inter-organizational relations. We used a two-stage web-based modified Delphi process to test the MMIC Framework against expert opinion using a random sample of participants from Canada's National Symposium on Integrated Care. Respondents were asked to rate the framework's clarity, comprehensiveness, usefulness, and importance using seven-point ordinal scales. Spaces for open comments were provided. Descriptive statistics were used to describe the structured responses, while open comments were coded and categorized using thematic analysis. The Kruskall-Wallis test was used to examine cross-group agreement by level of integration experience, current workplace, and current role. In the first round, 90 individuals responded (52% response rate), representing a wide range of professional roles and organization types from across the continuum of care. In the second round, 68 individuals responded (75.6% response rate). The quantitative and qualitative feedback from experts was used to revise the framework. The re-named "Integration Mindsets Framework" consists of a Strategy Mental Model and a Relationships Mental Model, comprising a total of nineteen content areas. The Integration Mindsets Framework draws the attention of researchers and practitioners to how various stakeholders think about and conceptualize integration. A cognitive approach to understanding and measuring normative integration complements dominant cultural approaches and allows for more fine-grained analyses. The framework can be used by managers and leaders to facilitate the interpretation, planning, implementation, management and evaluation of integration initiatives.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy

PubMed Central

2013-01-01

Background While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond “having” knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. Methods This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. Results Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. Conclusions There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills. PMID:23574731

A Fifteen-Year Forecast of Information-Processing Technology. Final Report.

ERIC Educational Resources Information Center

Bernstein, George B.

This study developed a variation of the DELPHI approach, a polling technique for systematically soliciting opinions from experts, to produce a technological forecast of developments in the information-processing industry. SEER (System for Event Evaluation and Review) combines the more desirable elements of existing techniques: (1) intuitive…

Use of expert judgment elicitation to estimate seismic vulnerability of selected building types

USGS Publications Warehouse

Jaiswal, K.S.; Aspinall, W.; Perkins, D.; Wald, D.; Porter, K.A.

2012-01-01

Pooling engineering input on earthquake building vulnerability through an expert judgment elicitation process requires careful deliberation. This article provides an overview of expert judgment procedures including the Delphi approach and the Cooke performance-based method to estimate the seismic vulnerability of a building category.

Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies.

PubMed

Kennie-Kaulbach, Natalie; Farrell, Barbara; Ward, Natalie; Johnston, Sharon; Gubbels, Ashley; Eguale, Tewodros; Dolovich, Lisa; Jorgenson, Derek; Waite, Nancy; Winslade, Nancy

2012-03-28

Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services. Using a modified Delphi process including assessing perception of the frequency and criticality of performing tasks, we validated competencies important to primary health care pharmacists practising across Canada. Ten key informants contributed to competency drafting; thirty-three expert pharmacists replied to a second round survey. The final primary health care pharmacist competencies consisted of 34 elements and 153 sub-elements organized in seven CanMeds-based domains. Highest importance rankings were allocated to the domains of care provider and professional, followed by communicator and collaborator, with the lower importance rankings relatively equally distributed across the manager, advocate and scholar domains. Expert pharmacists working in primary health care estimated their most important responsibilities to be related to direct patient care. Competencies that underlie and are required for successful fulfillment of these patient care responsibilities, such as those related to communication, collaboration and professionalism were also highly ranked. These ranked competencies can be used to help pharmacists understand their potential roles in these evolving practices, to help other health care professionals learn about pharmacists' contributions to primary health care, to establish standards and performance indicators, and to prioritize supports and education to maximize effectiveness in this role.

Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study.

PubMed

Sampaio, Francisco Miguel Correia; Sequeira, Carlos; Lluch Canut, Teresa

2017-04-01

To estimate the content validity of a psychotherapeutic intervention model in nursing. Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. Modified e-Delphi. Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia: The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process.

PubMed

Carr, Norman J; Cecil, Thomas D; Mohamed, Faheez; Sobin, Leslie H; Sugarbaker, Paul H; González-Moreno, Santiago; Taflampas, Panos; Chapman, Sara; Moran, Brendan J

2016-01-01

Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and its primary appendiceal neoplasia is contentious, and an international modified Delphi consensus process was instigated to address terminology and definitions. A classification of mucinous appendiceal neoplasia was developed, and it was agreed that "mucinous adenocarcinoma" should be reserved for lesions with infiltrative invasion. The term "low-grade appendiceal mucinous neoplasm" was supported and it was agreed that "cystadenoma" should no longer be recommended. A new term of "high-grade appendiceal mucinous neoplasm" was proposed for lesions without infiltrative invasion but with high-grade cytologic atypia. Serrated polyp with or without dysplasia was preferred for tumors with serrated features confined to the mucosa with an intact muscularis mucosae. Consensus was achieved on the pathologic classification of PMP, defined as the intraperitoneal accumulation of mucus due to mucinous neoplasia characterized by the redistribution phenomenon. Three categories of PMP were agreed-low grade, high grade, and high grade with signet ring cells. Acellular mucin should be classified separately. It was agreed that low-grade and high-grade mucinous carcinoma peritonei should be considered synonymous with disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis, respectively. A checklist for the pathologic reporting of PMP and appendiceal mucinous neoplasms was also developed. By adopting the classifications and definitions that were agreed, different centers will be able to use uniform terminology that will allow meaningful comparison of their results.

Development of quality indicators for transition from pediatric to adult care in sickle cell disease: A modified Delphi survey of adult providers.

PubMed

Sobota, Amy E; Shah, Nishita; Mack, Jennifer W

2017-06-01

Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition. Our expert panel consisted of members of the Sickle Cell Adult Provider Network. In the first round, the participants ranked a list of quality indicators by importance. In the second round, the participants chose their "top 5" quality indicators in terms of importance and also ranked them on feasibility. The response rates for the two rounds were 68 and 96%, respectively. Nine quality indicators were chosen as "top 5" by a majority of respondents, including communication between pediatric and adult providers, timing of first adult visit, patient self-efficacy, quality of life, and trust with their adult provider. Based on the comments from round 1, respondents were also asked for the optimal timing between leaving pediatric care and entering adult care. Most recommended a first adult visit within 2 months of the final pediatric visit. By using these quality indicators chosen by the majority of respondents, we can better develop and evaluate transition programs for young adults with SCD and improve health outcomes for these vulnerable patients. © 2016 Wiley Periodicals, Inc.

Developing a tool for nurses to assess risk of infection in pediatric oncology patients in China: a modified Delphi study.

PubMed

Zhou, Yufeng; Cui, Yan; Wang, Hong; Wang, Fang; Lu, Chao; Shen, Yan

2016-09-01

Infections are identified as the most common preventable cause of death in pediatric oncology patients. Assessing and stratifying risk of infections are essential to prevent infection in these patients. To date, no tool can fulfill this demand in China. This study aimed to develop a nursing work-based and Chinese-specific tool for pediatric nurses to assess risk of infection in oncology patients. This research was a modified Delphi study. Based on a literature review, a 37-item questionnaire rating on a 0-5 scale was developed. Twenty-four experts from 8 hospitals in 6 provinces of China were consulted for three rounds. Consensus for each item in the first round was defined as: the rating mean was>3 and the coefficient of variation (CV) was<0.5. Consensus for each item in the second round was defined as CV<0.3. Consensus among experts was defined as: P value of Kendall's coefficient of concordance ( W )<0.05. After three rounds of consultation, a two-part tool was developed: the Immune Status Scale (ISS) and the Checklist of Risk Factors of Infection (CRFI). There were 5 items in the ISS and 14 in the CRFI. Based on the ISS score, nurses could stratify children into the low-risk and high-risk groups. For high-risk children, nurses should screen risk factors of infection every day by the CRFI, and twice weekly for low-risk children. Further study is needed to verify this tool's efficacy. © 2016 the Journal of Biomedical Research. All rights reserved.

Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies

PubMed Central

2012-01-01

Background Pharmacists have expanded their roles and responsibilities as a result of primary health care reform. There is currently no consensus on the core competencies for pharmacists working in these evolving practices. The aim of this study was to develop and validate competencies for pharmacists' effective performance in these roles, and in so doing, document the perceived contribution of pharmacists providing collaborative primary health care services. Methods Using a modified Delphi process including assessing perception of the frequency and criticality of performing tasks, we validated competencies important to primary health care pharmacists practising across Canada. Results Ten key informants contributed to competency drafting; thirty-three expert pharmacists replied to a second round survey. The final primary health care pharmacist competencies consisted of 34 elements and 153 sub-elements organized in seven CanMeds-based domains. Highest importance rankings were allocated to the domains of care provider and professional, followed by communicator and collaborator, with the lower importance rankings relatively equally distributed across the manager, advocate and scholar domains. Conclusions Expert pharmacists working in primary health care estimated their most important responsibilities to be related to direct patient care. Competencies that underlie and are required for successful fulfillment of these patient care responsibilities, such as those related to communication, collaboration and professionalism were also highly ranked. These ranked competencies can be used to help pharmacists understand their potential roles in these evolving practices, to help other health care professionals learn about pharmacists' contributions to primary health care, to establish standards and performance indicators, and to prioritize supports and education to maximize effectiveness in this role. PMID:22455482

Development and content validation of performance assessments for endoscopic third ventriculostomy.

PubMed

Breimer, Gerben E; Haji, Faizal A; Hoving, Eelco W; Drake, James M

2015-08-01

This study aims to develop and establish the content validity of multiple expert rating instruments to assess performance in endoscopic third ventriculostomy (ETV), collectively called the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). The important aspects of ETV were identified through a review of current literature, ETV videos, and discussion with neurosurgeons, fellows, and residents. Three assessment measures were subsequently developed: a procedure-specific checklist (CL), a CL of surgical errors, and a global rating scale (GRS). Neurosurgeons from various countries, all identified as experts in ETV, were then invited to participate in a modified Delphi survey to establish the content validity of these instruments. In each Delphi round, experts rated their agreement including each procedural step, error, and GRS item in the respective instruments on a 5-point Likert scale. Seventeen experts agreed to participate in the study and completed all Delphi rounds. After item generation, a total of 27 procedural CL items, 26 error CL items, and 9 GRS items were posed to Delphi panelists for rating. An additional 17 procedural CL items, 12 error CL items, and 1 GRS item were added by panelists. After three rounds, strong consensus (>80% agreement) was achieved on 35 procedural CL items, 29 error CL items, and 10 GRS items. Moderate consensus (50-80% agreement) was achieved on an additional 7 procedural CL items and 1 error CL item. The final procedural and error checklist contained 42 and 30 items, respectively (divided into setup, exposure, navigation, ventriculostomy, and closure). The final GRS contained 10 items. We have established the content validity of three ETV assessment measures by iterative consensus of an international expert panel. Each measure provides unique assessment information and thus can be used individually or in combination, depending on the characteristics of the learner and the purpose of the assessment. These instruments must now be evaluated in both the simulated and operative settings, to determine their construct validity and reliability. Ultimately, the measures contained in the NEVAT may prove suitable for formative assessment during ETV training and potentially as summative assessment measures during certification.

Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study

PubMed Central

2017-01-01

Objective This study aimed to identify potentially important factors in explaining burnout in nursing that have been insufficiently studied or ignored. Methods A three-round Delphi study via e-mail correspondence was conducted, with a group of 40 European experts. The e-Delphi questionnaire consisted of 52 factors identified from a literature review. Experts rated and scored the importance of factors in the occurrence of burnout and the degree of attention given by researchers to each of the variables listed, on a six-point Likert scale. We used the agreement percentage (>80%) to measure the level of consensus between experts. Furthermore, to confirm the level of consensus, we also calculated mean scores and modes. Regardless of the degree of consensus reached by the experts, we have calculated the mean of the stability of the answers for each expert (individual's qualitative stability) and the mean of the stability percentages of the experts (qualitative group stability). Results The response rate in the three rounds was 93.02% (n = 40). Eight new factors were suggested in the first round. After modified, the e-Delphi questionnaire in the second and third rounds had 60 factors. All the factors reached the third round with a consensus level above 80% in terms of the attention that researchers gave them in their studies. Moreover, the data show a total mean qualitative group stability of 96.21%. In the third round 9 factors were classified by experts as ‘studied very little’, 17 as ‘studied little’ and 34 as 'well studied' Conclusion Findings show that not all the factors that may influence nursing burnout have received the same attention from researchers. The panel of experts has identified factors that, although important in explaining burnout, have been poorly studied or even forgotten. Our results suggest that further study into factors such as a lack of recognition of part of the tasks that nurses perform, feminine stereotype or excessive bureaucracy is needed for a better understanding of this syndrome and improve the quality of life in nurses. PMID:28388660

ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol.

PubMed

Helmy, R; Zullig, L L; Dunbar-Jacob, J; Hughes, D A; Vrijens, B; Wilson, I B; De Geest, S

2017-02-10

Medication adherence is fundamental to achieving optimal patient outcomes. Reporting research on medication adherence suffers from some issues-including conceptualisation, measurement and data analysis-that thwart its advancement. Using the ABC taxonomy for medication adherence as the conceptual basis, a steering committee of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) launched an initiative to develop ESPACOMP Medication Adherence Reporting Guidelines (EMERGE). This paper is a protocol for a Delphi study that aims to build consensus among a group of topic experts regarding an item list that will support developing EMERGE. This study uses a reactive-Delphi design where a group of topic experts will be asked to rate the relevance and clarity of an initial list of items, in addition to suggesting further items and/or modifications of the initial items. The initial item list, generated by the EMERGE steering committee through a structured process, consists of 26 items distributed in 2 sections: 4 items representing the taxonomy-based minimum reporting criteria, and 22 items organised according to the common reporting sections. A purposive sample of experts will be selected from relevant disciplines and diverse geographical locations. Consensus will be achieved through predefined decision rules to keep, delete or modify the items. An iterative process of online survey rounds will be carried out until consensus is reached. An ethics approval was not required for the study according to the Swiss federal act on research involving human beings. The participating experts will be asked to give an informed consent. The results of this Delphi study will feed into EMERGE, which will be disseminated through peer-reviewed publications and presentations at conferences. Additionally, the steering committee will encourage their endorsement by registering the guidelines at the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network and other relevant organisations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.

PubMed

Ueda, Kayo; Ohtera, Shosuke; Kaso, Misato; Nakayama, Takeo

2017-09-22

In childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan. We used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012. The assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively. We established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.

Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II*

PubMed Central

Thorlacius, L.; Garg, A.; Ingram, J.R.; Villumsen, B.; Riis, P. Theut; Gottlieb, A.B.; Merola, J.F.; Dellavalle, R.; Ardon, C.; Baba, R.; Bechara, F.G.; Cohen, A.D.; Daham, N.; Davis, M.; Emtestam, L.; Fernández-Peñas, P.; Filippelli, M.; Gibbons, A.; Grant, T.; Guilbault, S.; Gulliver, S.; Harris, C; Harvent, C.; Houston, K.; Kirby, J.S.; Matusiak, L.; Mehdizadeh, A.; Mojica, T.; Okun, M.; Orgill, D.; Pallack, L.; Parks-Miller, A.; Prens, E.P.; Randell, S.; Rogers, C.; Rosen, C.F.; Choon, S.E.; van der Zee, H.H.; Christensen, R.; Jemec, G.B.E.

2018-01-01

Summary Background A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items. Objectives To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains. Methods The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey. Results Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments. Conclusions The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings. PMID:29080368

The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach

PubMed Central

Macrae, Rhoda; Lillo-Crespo, Manuel; Rooney, Kevin D

2017-01-01

Abstract Introduction There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and ‘change making’ should become an intrinsic part of everyone’s job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy. Methods This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania. Results A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: ‘Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.’ Conclusions The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science. PMID:28289467

Which Behavior Change Techniques May Help Waterpipe Smokers to Quit? An Expert Consensus Using a Modified Delphi Technique.

PubMed

O'Neill, Nancy; Dogar, Omara; Jawad, Mohammed; Kellar, Ian; Kanaan, Mona; Siddiqi, Kamran

2018-01-05

Waterpipe smoking is addictive and harmful. The determinants of waterpipe smoking may differ from those of cigarette smoking; therefore, behavioral approaches to support quitting may also differ between these two tobacco products. While some evidence exists on effective behavioral change techniques (BCTs) to facilitate cigarette smoking cessation, there is little research on waterpipe smoking cessation. Twenty-four experts were selected from the author lists of peer-reviewed, randomized controlled trials on waterpipe smoking cessation. They were invited to two rounds of a consensus development exercise using modified Delphi technique. Experts ranked 55 BCTs categorized further into those that promote; "awareness of harms of waterpipe smoking and advantages of quitting" (14), "preparation and planning to quit" (29), and "relapse prevention and sustaining an ex-smoker identity" (12) on their potential effectiveness. Kendall's W statistics was used to assess agreement. Fifteen experts responded in round 1 and 14 completed both rounds. A strong consensus was achieved for BCTs that help in "relapse prevention and sustaining ex-smoker identity" (w = 0.7; p < .001) and a moderate for those that promote "awareness of harms of waterpipe smoking and advantages of quitting" (w = 0.6; p < .001) and "preparation and planning to quit" (w = 0.6; p < .001). Providing information on the consequences of waterpipe smoking and its cessation, assessing readiness and ability to quit, and making people aware of the withdrawal symptoms, were the three highest-ranking BCTs. Based on expert consensus, an inventory of BCTs ordered for their potential effectiveness can be useful for health professionals offering cessation support to waterpipe smokers. Waterpipe smoking is addictive, harmful, and gaining global popularity, particularly among youth. An expert consensus on behavior change techniques, likely to be effective in supporting waterpipe smokers to quit, has practice and research implications. Smoking cessation advisors can use these techniques to counsel waterpipe smokers who wish to quit. Behavioral and public health scientists can also use these to develop and evaluate behavioral support interventions for this client group. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Beyond the false negative rate: development of quality indicators for sentinel lymph node biopsy in breast cancer.

PubMed

Quan, May Lynn; Wells, Bryan J; McCready, David; Wright, Frances C; Fraser, Novlette; Gagliardi, Anna R

2010-02-01

Sentinel lymph node biopsy (SNLB) has been adopted as the standard method of axillary staging for women with clinically node-negative early-stage breast cancer. The false negative rate as a quality indicator is impractical given the need for a completion axillary dissection to calculate. The objective of this study was to develop practical quality indicators for SLNB using an expert consensus method and to determine if they were feasible to measure. We used a modified Delphi consensus process to develop quality indicators for SLNB. A multidisciplinary expert panel reviewed potential indicators extracted from the medical literature to select quality indicators that were relevant and measurable. Feasibility was determined by abstracting the quality indicator variables from a retrospective chart review. The expert panel prioritized 11 quality indicators as benchmarks for assessing the quality of surgical care in SNLB. Nine of the indicators were measurable at the chart or institutional level. A systematic evidence- and consensus-based approach was used to develop measurable quality indicators that could be used by practicing surgeons and administrators to evaluate performance of SLNB in breast cancer.

ACR Appropriateness Criteria® management of locoregionally advanced squamous cell carcinoma of the vulva.

PubMed

Kidd, Elizabeth; Moore, David; Varia, Mahesh A; Gaffney, David K; Elshaikh, Mohamed A; Erickson, Beth; Jhingran, Anuja; Lee, Larissa J; Mayr, Nina A; Puthawala, Ajmel A; Rao, Gautam G; Small, William; Wahl, Andrew O; Wolfson, Aaron H; Yashar, Catheryn M; Yuh, William; Cardenes, Higinia Rosa

2013-08-01

Locoregionally advanced vulvar cancer (LRAVC) is a rare disease that presents many challenging medical decisions. An expert panel was convened to reach consensus on the most appropriate pretreatment assessment and therapeutic interventions in LRAVC patients. The American College of Radiology Appropriateness Criteria are evidenced-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journal and the application of a well-established consensus methodology (modified Delphi) to rate appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to formulate recommendations. Three clinical variants were developed to address common scenarios in the management of LRAVC. Group members reached consensus on the appropriateness of specific evaluation and treatment approaches, with numerical ratings and descriptive commentary. In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate management of patients with LRAVC.

A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

PubMed Central

Stockfleth, Eggert; Peris, Ketty; Guillen, Carlos; Cerio, Rino; Basset-Seguin, Nicole; Foley, Peter; Sanches, José; Culshaw, Alex; Erntoft, Sandra; Lebwohl, Mark

2015-01-01

Background Topical therapy is important in the treatment of actinic keratosis, but guidance for improving adherence/persistence during topical therapy is still lacking. Objectives To utilize expert consensus to generate a list of recommendations to improve real-world efficacy when prescribing topical therapy for actinic keratosis. Methods An expert panel of eight dermatologists was convened to generate recommendations based on facilitated discussion and consensus generation using a modified Delphi session. The recommendations were ratified with the expert panel. Results Facilitated discussion generated 31 issues within five themes, which were prioritized using expert voting. Consensus was achieved on the importance of short and simple treatment regimens for maximizing patient compliance, physician awareness of the progression of actinic keratosis to squamous cell carcinoma, provision of appropriate patient information, and the use of effective communication strategies to educate physicians about actinic keratosis. Based on these key findings, eight recommendations were generated. Conclusions The recommendations will assist physicians when prescribing topical actinic keratosis therapy. Further research should focus on the types of patient outcomes that are influenced by the characteristics of topical field therapy. PMID:25865875

A core outcome set for clinical trials on non-specific low back pain: study protocol for the development of a core domain set.

PubMed

Chiarotto, Alessandro; Terwee, Caroline B; Deyo, Richard A; Boers, Maarten; Lin, Chung-Wei Christine; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Ostelo, Raymond W

2014-12-26

Low back pain (LBP) is one of the most disabling and costly disorders affecting modern society, and approximately 90% of patients are labelled as having non-specific LBP (NSLBP). Several interventions for patients with NSLBP have been assessed in clinical trials, but heterogeneous reporting of outcomes in these trials has hindered comparison of results and performance of meta-analyses. Moreover, there is a risk of selective outcome reporting bias. To address these issues, the development of a core outcome set (COS) that should be measured in all clinical trials for a specific health condition has been recommended. A standardized set of outcomes for LBP was proposed in 1998, however, with evolution in COS development methodology, new instruments, interventions, and understanding of measurement properties, it is appropriate to update that proposal. This protocol describes the methods used in the initial step in developing a COS for NSLBP, namely, establishing a core domain set that should be measured in all clinical trials. An International Steering Committee including researchers, clinicians, and patient representatives from four continents was formed to guide the development of this COS. The approach of initiatives like Core Outcome Measures in Effectiveness Trials (COMET) and Outcome Measures in Rheumatology (OMERACT) was followed. Participants were invited to participate in a Delphi study aimed at generating a consensus-based core domain set for NSLBP. A list of potential core domains was drafted and presented to the Delphi participants who were asked to judge which domains were core. Participant suggestions about overlap, aggregation, or addition of potential core domains were addressed during the study. The patients' responses were isolated to assess whether there was substantial disagreement with the rest of the Delphi panel. A priori thresholds for consensus were established before each Delphi round. All participants' responses were analysed from a quantitative and qualitative perspective to ascertain that no substantial discrepancies between the two approaches emerged. We present the initial step in developing a COS for NSLBP. The next step will be to determine which measurement instruments adequately cover the domains.

Which information on women's issues in epilepsy does a community pharmacist need to know? A Delphi consensus study.

PubMed

Shawahna, Ramzi

2017-12-01

The aim of this study was to develop and achieve consensus on a core list of important knowledge items that community pharmacists should know on women's issues in epilepsy. This was a consensual study using a modified Delphi technique. Knowledge items were collected from the literature and from nine key contacts who were interviewed on their views on what information community pharmacists should have on women's issues in epilepsy. More knowledge items were suggested by five researchers with interest in women's issues who were contacted to rate and comment on the knowledge items collected. Two iterative Delphi rounds were conducted among a panel of pharmacists (n=30) to achieve consensus on the knowledge items to be included in the core list. Ten panelists ranked the knowledge items by their importance using the Analytical Hierarchy Process (AHP). Consensus was achieved to include 68 knowledge under 13 categories in the final core list. Items ranked by their importance were related to the following: teratogenicity (10.3%), effect of pregnancy on epilepsy (7.4%), preconception counseling (10.3%), bone health (5.9%), catamenial epilepsy (7.4%), menopause and hormonal replacement therapy (2.9%), contraception (14.7%), menstrual disorders and infertility (8.8%), eclampsia (2.9%), breastfeeding (4.4%), folic acid and vitamin K (5.9%), counseling on general issues (14.7%), and sexuality (4.4%). Using consensual knowledge lists might promote congruence in educating and/or training community pharmacists on women's issues in epilepsy. Future studies are needed to investigate if such lists can improve health services provided to women with epilepsy (WWE). Copyright © 2017 Elsevier Inc. All rights reserved.

What should dental services for people with disabilities be like? Results of an Irish Delphi panel survey.

PubMed

Mac Giolla Phadraig, Caoimhin; Nunn, June; Dougall, Alison; O'Neill, Eunan; McLoughlin, Jacinta; Guerin, Suzanne

2014-01-01

This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland. The study used a three round modified e-Delphi method, involving dental service professionals and people with disabilities or their representatives, in Ireland. Three rounds were completed online using SurveyMonkey. Round 1 asked: "List what you think dental services for people with disabilities in Ireland should be like." Items for subsequent rounds were generated from responses to Round 1. Round 2 and Round 3 used 5 point Likert scales to rank these items by priority: from No Priority (1) to Top Priority (5). Consensus was achieved on each item where at least 80% of respondents considered an item either High or Top Priority. A consensus meeting concluded the process. Sixty-one panelists started and 48 completed the survey. The Delphi panel agreed on level of priority for 69 items and generated 16 consensus statements. These statements covered a range of topics such as access to care, availability of information and training, quality of care, dental treatment and cost. A recurrent theme relating to the appropriateness of care to individual need arose across topics suggesting a need to match service delivery according to the individual's needs, wants and expectations rather than the disability type/diagnosis based service which predominates today. This process produced a list of prioritised goals for dental services for people with disabilities. This creates a foundation for building evidence-based service models for people with disabilities in Ireland.

Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

PubMed

Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

2015-10-01

The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to benchmark and guide their quality improvement activities.

Ensuring that ecological science contributes to natural resource management using a Delphi-derived approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolfe, Amy K; Dale, Virginia H; Arthur, Taryn A

This chapter approaches participatory modeling in environmental decision making from an atypical perspective. It broadly addresses the question of how to assure that science conducted to assist practitioners improves resource management. More specifically, it describes a case involving environmental science and natural resource management at Fort Benning, a U.S. Army installation in the southeastern United States where disparate environmental research projects were funded by a single federal agency to enhance the ability of Fort Benning resource managers to achieve their resource management goals. The role of our effort was to integrate the scientific studies in a manner that would bemore » meaningful and useful for resource managers. Hence we assembled a team consisting of an anthropologist, ecologist, microbiologist, statistician, and geographic information systems specialist who developed a common framework that served as the basis for this integration. The team first used a Delphi expert elicitation, which evolved into an approach more akin to facilitated negotiation. This second approach arose organically, particularly when our team took advantage of an opportunity for face-to-face interaction. Although the shift in our approach was unplanned, it proved to be highly productive. We discuss the potential utility of our approach for other situations and suggest that it would be useful to initiate at the beginning of research where the aim is to produce scientific results that meet practitioners needs, specifically in the realm of environmental science and resource management.« less

Research priorities for respiratory nursing: a UK-wide Delphi study.

PubMed

Kelly, Carol Ann; Kirkcaldy, Andrew J; Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle; Knighting, Katherine

2018-04-01

Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) "Patient understanding of asthma control"; 2) "The clinical and cost-effectiveness of respiratory nurse interventions"; 3) "The impact of nurse-led clinics on patient care"; 4) "Inhaler technique"; and 5) two topics jointly scored: "Prevention of exacerbations" and "Symptom management". With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research.

Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Cohen, Robert; Adini, Bruria

2010-04-01

In December 2007, the European Society of Intensive Care Medicine established a Task Force to develop standard operating procedures (SOPs) for operating intensive care units (ICU) during an influenza epidemic or mass disaster. To provide direction for health care professionals in the preparation and management of emergency ICU situations during an influenza epidemic or mass disaster, standardize activities, and promote coordination and communication among the medical teams. Based on a literature review and contributions of content experts, a list of essential categories for managing emergency situations in the ICU were identified. Based on three cycles of a modified Delphi process, consensus was achieved regarding the categories. A primary author along with an expert group drafted SOPs for each category. Based on the Delphi cycles, the following key topics were found to be important for emergency preparedness: triage, infrastructure, essential equipment, manpower, protection of staff and patients, medical procedures, hospital policy, coordination and collaboration with interface units, registration and reporting, administrative policies and education. The draft SOPs serve as benchmarks for emergency preparedness and response of ICUs to emergencies or outbreak of pandemics.

Corruption and oil exploration: expert agreement about the prevention of HIV/AIDS in the Niger Delta of Nigeria.

PubMed

Udoh, Isidore A; Stammen, Ronald M; Mantell, Joanne E

2008-08-01

The Niger Delta, according to the Nigerian Ministry of Health, has a disproportionately high HIV infection rate, which is double the national average. The United Nations Development Program attributes the spiraling HIV infection rate in the region to poverty, migration and gender inequality. This paper examines two complementary suppositions: Is the high prevalence of HIV in the Niger Delta related to incompetent leadership and corruption? Is it related to the negative effects of oil exploration in the region? Currently, there is a dearth of research on the effectiveness of government programs or the role of the oil industry on the impact of AIDS in Nigeria. To address this gap, we conducted a survey with 27 internationally renowned experts from diverse disciplines using a three-round modified Delphi to formulate consensus about the impact of weak governance and oil corruption on AIDS in the Niger Delta. Results from the Delphi suggest that these factors and others have exacerbated the transmission of HIV in the region. To mitigate the impact of AIDS in the region, efforts to engage oil companies in implementing HIV prevention programs as part of their corporate environmental responsibility to the community are urgently needed.

Position Statement of the Israeli Society for Musculoskeletal Medicine on Intramuscular Stimulation for Myofascial Pain Syndrome-A Delphi Process.

PubMed

Ratmansky, Motti; Minerbi, Amir; Kalichman, Leonid; Kent, John; Wende, Osnat; Finestone, Aharon S; Vulfsons, Simon

2017-04-01

To develop consensus on a position paper on the use of intramuscular stimulation (IMS) for the treatment of myofascial pain syndrome (MPS) by physicians in Israel. The Israeli Society of Musculoskeletal Medicine ran a modified Delphi process to gather opinions from a multidisciplinary expert panel. Eight experts in the treatment of MPS were chosen and asked to participate, and six participated. The position paper was iterated three times. After three iterations, general consensus was reached by all six experts. The general statement that was agreed on was: "IMS is one of the preferred treatments for myofascial pain syndrome. The treatment is evidence-based, effective, safe, and inexpensive. The position of the Israeli Society of Musculoskeletal Medicine is that the treatment should be taught and used by all primary care physicians and those physicians in other areas of medicine who deal with pain in their work." The position paper is a basis for clinical work and education programs for physicians interested in a better understanding and ability to treat patients with a musculoskeletal complaint or manifestation of disease. © 2016 World Institute of Pain.

78 FR 48468 - Delphi Corporation, Electronics and Safety Division, Including On-Site Leased Workers From...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

..., Electronics and Safety Division, Including On-Site Leased Workers From Securitas, Bartech, Flint Janitorial... Adjustment Assistance on May 20, 2013, applicable to workers of Delphi Corporation, Electronics and Safety... on- site at the Flint, Michigan location of Delphi Corporation, Electronics and Safety Division. The...

Delphi: An Overview, An Application, Some Lessons.

ERIC Educational Resources Information Center

Moore, Carl M.; Coke, James G.

This paper discusses Delphi-a method of utilizing individuals' knowledge, judgment, and opinions to address complex questions and applies the method to a community planning project in Stow, Ohio. There are four phases of any Delphi: (1) exploring the subject under discussion, with each individual contributing pertinent information, (2) reaching an…

75 FR 20383 - Delphi Thermal Systems Currently Known as General Motors Components Holdings LLC, Lockport...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-63,818] Delphi Thermal Systems... 25, 2008, applicable to workers of Delphi Thermal Systems, Lockport Operations, Lockport, New York... workers are engaged in activities related to the production of automotive heat exchanger products and HVAC...

Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies.

PubMed

Diamond, Ivan R; Grant, Robert C; Feldman, Brian M; Pencharz, Paul B; Ling, Simon C; Moore, Aideen M; Wales, Paul W

2014-04-01

To investigate how consensus is operationalized in Delphi studies and to explore the role of consensus in determining the results of these studies. Systematic review of a random sample of 100 English language Delphi studies, from two large multidisciplinary databases [ISI Web of Science (Thompson Reuters, New York, NY) and Scopus (Elsevier, Amsterdam, NL)], published between 2000 and 2009. About 98 of the Delphi studies purported to assess consensus, although a definition for consensus was only provided in 72 of the studies (64 a priori). The most common definition for consensus was percent agreement (25 studies), with 75% being the median threshold to define consensus. Although the authors concluded in 86 of the studies that consensus was achieved, consensus was only specified a priori (with a threshold value) in 42 of these studies. Achievement of consensus was related to the decision to stop the Delphi study in only 23 studies, with 70 studies terminating after a specified number of rounds. Although consensus generally is felt to be of primary importance to the Delphi process, definitions of consensus vary widely and are poorly reported. Improved criteria for reporting of methods of Delphi studies are required. Copyright © 2014 Elsevier Inc. All rights reserved.

The Theory and Practice of Structural and Strategic Family Therapies: A Delphi Study.

ERIC Educational Resources Information Center

Fish, Linda Stone; Piercy, Fred P.

1987-01-01

Examined the similarities and differences in the theory and practice of structural and strategic family therapy. A national panel of structural and strategic therapists identified items they thought important to a profile of either structural or strategic family therapy. Mental Research Institute, Haley/Madanes, and Milan/Ackerman approaches to…

Heuristics: A Step Toward Getting There.

ERIC Educational Resources Information Center

Anderson, G. Ernest, Jr.

This paper describes a series of heuristic approaches to helping schools analyze problems by the use of a teletype time-sharing computer terminal. The examples detailed include 1) a Delphi exercise for students; 2) a budgeting model which examines the results of various levels of funding and of changes of relative priorities; 3) a school…

Equitable Leadership on the Ground: Converging on High-Leverage Practices

ERIC Educational Resources Information Center

Galloway, Mollie K.; Ishimaru, Ann M.

2017-01-01

What would leadership standards look like if developed through a lens and language of equity? We engaged with a group of 40 researchers, practitioners, and community leaders recognized as having expertise on equity in education to address this question. Using a Delphi technique, an approach designed to elicit expert feedback and measure…

Handbook for Educators Involved in Vocationally Oriented Programming for Moderately Retarded Adolescents.

ERIC Educational Resources Information Center

Pritchett, E. Milo; Pullman, Robert J.

The handbook is designed to help teachers and administrators develop or improve vocationally oriented programs for moderately retarded students. The major topics addressed in the book were identified through a Delphi data gathering approach. Seven sections are arranged in the order that activities should occur in program modification and/or…

Identifying a Core Set of Science Teaching Practices: A Delphi Expert Panel Approach

ERIC Educational Resources Information Center

Kloser, Matthew

2014-01-01

The "Framework for K-12 Science Education" details ambitious goals for students' learning of science content and practices. However, this document provides science teachers little guidance about instructional practices that are central to helping students achieve these goals. Research indicates that a teacher's instructional…

The ICNP-BaT--a multilingual web-based tool to support the collaborative translation of the International Classification for Nursing Practice (ICNP).

PubMed

Schrader, Ulrich; Tackenberg, Peter; Widmer, Rudolf; Portenier, Lucien; König, Peter

2007-01-01

To ease and speed up the translation of the ICNP version 1 into the German language a web service was developed to support the collaborative work of all Austrian, Swiss, and German translators and subsequently of the evaluators of the resultant translation. The web service does help to support a modified Delphi technique. Since the web service is multilingual by design it can facilitate the translation of the ICNP into other languages as well. The process chosen can be adopted by other projects involved in translating terminologies.

TREatment of ATopic eczema (TREAT) Registry Taskforce: protocol for an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema registries.

PubMed

Gerbens, Louise A A; Boyce, Aaron E; Wall, Dmitri; Barbarot, Sebastien; de Booij, Richard J; Deleuran, Mette; Middelkamp-Hup, Maritza A; Roberts, Amanda; Vestergaard, Christian; Weidinger, Stephan; Apfelbacher, Christian J; Irvine, Alan D; Schmitt, Jochen; Williamson, Paula R; Spuls, Phyllis I; Flohr, Carsten

2017-02-27

Patients with moderate-to-severe atopic eczema (AE) often require photo- or systemic immunomodulatory therapies to induce disease remission and maintain long-term control. The current evidence to guide clinical management is small, despite the frequent and often off-label use of these treatments. Registries of patients on photo- and systemic immunomodulatory therapies could fill this gap, and the collection of a core set concerning these therapies in AE will allow direct comparisons across registries as well as data sharing and pooling. Using an eDelphi approach, the international TREatment of ATopic eczema (TREAT) Registry Taskforce aims to seek consensus between key stakeholders internationally on a core set of domains and domain items for AE patient registries with a research focus that collect data of children and adults on photo- and systemic immunomodulatory therapies. Participants from six stakeholder groups will be invited: doctors, nurses, non-clinical researchers, patients, as well as industry and regulatory body representatives. The eDelphi will comprise three sequential online rounds, requesting participants to rate the importance of each proposed domain and domain items. Participants will be able to add domains and domain items to the proposed list in round 1. A final consensus meeting will be held with representatives of each stakeholder group. Identifying a uniform core set of domains and domain items to be captured by AE patient registries will increase the utility of individual registries, and provide greater insight into the effectiveness, safety and cost-effectiveness of photo- and systemic immunomodulatory therapies to guide clinical management across dermatology centres and country borders. Not applicable. This eDelphi study was registered in the Core Outcome Measures for Effectiveness Trials (COMET) database.

Developing a guideline for clinical trial protocol content: Delphi consensus survey

PubMed Central

2012-01-01

Background Recent evidence has highlighted deficiencies in clinical trial protocols, having implications for many groups. Existing guidelines for randomized clinical trial (RCT) protocol content vary substantially and most do not describe systematic methodology for their development. As one of three prespecified steps for the systematic development of a guideline for trial protocol content, the objective of this study was to conduct a three-round Delphi consensus survey to develop and refine minimum content for RCT protocols. Methods Panellists were identified using a multistep iterative approach, met prespecified minimum criteria and represented key stakeholders who develop or use clinical trial protocols. They were asked to rate concepts for importance in a minimum set of items for RCT protocols. The main outcome measures were degree of importance (scale of 1 to 10; higher scores indicating higher importance) and level of consensus for items. Results were presented as medians, interquartile ranges, counts and percentages. Results Ninety-six expert panellists participated in the Delphi consensus survey including trial investigators, methodologists, research ethics board members, funders, industry, regulators and journal editors. Response rates were between 88 and 93% per round. Overall, panellists rated 63 of 88 concepts of high importance (of which 50 had a 25th percentile rating of 8 or greater), 13 of moderate importance (median 6 or 7) and 12 of low importance (median less than or equal to 5) for minimum trial protocol content. General and item-specific comments and subgroup results provided valuable insight for further discussions. Conclusions This Delphi process achieved consensus from a large panel of experts from diverse stakeholder groups on essential content for RCT protocols. It also highlights areas of divergence. These results, complemented by other empirical research and consensus meetings, are helping guide the development of a guideline for protocol content. PMID:23006145

Defining the Bobath concept using the Delphi technique.

PubMed

Raine, Sue

2006-03-01

The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept. A four-round Delphi study design was used. The sample included all members of the British Bobath Tutor's Association, who are considered experts in the field. Initial statements were identified from the literature, with respondents generating additional statements during the study. The level of agreement was determined using a five-point Likert scale. The respondents were then provided with feedback on group opinions and given an opportunity to re-rate each statement. The level of group consensus was set at 80%. Fifteen experts took part. The response rate was 85% in the first round, and 93% in each subsequent round. Ten statements from the literature were rated with a further 12 generated by the experts. Thirteen statements achieved consensus for agreement and seven for disagreement. The Delphi study was an effective research tool, maintaining anonymity of responses and exploring expert opinions on the Bobath concept. The experts stated that Bobath's work has been misunderstood if it is considered as the inhibition of spasticity and the facilitation of normal movement, as described in some literature. They agreed that the Bobath concept was developed by the Bobaths as a living concept, understanding that as therapists' knowledge base grows their view of treatment broadens.

Current opinion and consensus statement regarding the diagnosis, prognosis, and treatment of patients with essential thrombocythemia: a survey of the Spanish Group of Ph-negative Myeloproliferative Neoplasms (GEMFIN) using the Delphi method.

PubMed

Besses, C; Hernández-Boluda, J C; Pérez Encinas, M; Raya, J M; Hernández-Rivas, J M; Jiménez Velasco, A; Martínez Lopez, J; Vicente, V; Burgaleta, C

2016-04-01

The current consensus on the diagnosis, prognosis, and treatment of essential thrombocythemia (ET) is based on experts' recommendations. However, several aspects of the diagnosis of, prognosis of, and therapy for ET are still controversial. The Delphi method was employed with an expert panel of members of the Spanish Group of Ph-negative Myeloproliferative Neoplasms in order to identify the degree of agreement on the diagnosis, prognosis, and treatment of ET. Nine leading experts selected a total of 41 clinical hematologists with well-known expertise in ET. An electronic questionnaire was used to collect the questions rated in a four-step scale. The questions were grouped into four blocks: diagnosis, risk stratification, goals of therapy, and treatment strategy. After the first round consisting of 80 questions, a second round including 14 additional questions focused on the recommendations advocated by experts of the European LeukemiaNet in 2011 was analyzed. The median and mean values for the first and second rounds were calculated. A summary of the conclusions considered as the most representative of each block of questions is presented. The Delphi method is a powerful instrument to address the current approaches and controversies surrounding ET.

Research Priorities for NCD Prevention and Climate Change: An International Delphi Survey

PubMed Central

Colagiuri, Ruth; Boylan, Sinead; Morrice, Emily

2015-01-01

Climate change and non-communicable diseases (NCDs) are arguably the greatest global challenges of the 21st Century. However, the confluence between them remains under-examined and there is little evidence of a comprehensive, systematic approach to identifying research priorities to mitigate their joint impact. Consequently, we: (i) convened a workshop of academics (n = 25) from the Worldwide Universities Network to identify priority areas at the interface between NCDs and climate change; (ii) conducted a Delphi survey of international opinion leaders in public health and relevant other disciplines; and (iii) convened an expert panel to review and advise on final priorities. Three research areas (water security; transport; conceptualising NCD harms to support policy formation) were listed among the top 10 priorities by >90% of Delphi respondents, and ranked among the top 12 priorities by >60% of respondents who ranked the order of priority. A fourth area (reducing the carbon footprint of cities) was ranked highest by the same >60% of respondents. Our results are consistent with existing frameworks on health and climate change, and extends them by focusing specifically on NCDs. Researching these priorities could progress understanding of climate change and NCDs, and inform global and national policy decisions for mitigating associated harms. PMID:26501301

The Delphi Predictions of Pathology Chairmen: A Six-Year Retrospective View.

ERIC Educational Resources Information Center

Hill, Rolla B.; Goodale, Fairfield

1981-01-01

A retrospective review is reported of progress in academic pathology since 1974, when the Association of Pathology Chairmen undertook a Delphi study of pathology chairmen's expectations and desires for the future. The Delphi study was useful in alerting academic pathologists to opportunities and in coalescing activities toward achievement of…

The Delphi Method for Graduate Research

ERIC Educational Resources Information Center

Skulmoski, Gregory J.; Hartman, Francis T.; Krahn, Jennifer

2007-01-01

The Delphi method is an attractive method for graduate students completing masters and PhD level research. It is a flexible research technique that has been successfully used in our program at the University of Calgary to explore new concepts within and outside of the information systems body of knowledge. The Delphi method is an iterative process…

Exploration to Identify Professional Dispositions of School Librarians: A Delphi Study

ERIC Educational Resources Information Center

Bush, Gail; Jones, Jami L.

2010-01-01

This article reports the findings of an exploratory study to identify professional dispositions of school librarians. The authors employed the Delphi method, a qualitative research method that emphasizes expert knowledge and consensus within a particular field. The Delphi panel consisted of members of the editorial boards of nationally recognized…

Identifying Core Concepts of Cybersecurity: Results of Two Delphi Processes

ERIC Educational Resources Information Center

Parekh, Geet; DeLatte, David; Herman, Geoffrey L.; Oliva, Linda; Phatak, Dhananjay; Scheponik, Travis; Sherman, Alan T.

2018-01-01

This paper presents and analyzes results of two Delphi processes that polled cybersecurity experts to rate cybersecurity topics based on importance, difficulty, and timelessness. These ratings can be used to identify core concepts--cross-cutting ideas that connect knowledge in the discipline. The first Delphi process identified core concepts that…

Setting Priorities for Gerontological Social Work Research: A National Delphi Study

ERIC Educational Resources Information Center

Burnette, Denise; Morrow-Howell, Nancy; Chen, Li-Mei

2003-01-01

Purpose: An increasingly important task for all disciplines involved in aging research is to identify and prioritize areas for investigation. This article reports the results of a national Delphi study on setting research priorities for gerontological social work. Design and Methods: Delphi methodology, a structured process for eliciting and…

Terminating Sequential Delphi Survey Data Collection

ERIC Educational Resources Information Center

Kalaian, Sema A.; Kasim, Rafa M.

2012-01-01

The Delphi survey technique is an iterative mail or electronic (e-mail or web-based) survey method used to obtain agreement or consensus among a group of experts in a specific field on a particular issue through a well-designed and systematic multiple sequential rounds of survey administrations. Each of the multiple rounds of the Delphi survey…

Engaging Patients and Caregivers Managing Rare Diseases to Improve the Methods of Clinical Guideline Development: A Research Protocol

PubMed Central

Kinnett, Kathi; Grant, Sean; Lucas, Ann; Martin, Ann; Denger, Brian; Peay, Holly; Coulter, Ian; Fink, Arlene

2017-01-01

Background Clinical guidelines provide systematically developed recommendations for deciding on appropriate health care options for specific conditions and clinical circumstances. Up until recently, patients and caregivers have rarely been included in the process of developing care guidelines. Objective This project will develop and test a new online method for including patients and their caregivers in this process using Duchenne muscular dystrophy (DMD) care guidelines as an example. The new method will mirror and complement the RAND/UCLA Appropriateness Method (RAM)—the gold standard approach for conducting clinical expert panels that uses a modified Delphi format. RAM is often used in clinical guideline development to determine care appropriateness and necessity in situations where existing clinical evidence is uncertain, weak, or unavailable. Methods To develop the new method for engaging patients and their caregivers in guideline development, we will first conduct interviews with experts on RAM, guideline development, patient engagement, and patient-centeredness and engage with Duchenne patients and caregivers to identify how RAM should be modified for the purposes of patient engagement and what rating criteria should patients and caregivers use to provide their input during the process of guideline development. Once the new method is piloted, we will test it by conducting two concurrently run patient/caregiver panels that will rate patient-centeredness of a subset of DMD care management recommendations already deemed clinically appropriate and necessary. The ExpertLens™ system—a previously evaluated online modified Delphi system that combines two rounds of rating with a round of feedback and moderated online discussions—will be used to conduct these panels. In addition to developing and testing the new engagement method, we will work with the members of our project’s Advisory Board to generate a list of best practices for enhancing the level of patient and caregiver involvement in the guideline development process. We will solicit input on these best practice from Duchenne patients, caregivers, and clinicians by conducting a series of round-table discussions and making a presentation at an annual conference on Duchenne. Results The study protocol was reviewed by RAND’s Human Subjects Protection Committee, which determined it to be exempt from review. Interviews with RAM experts have been completed. The projected study completion date is May 2020. Conclusions We expect that the new method will make it easier to engage large numbers of patients and caregivers in the process of guideline development in a rigorous and culturally appropriate manner that is consistent with the way clinicians participate in guideline development. Moreover, this project will develop best practices that could help involve patients and caregivers in the clinical guideline development process in other clinical areas, thereby facilitating the work of guideline developers. PMID:28455279

76 FR 46852 - Workers From Kelly Services, Working On-Site at Delphi Automotive Systems, LLC, Powertrain...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... Services, Working On-Site at Delphi Automotive Systems, LLC, Powertrain Division, El Paso, TX; Amended..., 2011, applicable to leased workers from Kelly Services working on-site at Delphi Automotive Systems... automotive components. The notice will be published soon in the Federal Register. At the request of the State...

Lessons Learned from Teaching Scratch as an Introduction to Object-Oriented Programming in Delphi

ERIC Educational Resources Information Center

van Zyl, Sukie; Mentz, Elsa; Havenga, Marietjie

2016-01-01

As part of curriculum changes in South Africa, an introductory programming language, Scratch, must first be taught before switching to the well-established teaching of Delphi. The nature of programming in Scratch is considerably different from that in Delphi. It was assumed that the teaching of Scratch as introductory programming language could…

Reference Materials in LIS Instruction: A Delphi Study

ERIC Educational Resources Information Center

Rabina, Debbie

2013-01-01

This paper presents the results of a Delphi study conducted over a two-month period in 2011. The purpose of the study was to identify reference sources that should be covered in basic reference courses taught in LIS programs in the United States. The Delphi method was selected for its appropriateness in soliciting expert opinions and assessing the…

A Delphi Study: Exploring Faculty Perceptions of the Best Practices Influencing Student Persistence in Blended Courses

ERIC Educational Resources Information Center

Manning, Kim Elise

2010-01-01

This Delphi study explored the instructional practices of community college faculty who were teaching blended or Web-assisted courses and how these practices influenced student persistence. The Delphi method provided qualitative data in the form of expert advice through consensus building on the instructional practices most likely to influence…

What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

ERIC Educational Resources Information Center

Zhang, Yin; Salaba, Athena

2009-01-01

This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

Career and Technical Education at a Crossroads: A Delphi Study

ERIC Educational Resources Information Center

Cutright, Michael W.

2011-01-01

Career and technical education in the United States has reached a critical juncture. A three round Delphi method was used to determine a consensus on the future events of career and technical education to better inform educational decision makers. Forty-one individual experts in the field were invited to serve as panelists for the Delphi study and…

Advantages and Limitations of the e-Delphi Technique: Implications for Health Education Researchers

ERIC Educational Resources Information Center

Donohoe, Holly; Stellefson, Michael; Tennant, Bethany

2012-01-01

In the last 30 years, the application of the Delphi technique has been increasing. With the recent availability and established popularity of Internet-based research tools, the Internet has been identified as a means for mitigating Delphi limitations, maximizing its advantages, and expanding the breadth of its application. The discourse on the…

A Delphi Study on Staff Bereavement Training in the Intellectual and Developmental Disabilities Field

ERIC Educational Resources Information Center

Gray, Jennifer A.; Truesdale, Jesslyn

2015-01-01

The Delphi technique was used to obtain expert panel consensus to prioritize content areas and delivery methods for developing staff grief and bereavement curriculum training in the intellectual and developmental disabilities (IDD) field. The Delphi technique was conducted with a panel of 18 experts from formal and informal disability caregiving,…

75 FR 41521 - Delphi Corporation, Automotive Holding Group, Plant 6, Currently Known as General Motors...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-16

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-62,069; TA-W-62,069A] Delphi Corporation, Automotive Holding Group, Plant 6, Currently Known as General Motors Corporation Including On-Site Leased Workers From Securitas, EDS, Bartech, Mays Chemicals, Interim Physicians, LLC and HSS Material Management, Flint, MI; Delphi...

Institutional Oversight of Faculty-Industry Consulting Relationships in U.S. Medical Schools: A Delphi Study.

PubMed

Morain, Stephanie R; Joffe, Steven; Campbell, Eric G; Mello, Michelle M

2015-01-01

The conflicts of interest that may arise in relationships between academic researchers and industry continue to prompt controversy. The bulk of attention has focused on financial aspects of these relationships, but conflicts may also arise in the legal obligations that faculty acquire through consulting contracts. However, oversight of faculty members' consulting agreements is far less vigorous than for financial conflicts, creating the potential for faculty to knowingly or unwittingly contract away important rights and freedoms. Increased regulation could prevent this, but it is unclear what forms of oversight universities view as feasible and effective. In this article, we report on a Delphi study to evaluate several approaches for oversight of consulting agreements by medical schools. The panel was comprised of 11 senior administrators with responsibility for oversight of faculty consulting relationships. We found broad agreement among panelists regarding the importance of institutional oversight to protect universities' interests. There was strong support for two specific approaches: providing educational resources to faculty and submitting consulting agreements for institutional review. Notwithstanding the complexities of asserting authority to regulate private consulting agreements between faculty members and companies, medical school administrators reached consensus that several approaches to improving institutional oversight are feasible and useful. © 2015 American Society of Law, Medicine & Ethics, Inc.

Navigating future uncertainty in marine protected area governance: Lessons from the Scottish MPA network

NASA Astrophysics Data System (ADS)

Hopkins, Charlotte Rachael; Bailey, David Mark; Potts, Tavis

2018-07-01

As international pressure for marine protection has increased, Scotland has increased spatial protection through the development of a Marine Protected Area (MPA) network. Few MPA networks to date have included specific considerations of climate change in the design, monitoring or management of the network. The Scottish MPA network followed a feature-led approach to identify a series of MPAs across the Scottish marine area and incorporated the diverse views of many different stakeholders. This feature led approach has led to wide ranging opinions and understandings regarding the success of the MPA network. Translating ideas of success into a policy approach whilst also considering how climate change may affect these ideas of success is a complex challenge. This paper presents the results of a Delphi process that aimed to facilitate clear communication between academics, policy makers and stakeholders in order to identify specific climate change considerations applicable to the Scottish MPA network. This study engaged a group of academic and non-academic stakeholders to discuss potential options that could be translated into an operational process for management of the MPA network. The results of Delphi process discussion are presented with the output of a management matrix tool, which could aid in future decisions for MPA management under scenarios of climate change.

Diagnosis and Management of Iliac Artery Endofibrosis: Results of a Delphi Consensus Study.

PubMed

2016-07-01

Iliac endofibrosis is a rare condition that may result in a reduction of blood flow to the lower extremity in young, otherwise healthy individuals. The data to inform everyday clinical management are weak and therefore a Delphi consensus methodology was used to explore areas of consensus and disagreement concerning the diagnosis and management of patients with suspected iliac endofibrosis. A three-round Delphi questionnaire approach was used among vascular surgeons, sports physicians, sports scientists, radiologists, and clinical vascular scientists with experience of treating this condition to explore diagnosis and clinical management issues for patients with suspected iliac artery endofibrosis. Analysis is based on 18 responses to round 2 and 14 responses to round 3, with agreement reported when 70% of respondents were in agreement. Initially there was agreement on the typical symptoms at presentation and the need for an exercise test in the diagnosis. Round 3 clarified that duplex ultrasound was a useful tool in the diagnosis of endofibrosis. There was consensus on the most appropriate type of surgery (endarterectomy and vein patch) and that endovascular interventions were inadvisable. The final round helped to inform aspects of the natural history and post-operative surveillance. Progression of the disease was likely with continued exercise but cessation may prevent progression. Surveillance after surgery is generally recommended yearly with at least a clinical assessment. There is broad agreement about the presenting symptoms and the investigations required to confirm (or exclude) the diagnosis of iliac endofibrosis. There was consensus on the surgical approach to repair. Disagreement existed about the specific diagnostic criteria that should be applied during non-invasive testing and about post-operative care and resumption of exercise. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

The expert's guide to mealtime interventions - A Delphi method survey.

PubMed

Conchin, Simone; Carey, Sharon

2017-09-27

Prevalence of malnutrition and a myriad of barriers to adequate oral diet in hospitalised patients warrants further investment to improve the patient mealtime experience. The aim of this study was to explore barriers and enablers to implementing effective mealtime interventions and develop a process framework to guide clinicians and researchers in the area. Potential experts in the area of hospital mealtime intervention were identified as having published in this field of work within the Australasian setting. Further information was sought by email and telephone communication on professional background; research experience; interest; and capacity to participate. Recruited participants were surveyed using a modified Delphi method to establish opinion and experience in the area of mealtime interventions. Results were collated and content was coded using a thematic analysis approach by the primary researcher and two additional reviewers. Thirty-two Australian authors in the area of mealtime interventions within the hospital environment were identified from publication. Twenty-one participants were able to be contacted and nineteen of these consented to enrol in the study. Participants included those from a dietetic (n = 14), nursing (n = 4) and medical (n = 1) background. Participants were deemed to have expert knowledge if they had significant involvement in the published research and demonstrated a deep level of understanding of hospital mealtime interventions. All participants provided key insights into barriers to oral intake in the hospital environment and suggestions for interventions to address these barriers. From the survey, an eight step framework to guide mealtime interventions was developed. Hospital mealtime interventions are complex processes. Interventions should be implemented after careful consideration of the local context and baseline data; and tailored to address barriers. Roles and responsibilities for nutrition care should be clear and consistent. Implementation planning is recommended to ensure that an ongoing process is in place to engage executive support and staff involvement, foster project team resilience and ensure sustainability of interventions. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Examining Curricular Integration Strategies To Optimize Learning Of The Anatomical Sciences

NASA Astrophysics Data System (ADS)

Lisk, Kristina Adriana Ayako

Background: Integration of basic and clinical science knowledge is essential to clinical practice. Although the importance of these two knowledge domains is well-recognized, successfully supporting the development of learners' integrated basic and clinical science knowledge, remains an educational challenge. In this dissertation, I examine curricular integration strategies to optimize learning of the anatomical sciences. Objectives: The studies were designed to achieve the following research aims: 1) to objectively identify clinically relevant content for an integrated musculoskeletal anatomy curriculum; 2) to examine the value of integrated anatomy and clinical science instruction compared to clinical science instruction alone on novices' diagnostic accuracy and diagnostic reasoning process; 3) to compare the effect of integrating and segregating anatomy and clinical science instruction along with a learning strategy (self-explanation) on novices' diagnostic accuracy. Methods: A modified Delphi was used to objectively select clinically relevant content for an integrated musculoskeletal anatomy curriculum. Two experimental studies were created to compare different instructional strategies to optimize learning of the curricular content. In both of these studies, novice learners were taught the clinical features of musculoskeletal pathologies using different learning approaches. Diagnostic performance was measured immediately after instruction and one-week later. Results: The results show that the Delphi method is an effective strategy to select clinically relevant content for integrated anatomy curricula. The findings also demonstrate that novices who were explicitly taught the clinical features of musculoskeletal diseases using causal basic science descriptions had superior diagnostic accuracy and a better understanding of the relative importance of key clinical features for disease categories. Conclusions: This research demonstrates how integration strategies can be applied at multiple levels of the curriculum. Further, this work shows the value of cognitive integration of anatomy and clinical science and it emphasizes the importance of purposefully linking the anatomical and clinical sciences in day-to-day teaching.

Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists

PubMed Central

2017-01-01

Purpose This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. Methods A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects’ responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. Results Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. Conclusion Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience. PMID:28900069

Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists.

PubMed

Hwang, Yoon-Sook; Kang, Hyun-Sook; Kim, Soo-Hwa; Moon, Hee-Jung; Lee, Sun-Mi; Jung, Jae-Yeon; Hwang, Su-Jeong; Ha, Jung-Eun

2017-01-01

This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects' responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience.

The Global Spine Care Initiative: a consensus process to develop and validate a stratification scheme for surgical care of spinal disorders as a guide for improved resource utilization in low- and middle-income communities.

PubMed

Acaroğlu, Emre; Mmopelwa, Tiro; Yüksel, Selcen; Ayhan, Selim; Nordin, Margareta; Randhawa, Kristi; Haldeman, Scott

2017-10-16

The purpose of this study was to develop a stratification scheme for surgical spinal care to serve as a framework for referrals and distribution of patients with spinal disorders. We used a modified Delphi process. A literature search identified experts for the consensus panel and the panel was expanded by inviting spine surgeons known to be global opinion leaders. After creating a seed document of five hierarchical levels of surgical care, a four-step modified Delphi process (question validation, collection of factors, evaluation of factors, re-evaluation of factors) was performed. Of 78 invited experts, 19 participated in round 1, and of the 19, 14 participated in 2, and 12 in 3 and 4. Consensus was fairly heterogeneous for levels of care 2-4 (moderate resources). Only simple assessment methods based on the clinical skills of the medical personnel were considered feasible and safe in low-resource settings. Diagnosis, staging, and treatment were deemed feasible and safe in a specialized spine center. Accurate diagnostic workup was deemed feasible and safe for lower levels of care complexity (from level 3 upwards) compared to non-invasive procedures (level 4) and the full range of invasive procedures (level 5). This study introduces a five-level stratification scheme for the surgical care of spinal disorders. This stratification may provide input into the Global Spine Care Initiative care pathway that will be applied in medically underserved areas and low- and middle-income countries. These slides can be retrieved under Electronic Supplementary Material.

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.

PubMed

Delahunt, Eamonn; Bleakley, Chris M; Bossard, Daniela S; Caulfield, Brian M; Docherty, Carrie L; Doherty, Cailbhe; Fourchet, François; Fong, Daniel T; Hertel, Jay; Hiller, Claire E; Kaminski, Thomas W; McKeon, Patrick O; Refshauge, Kathryn M; Remus, Alexandria; Verhagen, Evert; Vicenzino, Bill T; Wikstrom, Erik A; Gribble, Phillip A

2018-06-09

Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

PubMed

Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

2016-05-20

Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review

PubMed Central

de Boer, Karin; Burggraaf, Henriëtte; Derks, Jan B.; van Dijk, Det; van Dillen, Jeroen; Dirksen, Carmen D.; Duvekot, Johannes J.; Franx, Arie; Hasaart, Tom H. M.; Huisjes, Anjoke J. M.; Kolkman, Diny; Kwee, Anneke; Mol, Ben W.; van Pampus, Mariëlle G.; de Roon-Immerzeel, Alieke; van Roosmalen, Jos J. M.; Roumen, Frans J. M. E.; Smid-Koopman, Ellen; Spaans, Wilbert A.; Visser, Harry; van Wijngaarden, Wim J.; Willekes, Christine; Wouters, Maurice G. A. J.

2016-01-01

Background There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS) rates. Method Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modified Delphi method. A multi-center study was performed and medical charts of 1024 women with a CS and a stratified and weighted randomly selected group of 1036 women with a vaginal delivery were analysed. Quality indicator frequency and adherence were scored in 2060 women with a CS or vaginal delivery. Results The expert panel developed 16 indicators on planned CS and 11 indicators on unplanned CS. Indicator adherence was calculated, defined as the number of women in a specific obstetrical situation in which care was performed as recommended in both planned and unplanned CS settings. The most frequently occurring obstetrical situations with low indicator adherence were: 1) suspected fetal distress (frequency 17%, adherence 46%), 2) non-progressive labour (frequency 12%, CS performed too early in over 75%), 3) continuous support during labour (frequency 88%, adherence 37%) and 4) previous CS (frequency 12%), with adequate counselling in 15%. Conclusions We identified four concrete target groups for improvement of obstetrical care, which can be used as a starting point to reduce CS rates worldwide. PMID:26783742

The perspective of European researchers of national occupational safety and health institutes for contributing to a European research agenda: a modified Delphi study

PubMed Central

Gagliardi, Diana; Rondinone, Bruna M; Mirabile, Marco; Buresti, Giuliana; Ellwood, Peter; Hery, Michel; Paszkiewicz, Peter; Valenti, Antonio; Iavicoli, Sergio

2017-01-01

Objectives This study, developed within the frame of the Partnership for European Research on Occupational Safety and Health joint research activities and based on the frame designed by the 2013 European Agency for Safety and Health at Work (EU-OSHA) study, is the first example of using the points of view of European occupational safety and health (OSH) researchers. The objective is to identify priorities for OSH research that may contribute to the achievement of present and future sustainable growth objectives set by the European strategies. Methods The study was carried out using a modified Delphi method with a two-round survey. Each round involved a panel of about 110 researchers representing the network member institutes was selected according to specific criteria, including the ownership of research expertise in at least one of the four macroareas identified by the reference report developed by EU-OSHA in 2013. Results The study identified some innovative research topics (for example, ‘Emerging technological devices’ and ‘OSH consequences of markets integration’) and research priorities (ie, crowdsourcing, e-work, zero-hours contracts) that are not reflected in previous studies of this nature. The absence of any reference to violence and harassment at work among the researchers’ proposals is a major difference from previous similar studies, while topics related to gender issues and electromagnetic fields show a lower importance. Conclusions The innovative design of a research priorities identification process, which takes advantage of a large, representative and qualified panel of European researchers allowed the definition of a number of research priorities able to support the inclusion of innovative OSH research issues in the scope of the next European research agenda. PMID:28645965

International perspective on common core competencies for occupational physicians: a modified Delphi study.

PubMed

Lalloo, Drushca; Demou, Evangelia; Kiran, Sibel; Cloeren, Marianne; Mendes, René; Macdonald, Ewan B

2016-07-01

The competencies required of occupational physicians (OPs) have been the subject of peer-reviewed research in Europe and individual countries around the world. In the European Union (EU), there has been development of guidance on training and common competencies, but little research has extended beyond this. The aim of this study was to obtain consensus on and identify the common core competencies required of OPs around the world. A modified Delphi study was carried out among representative organisations and networks of OPs in a range of countries around the world. It was conducted in 2 rounds using a questionnaire based on the specialist training syllabus of a number of countries, expert panel reviews and conference discussions. Responses were received from 51 countries around the world, with the majority from Europe (60%; 59%) and North and South America (24%; 32%) in rounds 1 and 2, respectively. General principles of assessment and management of occupational hazards to health and good clinical care were jointly considered most important in ranking when compared with the other topic areas. Assessment of disability and fitness for work, communication skills and legal and ethical issues completed the top five. In both rounds, research methods and teaching and educational supervision were considered least important. This study has established the current priorities among OPs across 51 countries of the common competencies required for occupational health (OH) practice. These findings can serve as a platform for the development of common core competencies/qualifications within specific geographical regions or internationally. This is particularly pertinent with globalisation of commerce and free movement within the EU. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Applying the Modified Delphi Technique to Develop the Role of HIV Case Managers and Essential Nursing Competencies in HIV Care].

PubMed

Ko, Nai-Ying; Hsieh, Chia-Yin; Chen, Yen-Chin; Tsai, Chen-Hsi; Liu, Hsiao-Ying; Liu, Li-Fang

2015-08-01

Since 2005, the Taiwan Centers for Disease Control (Taiwan CDC) initiated an HIV case management program in AIDS-designated hospitals to provide integrative services and risk-reduction counseling for HIV-infected individuals. In light of the increasingly complex and highly specialized nature of clinical care, expanding and improving competency-based professional education is important to enhance the quality of HIV/AIDS care. The aim of this study was to develop the essential competency framework for HIV care for HIV case managers in Taiwan. We reviewed essential competencies of HIV care from Canada, the United Kingdom, and several African countries and devised descriptions of the roles of case managers and of the associated core competencies for HIV care in Taiwan. The modified Delphi technique was used to evaluate the draft framework of these roles and core competencies. A total of 15 HIV care experts were invited to join the expert panel to review and rank the draft framework. The final framework consisted of 7 roles and 27 competencies for HIV case managers. In Round 1, only 3 items did not receive consensus approval from the experts. After modification based on opinions of the experts, 7 roles and 27 competencies received 97.06% consensus approval in Round 2 and were organized into the final framework for HIV case managers. These roles and associated core competencies were: HIV Care Expert (9 competencies), Communicator (1 competency), Collaborator (4 competencies), Navigator (2 competencies), Manager (4 competencies), Advocate (2 competencies), and Professional (5 competencies). The authors developed an essential competency framework for HIV care using the consensus of a multidisciplinary expert panel. Curriculum developers and advanced nurses and practitioners may use this framework to support developments and to ensure a high quality of HIV care.

Reporting Guidelines for Clinical Pharmacokinetic Studies: The ClinPK Statement.

PubMed

Kanji, Salmaan; Hayes, Meghan; Ling, Adam; Shamseer, Larissa; Chant, Clarence; Edwards, David J; Edwards, Scott; Ensom, Mary H H; Foster, David R; Hardy, Brian; Kiser, Tyree H; la Porte, Charles; Roberts, Jason A; Shulman, Rob; Walker, Scott; Zelenitsky, Sheryl; Moher, David

2015-07-01

Transparent reporting of all research is essential for assessing the validity of any study. Reporting guidelines are available and endorsed for many types of research but are lacking for clinical pharmacokinetic studies. Such tools promote the consistent reporting of a minimal set of information for end users, and facilitate knowledge translation of research. The objective of this study was to create a guideline to assist in the transparent and complete reporting of clinical pharmacokinetic studies. Preliminary content to be considered was identified from a systematic search of the literature and regulatory documents. Stakeholders were identified to participate in a modified Delphi exercise and a virtual meeting to generate consensus for items considered essential in the reporting of clinical pharmacokinetic studies. The proposed checklist was pilot tested on 100 recently published clinical pharmacokinetic studies. Overall and itemized compliance with the proposed guidance was determined for each study. Sixty-eight stakeholders from nine countries consented to participate. Four rounds of a modified Delphi survey and a series of small virtual meetings were required to generate consensus for a 24-item checklist considered to be essential to the reporting of clinical pharmacokinetic studies. When applied to the 100 most recently published clinical pharmacokinetic studies, 45 were determined to be compliant with at least 80 % of the checklist items. Explanatory text was prepared using examples of compliant reporting from these and other relevant studies. The reader's ability to judge the validity of pharmacokinetic research can be greatly compromised by the incomplete reporting of study information. Using consensus methods, we have developed a tool to guide transparent and accurate reporting of clinical pharmacokinetic studies. Endorsement and implementation of these guidelines by researchers, clinicians and journals would promote more consistent reporting of these studies and allow for better assessment of utility for clinical applications.

Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique.

PubMed

Rankin, Gabrielle; Rushton, Alison; Olver, Pat; Moore, Ann

2012-09-01

To define research priorities to strategically inform the evidence base for physiotherapy practice. A modified Delphi method using SurveyMonkey software identified priorities for physiotherapy research through national consensus. An iterative process of three rounds provided feedback. Round 1 requested five priorities using pre-defined prioritisation criteria. Content analysis identified research themes and topics. Round 2 requested rating of the importance of the research topics using a 1-5 Likert scale. Round 3 requested a further process of rating. Quantitative and qualitative data informed decision-making. Level of consensus was established as mean rating ≥ 3.5, coefficient of variation ≤ 30%, and ≥ 55% agreement. Consensus across participants was evaluated using Kendall's W. Four expert panels (n=40-61) encompassing a range of stakeholders and reflecting four core areas of physiotherapy practice were established by steering groups (n=204 participants overall). Response rates of 53-78% across three rounds were good. The identification of 24/185 topics for musculoskeletal, 43/174 for neurology, 30/120 for cardiorespiratory and medical rehabilitation, and 30/113 for mental and physical health and wellbeing as priorities demonstrated discrimination of the process. Consensus between participants was good for most topics. Measurement validity of the research topics was good. The involvement of multiple stakeholders as participants ensured the current context of the intended use of the priorities. From a process of national consensus involving key stakeholders, including service users, physiotherapy research topics have been identified and prioritised. Setting priorities provides a vision of how research can contribute to the developing research base in physiotherapy to maximise focus. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Design of a consensus-derived synoptic operative report for lung cancer surgery.

PubMed

Schneider, Laura; Shargall, Yaron; Schieman, Colin; Seely, Andrew J; Srinathan, Sadeesh; Malthaner, Richard A; Pierre, Andrew F; Safieddine, Najib; Vaillancourt, Rosaire; Plourde, Madelaine; Bond, James; Johnson, Scott; Smith, Shona E; Finley, Christian J

2014-04-01

For lung cancer surgery, a narrative operative report is the standard reporting procedure, whereas a synoptic-style report is increasingly utilized by healthcare professionals in various specialties with great success. A synoptic operative report more succinctly and accurately captures vital information and is rapidly generated with good intraobserver reliability. The objective of this study was to systematically develop a synoptic operative report for lung cancer surgery following a modified Delphi consensus model with the support of the Canadian thoracic surgery community. Using online survey software, thoracic surgeons and related physicians were asked to suggest and rate data elements for a synoptic report following the modified Delphi consensus model. The consensus exercise-derived template was forwarded to a small working group, who further refined the definition and priority designation of elements until the working group had reached a satisfactory consensus. In all, 139 physicians were invited to participate in the consensus exercise, with 36.7%, 44.6%, and 19.5% response rates, respectively, in the three rounds. Eighty-nine elements were agreed upon at the conclusion of the exercise, but 141 elements were forwarded to the working group. The working group agreed upon a final data set of 180 independently defined data elements, with 72 mandatory and 108 optional elements for implementation in the final report. This study demonstrates the process involved in developing a multidisciplinary, consensus-based synoptic lung cancer operative report. This novel report style is a quality improvement initiative to improve the capture, dissemination, readability, and potential utility of critical surgical information. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Identifying Markers of Dignity-Conserving Care in Long-Term Care: A Modified Delphi Study

PubMed Central

Thompson, Genevieve N.; McArthur, Jennifer; Doupe, Malcolm

2016-01-01

Ensuring that people living in nursing homes (NHs) are afforded with dignity in their daily lives is an essential and humane concern. Promoting dignity-conserving care is fundamentally important. By nature, however, this care is all-encompassing and holistic, and from current knowledge it is challenging to create explicit strategies for measuring dignity-conserving care. In practice the majority of current NH indicators of quality care are derived from information that is routinely collected on NH residents using the RAI-Minimum Data Set (MDS). In this regard, issues that are more tangible to resident dignity such as being treated with respect, compassion, and having opportunities to engage with others are not adequately captured in current NH quality of care indicators. An initial set of markers was created by conducting an integrative literature review of existing markers and indicators of dignity in the NH setting. A modified Delphi process was used to prioritize essential dignity-conserving care markers for use by NH providers, based on factors such as the importance to fostering a culture of dignity, the impact it may have on the residents, and how achievable it is in practice. Through this consensus building technique, we were able to develop a comprehensive set of markers that capture the range and diversity of important dignity-conserving care strategies for use in NHs. The final 10 markers were judged as having high face validity by experts in the field and have explicit implications for enhancing the provision of daily dignified care to NH residents. These markers make an important addition to the traditional quality indicators used in the NH setting and as such, bridge an important gap in addressing the psychosocial and the less easily quantified needs of NH residents. PMID:27304853

The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.

PubMed

Tu, Jack V; Maclagan, Laura C; Ko, Dennis T; Atzema, Clare L; Booth, Gillian L; Johnston, Sharon; Tu, Karen; Lee, Douglas S; Bierman, Arlene; Hall, Ruth; Bhatia, R Sacha; Gershon, Andrea S; Tobe, Sheldon W; Sanmartin, Claudia; Liu, Peter; Chu, Anna

2017-04-25

High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care. We used a 2-stage modified Delphi panel process to rate potential indicators, which were identified from the literature and national cardiovascular organizations. The top-rated indicators were pilot tested to determine their measurement feasibility with the use of data routinely collected in the Canadian health care system. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes. The indicators reflect the major cardiovascular risk factors including smoking, obesity, hypertension, diabetes, dyslipidemia and atrial fibrillation. All indicators were determined to be amenable to measurement with the use of population-based administrative (physician claims, hospital admission, laboratory, medication), survey or electronic medical record databases. The Cardiovascular Health in Ambulatory Care Research Team indicators of primary prevention performance provide a framework for the measurement of cardiovascular primary prevention efforts in Canada. The indicators may be used by clinicians, researchers and policy-makers interested in measuring and improving the prevention of cardiovascular disease in ambulatory care settings. Copyright 2017, Joule Inc. or its licensors.

Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK.

PubMed

Pressler, Ronit M; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G

2017-08-01

Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

The Delphi Method: An Approach for Facilitating Evidence Based Practice in Athletic Training

ERIC Educational Resources Information Center

Sandrey, Michelle A.; Bulger, Sean M.

2008-01-01

Objective: The growing importance of evidence based practice in athletic training is necessitating academics and clinicians to be able to make judgments about the quality or lack of the body of research evidence and peer-reviewed standards pertaining to clinical questions. To assist in the judgment process, consensus methods, namely brainstorming,…

Identifying Novice Student Programming Misconceptions and Errors from Summative Assessments

ERIC Educational Resources Information Center

Veerasamy, Ashok Kumar; D'Souza, Daryl; Laakso, Mikko-Jussi

2016-01-01

This article presents a study aimed at examining the novice student answers in an introductory programming final e-exam to identify misconceptions and types of errors. Our study used the Delphi concept inventory to identify student misconceptions and skill, rule, and knowledge-based errors approach to identify the types of errors made by novices…

Toward an Innovative, Basic Program Model for the Improvement of Professional Instruction in Dental Education: A Review of the Literature.

ERIC Educational Resources Information Center

Wulf, Kathleen M.; And Others

1980-01-01

An analysis of the massive amount of literature pertaining to the improvement of professional instruction in dental education resulted in the formation of a comprehensive model of 10 categories, including Delphi technique; systems approach; agencies; workshops; multi-media, self-instruction; evaluation paradigms, measurement, courses, and…

Characterizing the sustainable forestry issue network in thc United States

Treesearch

Steverson O. Moffat; Frederick W. Cubbage; Thomas P. Holmes; Elizabethann O' Sullivan

2001-01-01

Issue network analysis techniques were applied to the issue sustainable forestry in the United States to identify potential public and private outcomes for the issue. A quantitative approach based on work by Laumann and Knoke [(The Organizational State (1987)] was utilized in conjunction with the Delphi method. Results suggest that the parity in the distribution of...

A Simulation Study of Mutations in the Genetic Regulatory Hierarchy for Butterfly Eyespot Focus Determination

PubMed Central

Marcus, Jeffrey M.; Evans, Travis M.

2008-01-01

The color patterns on the wings of butterflies have been an important model system in evolutionary developmental biology. A recent computational model tested genetic regulatory hierarchies hypothesized to underlie the formation of butterfly eyespot foci (Evans and Marcus, 2006). The computational model demonstrated that one proposed hierarchy was incapable of reproducing the known patterns of gene expression associated with eyespot focus determination in wild-type butterflies, but that two slightly modified alternative hierarchies were capable of reproducing all of the known gene expressions patterns. Here we extend the computational models previously implemented in Delphi 2.0 to two mutants derived from the squinting bush brown butterfly (Bicyclus anynana). These two mutants, comet and Cyclops, have aberrantly shaped eyespot foci that are produced by different mechanisms. The comet mutation appears to produce a modified interaction between the wing margin and the eyespot focus that results in a series of comet-shaped eyespot foci. The Cyclops mutation causes the failure of wing vein formation between two adjacent wing-cells and the fusion of two adjacent eyespot foci to form a single large elongated focus in their place. The computational approach to modeling pattern formation in these mutants allows us to make predictions about patterns of gene expression, which are largely unstudied in butterfly mutants. It also suggests a critical experiment that will allow us to distinguish between two hypothesized genetic regulatory hierarchies that may underlie all butterfly eyespot foci. PMID:18586070

Global research priorities for interpersonal violence prevention: a modified Delphi study.

PubMed

Mikton, Christopher R; Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L

2017-01-01

To establish global research priorities for interpersonal violence prevention using a systematic approach. Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. In round 2, "developing, implementing and evaluating interventions" was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, "scaling up interventions and evaluating their cost-effectiveness" was ranked lowest for all types of violence. In round 3, research into "developing, implementing and evaluating interventions" that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority.

Global research priorities for interpersonal violence prevention: a modified Delphi study

PubMed Central

Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L

2017-01-01

Abstract Objective To establish global research priorities for interpersonal violence prevention using a systematic approach. Methods Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. Findings In round 2, “developing, implementing and evaluating interventions” was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, “scaling up interventions and evaluating their cost–effectiveness” was ranked lowest for all types of violence. In round 3, research into “developing, implementing and evaluating interventions” that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. Conclusion These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority. PMID:28053363

Reducing Energy Cost and Greenhouse Gas Emission in the Corporate Sector, a Delphi Study

ERIC Educational Resources Information Center

Kramer, Maxim L.

2013-01-01

The study is titled "Reducing energy cost and GreenHouse Gas emission in the corporate sector, A Delphi Study". The study applied the Delphi methodology and focused on the Green IT solutions that can help the modern corporate organizations with less than 1000 employees to decrease their energy costs and GHG emissions. The study presents…

Concepts and Contexts in Engineering and Technology Education: An International and Interdisciplinary Delphi Study

ERIC Educational Resources Information Center

Rossouw, Ammeret; Hacker, Michael; de Vries, Marc J.

2011-01-01

Inspired by a similar study by Osborne et al. we have conducted a Delphi study among experts to identify key concepts to be taught in engineering and technology education and relevant and meaningful contexts through which these concepts can be taught and learnt. By submitting the outcomes of the Delphi study to a panel of experts in a two-day…

Consensus development of core competencies in intensive and critical care medicine training in China.

PubMed

Hu, Xiaoyun; Xi, Xiuming; Ma, Penglin; Qiu, Haibo; Yu, Kaijiang; Tang, Yaoqing; Qian, Chuanyun; Fang, Qiang; Wang, Yushan; Yu, Xiangyou; Xu, Yuan; Du, Bin

2016-10-16

The aim of this study is to develop consensus on core competencies required for postgraduate training in intensive care medicine. We used a combination of a modified Delphi method and a nominal group technique to create and modify the list of core competencies to ensure maximum consensus. Ideas were generated modified from Competency Based Training in Intensive Care Medicine in Europe collaboration (CoBaTrICE) core competencies. An online survey invited healthcare professionals, educators, and trainees to rate and comment on these competencies. The output from the online survey was edited and then reviewed by a nominal group of 13 intensive care professionals to identify each competence for importance. The resulting list was then recirculated in the nominal group for iterative rating. The online survey yielded a list of 199 competencies for nominal group reviewing. After five rounds of rating, 129 competencies entered the final set defined as core competencies. We have generated a set of core competencies using a consensus technique which can serve as an indicator for training program development.

A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process

PubMed Central

2011-01-01

Background There has been a growing concern in designing physical activity (PA) programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM) and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree) and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles), the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for the elderly. Conclusion Based on experts' opinions, a self-assessment tool was found in order to access quality of PA programmes for the elderly. Information obtained with evaluations would be useful to organizations seeking to improve their services, customer satisfaction and, consequently, adherence to PA programmes, targeting the ageing population. PMID:21958203

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery.

PubMed

Holubar, Stefan D; Hedrick, Traci; Gupta, Ruchir; Kellum, John; Hamilton, Mark; Gan, Tong J; Mythen, Monty G; Shaw, Andrew D; Miller, Timothy E

2017-01-01

Colorectal surgery (CRS) patients are an at-risk population who are particularly vulnerable to postoperative infectious complications. Infectious complications range from minor infections including simple cystitis and superficial wound infections to life-threatening situations such as lobar pneumonia or anastomotic leak with fecal peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches that can be used to reduce the risk of postoperative infections. With input from a multidisciplinary, international group of experts and through a focused (non-systematic) review of the literature, and use of a modified Delphi method, we achieved consensus surrounding the topic of prevention of postoperative infection in the perioperative period for CRS patients. As a part of the first Perioperative Quality Initiative (POQI-1) workgroup meeting, we sought to develop a consensus statement describing a comprehensive, yet practical, approach for reducing postoperative infections, specifically for CRS within an ERP. Surgical site infection (SSI) is the most common postoperative infection. To reduce SSI, we recommend routine use of a combined isosmotic mechanical bowel preparation with oral antibiotics before elective CRS and that infection prevention strategies (also called bundles) be routinely implemented as part of colorectal ERPs. We recommend against routine use of abdominal drains. We also give consensus guidelines for reducing pneumonia, urinary tract infection, and central line-associated bloodstream infection (CLABSI).

Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment. Part VI: Lumbar Spinal Stenosis.

PubMed

Fritz, Julie M; Rundell, Sean D; Dougherty, Paul; Gentili, Angela; Kochersberger, Gary; Morone, Natalia E; Naga Raja, Srinivasa; Rodriguez, Eric; Rossi, Michelle I; Shega, Joseph; Sowa, Gwendolyn; Weiner, Debra K

2016-03-01

. To present the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. . The evaluation and treatment algorithm, a table articulating the rationale for the individual algorithm components, and stepped-care drug recommendations were developed using a modified Delphi approach. The Principal Investigator, a five-member content expert panel and a nine-member primary care panel were involved in the iterative development of these materials. The illustrative clinical case was taken from the clinical practice of a contributor's colleague (SR). . We present an algorithm and supportive materials to help guide the care of older adults with LSS, a condition that occurs not uncommonly in those with CLBP. The case illustrates the importance of function-focused management and a rational approach to conservative care. . Lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery. Treatment should address all conditions in addition to LSS contributing to pain and disability. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

INTERPRETING PHYSICAL AND BEHAVIORAL HEALTH SCORES FROM NEW WORK DISABILITY INSTRUMENTS

PubMed Central

Marfeo, Elizabeth E.; Ni, Pengsheng; Chan, Leighton; Rasch, Elizabeth K.; McDonough, Christine M.; Brandt, Diane E.; Bogusz, Kara; Jette, Alan M.

2015-01-01

Objective To develop a system to guide interpretation of scores generated from 2 new instruments measuring work-related physical and behavioral health functioning (Work Disability – Physical Function (WD-PF) and WD – Behavioral Function (WD-BH)). Design Cross-sectional, secondary data from 3 independent samples to develop and validate the functional levels for physical and behavioral health functioning. Subjects Physical group: 999 general adult subjects, 1,017 disability applicants and 497 work-disabled subjects. Behavioral health group: 1,000 general adult subjects, 1,015 disability applicants and 476 work-disabled subjects. Methods Three-phase analytic approach including item mapping, a modified-Delphi technique, and known-groups validation analysis were used to develop and validate cut-points for functional levels within each of the WD-PF and WD-BH instrument’s scales. Results Four and 5 functional levels were developed for each of the scales in the WD-PF and WD-BH instruments. Distribution of the comparative samples was in the expected direction: the general adult samples consistently demonstrated scores at higher functional levels compared with the claimant and work-disabled samples. Conclusion Using an item-response theory-based methodology paired with a qualitative process appears to be a feasible and valid approach for translating the WD-BH and WD-PF scores into meaningful levels useful for interpreting a person’s work-related physical and behavioral health functioning. PMID:25729901

Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: policy coherence and application lessons for low and middle income countries.

PubMed

El-Jardali, Fadi; Saleh, Shadi; Ataya, Nour; Jamal, Diana

2011-12-01

This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A Delphi survey on diagnosis and management of stress velopharyngeal insufficiency in wind musicians.

PubMed

Evans, Alison; Driscoll, Tim; Ackermann, Bronwen

2014-10-01

The aim of this study was to identify current trends in clinical assessment and management of stress velopharyngeal insufficiency (VPI) in wind musicians. This was an online two-round Delphi survey of health practitioners familiar with assessing and treating musicians with stress VPI. Fourteen specialists (seven otolaryngologists and seven speech-language pathologists) from four countries participated in the Delphi survey. From the first round questionnaire, 32 items were identified as being causes, assessment tools, diagnostic indicators, and treatment methods for stress VPI. The second round questionnaire revealed that prolonged exposure to high intra-oral pressures was important in determining the cause of stress VPI. The most important assessment tools for stress VPI were case history and nasendoscopy. The most important indicator for stress VPI was self-reported symptoms. There was no clear agreement identified on the management methods for stress VPI for musicians. However, the trend followed by most of the survey participants was a combination of conservative management approaches (including rest or watch and wait, speech-language pathology intervention, velopharyngeal muscle training, and changes to the instrument or reed), and then, if symptoms persist, to use injection pharyngoplasty or pharyngeal flap. This survey demonstrates that no standard management protocol currently exists for musicians diagnosed with stress VPI, but provides current trends in the assessment and management which can be used in future guidelines for health professionals who treat wind musicians.

The development of a core syllabus for the teaching of oral anatomy, histology, and embryology to dental students via an international 'Delphi Panel'.

PubMed

Moxham, Bernard John; McHanwell, Stephen; Berkovitz, Barry

2018-03-01

The formulation of core syllabuses for the biomedical sciences within medical and dental courses is partially driven by the need to cope with decreased time allocations for these subjects as a result of major curricular changes taking place worldwide. There is also a requirement to deal with the request for increased clinical relevance. In response to such demands, the International Federation of Associations of Anatomists (IFAA) is devising core syllabuses for the anatomical sciences relating to the education and training of both scientific and clinical professions. The process initially involves using Delphi Panels consisting of a team of anatomists, scientists, and clinicians who evaluate syllabus content in detail and accord each element/topic 'essential,' 'important,' 'acceptable,' or 'not required' status. Their conjectures, published on the IFAA website, provide merely a framework to enable other stakeholders to comment. The approach is international in scope, is conceptually 'democratic,' and is developmentally fluid in being readily available for amendment. The aim is to set internationally recognized standards and thus to provide guidelines concerning anatomical knowledge when engaged in course development. This article presents the deliberations of an IFAA Delphi Panel into a core syllabus for oral anatomy, histology, and embryology within the dental curriculum. Clin. Anat. 31:231-249, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Exploring Organizational Evaluation Capacity and Evaluation Capacity Building: A Delphi Study of Taiwanese Elementary and Junior High Schools

ERIC Educational Resources Information Center

Cheng, Shu-Huei; King, Jean A.

2017-01-01

Researchers have conducted numerous empirical studies on evaluation capacity (EC) and evaluation capacity building (ECB) in Western cultural settings. However, little is known about these practices in non-Western contexts. To that end, this study identified the major dimensions of EC and feasible ECB approaches in Taiwanese elementary and junior…

A Delphi Approach to the Preparation of Early-Career Agricultural Educators in the Curriculum Area of Agricultural Mechanics: Fully Qualified and Highly Motivated or Status Quo?

ERIC Educational Resources Information Center

Saucier, P. Ryan; McKim, Billy R.; Tummons, John D.

2012-01-01

According to the National Research Agenda for Agricultural Education and Communication, preservice agriculture teacher education programs should "prepare and provide an abundance of fully qualified and highly motivated agricultural educators at all levels" (Osborne, 2007, 8). The lack of preparation of entry career agricultural educators…

A Change Management Approach to Enhance Facility Maintenance Programs

DTIC Science & Technology

2014-03-27

dependent on the particular research effort and the researcher’s experience. Large groups tend to increase the decision quality but can be difficult...consolidate SME opinions on facility maintenance criteria. The Delphi method utilizes numerous questionnaire rounds to capitalize on a group think...effort provides the discussion and conclusions, recommendations, and suggestions for follow on research . 9 II. Literature Review This

Consensus process to develop a best-practice document on the role of chiropractic care in health promotion, disease prevention, and wellness.

PubMed

Hawk, Cheryl; Schneider, Michael; Evans, Marion Willard; Redwood, Daniel

2012-09-01

The purposes of this project were to develop consensus definitions for a set of best practices that doctors of chiropractic may use for promoting health and wellness and preventing disease and to describe the appropriate components and procedures for these practices. A multidisciplinary steering committee of 10 health care professionals developed seed statements based on their clinical experience and relevant literature. A Delphi consensus process was conducted from January to July 2011, following the RAND methodology. Consensus was reached when at least 80% of the panelists were in agreement. There were 44 Delphi panelists (36 doctors of chiropractic, 6 doctors of philosophy, 1 doctor of naturopathy, 1 registered nurse). The statements developed defined the terms and practices for chiropractic care to promote health and wellness and prevent disease. This document describes the procedures and features of wellness care that represent a reasonable approach to wellness care and disease prevention in chiropractic clinical practice. This living document provides a general framework for an evidence-based approach to chiropractic wellness care. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Development of a multimedia educational programme for first-time hearing aid users: a participatory design.

PubMed

Ferguson, Melanie; Leighton, Paul; Brandreth, Marian; Wharrad, Heather

2018-05-02

To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

Identification of competencies for patient education in physiotherapy using a Delphi approach.

PubMed

Forbes, Roma; Mandrusiak, Allison; Smith, Michelle; Russell, Trevor

2018-06-01

Patient education is a critical part of physiotherapy practice however an empirically derived set of competencies for its use does not exist. This study aimed to generate a set of competencies for patient education in physiotherapy using a consensus approach. A Delphi study with two rounds using a panel of expert physiotherapists within Australia was undertaken. In the first round, the panel of 12 specialist physiotherapists identified competencies required for patient education in the physiotherapy setting. Framework analysis was applied to develop a set of competencies that were assessed in the second round where ≥80% agreement of importance from the panel indicated consensus. Response rates of specialist physiotherapists agreeing to participate were 67% for the first round and 100% for the second round. Analysis following the first round produced 25 competencies. The second round resulted in agreement on a final set of 22 competencies. This study developed a concise list of competencies for patient education with a high level of expert agreement. By identifying the key competencies in this area, there is potential to benchmark patient education training and assessment of physiotherapists for improved educational and professional outcomes. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Defining the Medical Library Association research agenda: methodology and final results from a consensus process

PubMed Central

Eldredge, Jonathan D.; Harris, Martha R.; Ascher, Marie T.

2009-01-01

Objective: Using a group consensus methodology, the research sought to generate a list of the twelve to fifteen most important and answerable research questions in health sciences librarianship as part of a broader effort to implement the new Medical Library Association (MLA) research policy. Methods: The delphi method was used. The committee distributed a brief survey to all estimated 827 MLA leaders and 237 MLA Research Section members, requesting they submit what they considered to be the most important and answerable research questions facing the profession. The submitted questions were then subjected to 2 rounds of voting to produce a short list of top-ranked questions. Results: The survey produced 62 questions from 54 MLA leaders and MLA Research Section members, who responded from an estimated potential population of 1,064 targeted colleagues. These questions were considered by the process participants to be the most important and answerable research questions facing the profession. Through 2 rounds of voting, these 62 questions were reduced to the final 12 highest priority questions. Conclusion: The modified delphi method accomplished its desired survey and consensus goals. Future survey and consensus processes will be revised to generate more initial questions and to distill a larger number of ranked prioritized research questions. PMID:19626143

International identification of research priorities for postgraduate theses in musculoskeletal physiotherapy using a modified Delphi technique.

PubMed

Rushton, Alison; Moore, Ann

2010-04-01

Research priorities are established to identify gaps and maximise opportunities in developing an evidence base. Numerous postgraduate research theses are undertaken each year within the specialist area of musculoskeletal physiotherapy, and although some are published, greater potential for influence exists. This paper identifies international research priorities for postgraduate theses developed using a consensual Delphi process. A purposive sample included course tutors and expert clinicians nominated by Member Organisations of the International Federation of Orthopaedic Manipulative Physical Therapists (N=91). Round 1 requested >10 priorities for theses, and content analysis identified research themes. Round 2 requested participants rank the importance of each theme on a 1-5 scale, and round 3 requested ranking the importance and feasibility of the research question areas within each agreed theme. Descriptive analysis and use of Kendall's coefficient of concordance enabled interpretation of consensus. The response rate of 68% was good, identifying 23 research themes in round 1. Round 2 identified 14 research themes as important. Participant rating of the importance and feasibility of research question areas in round 3 supported 43 agreed priorities demonstrating good measurement validity. Establishing priorities provides a vision of how postgraduate theses can contribute to the developing evidence base and offer a focus for international collaboration. Copyright 2009 Elsevier Ltd. All rights reserved.

Management of intrathecal baclofen therapy for severe acquired brain injury: consensus and recommendations for good clinical practice.

PubMed

De Tanti, Antonio; Scarponi, Federico; Bertoni, Michele; Gasperini, Giulio; Lanzillo, Bernardo; Molteni, Franco; Posteraro, Federico; Vitale, Dino Francesco; Zanpolini, Mauro

2017-08-01

Although widespread in the treatment of generalised spasticity due to severe acquired brain injury, clinical use of intrathecal baclofen administered through an implanted catheter is not yet supported by full scientific evidence. The aim of the study is to provide recommendations for good clinical practice regarding intrathecal baclofen therapy. We used a modified RAND Delphi method to develop consensus-based medical guidelines, involving clinicians who use intrathecal baclofen therapy throughout Italy. The clinicians were asked 38 questions grouped in six areas (patient selection, contraindications for implant, tests prior to implant, method of implant and management of therapy, efficacy evaluation and goal setting, and management of complications). To establish consensus, 75% agreement was required in answers to every question. Consensus was reached on the second round of the Delphi process on 27/38 questions (71%), specifically those regarding identification of objectives, efficacy evaluation, and method of implant and management of therapy, whereas management of complications and contraindications for implant remained critical areas. Despite the limits of our method, a set of recommendations was drawn up for clinical practice in this sector. The study also revealed residual critical areas and indicated future lines of research necessary to reach evidence-based consensus.

Corruption and oil exploration: expert agreement about the prevention of HIV/AIDS in the Niger Delta of Nigeria

PubMed Central

Udoh, Isidore A.; Stammen, Ronald M.; Mantell, Joanne E.

2008-01-01

The Niger Delta, according to the Nigerian Ministry of Health, has a disproportionately high HIV infection rate, which is double the national average. The United Nations Development Program attributes the spiraling HIV infection rate in the region to poverty, migration and gender inequality. This paper examines two complementary suppositions: Is the high prevalence of HIV in the Niger Delta related to incompetent leadership and corruption? Is it related to the negative effects of oil exploration in the region? Currently, there is a dearth of research on the effectiveness of government programs or the role of the oil industry on the impact of AIDS in Nigeria. To address this gap, we conducted a survey with 27 internationally renowned experts from diverse disciplines using a three-round modified Delphi to formulate consensus about the impact of weak governance and oil corruption on AIDS in the Niger Delta. Results from the Delphi suggest that these factors and others have exacerbated the transmission of HIV in the region. To mitigate the impact of AIDS in the region, efforts to engage oil companies in implementing HIV prevention programs as part of their corporate environmental responsibility to the community are urgently needed. PMID:17906312

Potential Effects of the Electronic Health Record on the Small Physician Practice: A Delphi Study.

PubMed

Sines, Chad C; Griffin, Gerald R

2017-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act established the requirement of all medical practices to have certified electronic health records (EHRs). Some primary concerns that have been delaying implementation are issues of cost, revenue impact, and the effect on the patient encounter. Small physician practices (one to four physicians) account for 46 percent of all physicians. The purpose of this qualitative study using a modified Delphi research design was to examine the potential effect of the adoption of the EHR on revenue, unintended costs or savings, and changes in the patient encounter. Fifteen expert panelists completed the three-round survey process. The expert panelists reached a consensus that EHRs would reduce the number of patients seen per day, thereby reducing their revenue. Although the panelists limited their discussion on the effect of patient outcomes, their most dominant concern was the loss of face-to-face time with the patient. They felt that the use of an EHR would reduce the focus on the patient and potentially cause physicians to miss medical conditions. The results of this study indicate an avenue for EHR vendors to develop educational avenues to teach physicians how to optimize the EHR as well as to share success stories that demonstrate improved financial impact.

Research priorities for respiratory nursing: a UK-wide Delphi study

PubMed Central

Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle

2018-01-01

Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) “Patient understanding of asthma control”; 2) “The clinical and cost-effectiveness of respiratory nurse interventions”; 3) “The impact of nurse-led clinics on patient care”; 4) “Inhaler technique”; and 5) two topics jointly scored: “Prevention of exacerbations” and “Symptom management”. With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research. PMID:29692999

Potential Effects of the Electronic Health Record on the Small Physician Practice: A Delphi Study

PubMed Central

Sines, Chad C.; Griffin, Gerald R.

2017-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act established the requirement of all medical practices to have certified electronic health records (EHRs). Some primary concerns that have been delaying implementation are issues of cost, revenue impact, and the effect on the patient encounter. Small physician practices (one to four physicians) account for 46 percent of all physicians. The purpose of this qualitative study using a modified Delphi research design was to examine the potential effect of the adoption of the EHR on revenue, unintended costs or savings, and changes in the patient encounter. Fifteen expert panelists completed the three-round survey process. The expert panelists reached a consensus that EHRs would reduce the number of patients seen per day, thereby reducing their revenue. Although the panelists limited their discussion on the effect of patient outcomes, their most dominant concern was the loss of face-to-face time with the patient. They felt that the use of an EHR would reduce the focus on the patient and potentially cause physicians to miss medical conditions. The results of this study indicate an avenue for EHR vendors to develop educational avenues to teach physicians how to optimize the EHR as well as to share success stories that demonstrate improved financial impact. PMID:28566989

A Research Study Using the Delphi Method to Define Essential Competencies for a High School Game Art and Design Course Framework at the National Level

ERIC Educational Resources Information Center

Mack, Nayo Corenus-Geneva

2011-01-01

This research study reports the findings of a Delphi study conducted to determine the essential competencies and objectives for a high school Game Art and Design course framework at the national level. The Delphi panel consisted of gaming, industry and educational experts from all over the world who were members of the International Game…

Using the Internet to Improve HRD Research: The Case of the Web-Based Delphi Research Technique to Achieve Content Validity of an HRD-Oriented Measurement

ERIC Educational Resources Information Center

Hatcher, Tim; Colton, Sharon

2007-01-01

Purpose: The purpose of this article is to highlight the results of the online Delphi research project; in particular the procedures used to establish an online and innovative process of content validation and obtaining "rich" and descriptive information using the internet and current e-learning technologies. The online Delphi was proven to be an…

Delphi`s DETOXSM process: Preparing to treat high organic content hazardous and mixed wastes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robertson, D.T.; Rogers, T.W.; Goldblatt, S.D.

1998-12-31

The US Department of Energy (DOE) Federal Energy Technology Center is sponsoring a full-scale technology demonstration of Delphi Research, Inc.`s patented DETOX{sup SM} catalytic wet chemical oxidation waste treatment process at the Savannah River Site (SRS) in South Carolina. The process is being developed primarily to treat hazardous and mixed wastes within the DOE complex as an alternative to incineration, but it has significant potential to treat wastes in the commercial sector. The results of the demonstration will be intensively studied and used to validate the technology. A critical objective in preparing for the demonstration was the successful completion ofmore » a programmatic Operational Readiness Review. Readiness Reviews are required by DOE for all new process startups. The Readiness Review provided the vehicle to ensure that Delphi was ready to start up and operate the DETOX{sup SM} process in the safest manner possible by implementing industry accepted management practices for safe operation. This paper provides an overview of the DETOX{sup SM} demonstration at SRS, and describes the crucial areas of the Readiness Review that marked the first steps in Delphi`s transition from a technology developer to an operating waste treatment services provider.« less

Application of Delphi expert panel in joint venture projects

NASA Astrophysics Data System (ADS)

Adnan, H.; Rosman, M. R.; Rashid, Z. Z. Ahmad; Mohamad Yusuwan, N.; Bakhary, N. A.

2018-02-01

This study was conducted with the aim to identify the application of the Delphi Technique in validating findings obtained from questionnaire surveys and interviews done in- depth on the subject of joint venture projects in Malaysia. The Delphi technique aims to achieve a consensus of opinion amongst expert panellist that were selected on the primary factors in JV projects. To achieve research objectives, a progressive series of questions was designed where a selected panel of expert to confirm and validate the final findings. The rationale, benefits, limitations and recommendations for the use of Delphi were given in this study. From the literature review done, twenty-one factors were identified as critical factors to the making any joint venture project successful. Detail information from contractors were obtained by using the questionnaire survey method and forty-three in-depth interviews were carried out. Trust between partners, mutual understanding, partner selection criteria, agreement of contract, objective compatibility, conflict, and commitment were confirmed by the Delphi panel to be the critical success factors besides another fourteen factors which were found to be the Failure Reduction Criteria. Delphi techniques has proven to successfully assist in recognising the main factors and would be beneficial in supplementing the success of joint venture arrangements application for construction projects in Malaysia.

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review.

PubMed

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D'Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2017-09-01

There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018.

What works for wellbeing in culture and sport? Report of a DELPHI process to support coproduction and establish principles and parameters of an evidence review

PubMed Central

Daykin, Norma; Mansfield, Louise; Payne, Annette; Kay, Tess; Meads, Catherine; D’Innocenzo, Giorgia; Burnett, Adele; Dolan, Paul; Julier, Guy; Longworth, Louise; Tomlinson, Alan; Testoni, Stefano; Victor, Christina

2016-01-01

Aims: There is a growing recognition of the ways in which culture and sport can contribute to wellbeing. A strong evidence base is needed to support innovative service development and a 3-year research programme is being undertaken to capture best evidence of wellbeing impacts and outcomes of cultural and sporting activities in order to inform UK policy and practice. This article provides an overview of methods and findings from an initial coproduction process with key stakeholders that sought to explore and agree principles and parameters of the evidence review for culture, sport and wellbeing (CSW). Methods: A two-stage DELPHI process was conducted with a purposeful sample of 57 stakeholders between August and December 2015. Participants were drawn from a range of culture and sport organisations and included commissioners and managers, policy makers, representatives of service delivery organisations (SDOs) and scholars. The DELPHI 1 questionnaire was developed from extensive consultation in July and August 2015. It explored definitions of wellbeing, the role of evidence, quality assessment, and the culture and sport populations, settings and interventions that are most likely to deliver wellbeing outcomes. Following further consultation, the results, presented as a series of ranked statements, were sent back to participants (DELPHI 2), which allowed them to reflect on and, if they wished, express agreement or disagreement with the emerging consensus. Results: A total of 40 stakeholders (70.02%) responded to the DELPHI questionnaires. DELPHI 1 mapped areas of agreement and disagreement, confirmed in DELPHI 2. The exercise drew together the key priorities for the CSW evidence review. Conclusion: The DELPHI process, in combination with face-to-face deliberation, enabled stakeholders to engage in complex discussion and express nuanced priorities while also allowing the group to come to an overall consensus and agree outcomes. The results will inform the CSW evidence review programme until its completion in March 2018. PMID:27789779

Barriers to patient involvement in health service planning and evaluation: an exploratory study.

PubMed

Gagliardi, Anna R; Lemieux-Charles, Louise; Brown, Adalsteinn D; Sullivan, Terrence; Goel, Vivek

2008-02-01

Patient involvement in health service planning and evaluation is considered important yet not widely practiced. This study explored stakeholder beliefs about patient participation in performance indicator selection to better understand hypothesized barriers. Interviews with 30 cancer patients and health professionals from two teaching hospitals were analyzed qualitatively. All groups believed patients, not members of the public, should be involved in the selection of indicators. Ongoing, interactive methods such as committee involvement, rather than single, passive efforts such as surveys were preferred. Health professionals recommended patients assume a consultative, rather than decision-making role. Older patients agreed with this. Variable patient interest, health professional attitudes, and a lack of insight on appropriate methods may be limiting patient involvement in this, and other service planning and evaluation activities. More research is required to validate expressed views among the populations these stakeholders represent, and to establish effective methods for engaging patients. Efforts to encourage a change in health professional attitude may be required, along with dedicated organizational resources, coordinators and training. Methods to engage patients should involve deliberation, which can be achieved through modified Delphi panel or participatory research approaches.

Advancing Patient-centered Outcomes in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Kanzaria, Hemal K; McCabe, Aileen M; Meisel, Zachary M; LeBlanc, Annie; Schaffer, Jason T; Bellolio, M Fernanda; Vaughan, William; Merck, Lisa H; Applegate, Kimberly E; Hollander, Judd E; Grudzen, Corita R; Mills, Angela M; Carpenter, Christopher R; Hess, Erik P

2015-12-01

Diagnostic imaging is integral to the evaluation of many emergency department (ED) patients. However, relatively little effort has been devoted to patient-centered outcomes research (PCOR) in emergency diagnostic imaging. This article provides background on this topic and the conclusions of the 2015 Academic Emergency Medicine consensus conference PCOR work group regarding "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The goal was to determine a prioritized research agenda to establish which outcomes related to emergency diagnostic imaging are most important to patients, caregivers, and other key stakeholders and which methods will most optimally engage patients in the decision to undergo imaging. Case vignettes are used to emphasize these concepts as they relate to a patient's decision to seek care at an ED and the care received there. The authors discuss applicable research methods and approaches such as shared decision-making that could facilitate better integration of patient-centered outcomes and patient-reported outcomes into decisions regarding emergency diagnostic imaging. Finally, based on a modified Delphi process involving members of the PCOR work group, prioritized research questions are proposed to advance the science of patient-centered outcomes in ED diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis.

PubMed

Stockfleth, Eggert; Peris, Ketty; Guillen, Carlos; Cerio, Rino; Basset-Seguin, Nicole; Foley, Peter; Sanches, José; Culshaw, Alex; Erntoft, Sandra; Lebwohl, Mark

2015-01-01

Topical therapy is important in the treatment of actinic keratosis, but guidance for improving adherence/persistence during topical therapy is still lacking. To utilize expert consensus to generate a list of recommendations to improve real-world efficacy when prescribing topical therapy for actinic keratosis. An expert panel of eight dermatologists was convened to generate recommendations based on facilitated discussion and consensus generation using a modified Delphi session. The recommendations were ratified with the expert panel. Facilitated discussion generated 31 issues within five themes, which were prioritized using expert voting. Consensus was achieved on the importance of short and simple treatment regimens for maximizing patient compliance, physician awareness of the progression of actinic keratosis to squamous cell carcinoma, provision of appropriate patient information, and the use of effective communication strategies to educate physicians about actinic keratosis. Based on these key findings, eight recommendations were generated. The recommendations will assist physicians when prescribing topical actinic keratosis therapy. Further research should focus on the types of patient outcomes that are influenced by the characteristics of topical field therapy. © 2015 The Authors. International Journal of Dermatology published by John Wiley & Sons Ltd on behalf of International Society of Dermatology.

First year specialist trainees' engagement with reflective practice in the e-portfolio.

PubMed

McNeill, Helen; Brown, Jeremy M; Shaw, Nigel J

2010-10-01

Doctors in specialist training posts in the Mersey Deanery are expected to reflect on their clinical practice and to document their learning experiences in an e-portfolio. This study aims specifically to explore how they have engaged in reflection on their practice and how they utilise their learning portfolio to document evidence of this. A modified Delphi technique was used to develop a grading system to identify the level of reflection recorded by participants in the e-portfolio. Transcripts of the reflective accounts were then analysed using a qualitative approach which involved coding and categorising the data. This study demonstrated a wide variation in both the quantity and quality of reflection. Of particular note in the qualitative data analysis were themes relating to clinical knowledge and skills, learning in practice, communication, feelings, types of learning experience reflected on and wider aspects of medical practice. Findings indicate there is variation is the extent to which doctors both engage in and document evidence of reflection. Further research is needed to explore factors that enable or inhibit the use of the e-portfolio for reflection and whether recorded reflection is a true picture of the cognitive process involved.

Developing an emergency department crowding dashboard: A design science approach.

PubMed

Martin, Niels; Bergs, Jochen; Eerdekens, Dorien; Depaire, Benoît; Verelst, Sandra

2017-08-30

As an emergency department (ED) is a complex adaptive system, the analysis of continuously gathered data is valuable to gain insight in the real-time patient flow. To support the analysis and management of ED operations, relevant data should be provided in an intuitive way. Within this context, this paper outlines the development of a dashboard which provides real-time information regarding ED crowding. The research project underlying this paper follows the principles of design science research, which involves the development and study of artifacts which aim to solve a generic problem. To determine the crowding indicators that are desired in the dashboard, a modified Delphi study is used. The dashboard is implemented using the open source Shinydashboard package in R. A dashboard is developed containing the desired crowding indicators, together with general patient flow characteristics. It is demonstrated using a dataset of a Flemish ED and fulfills the requirements which are defined a priori. The developed dashboard provides real-time information on ED crowding. This information enables ED staff to judge whether corrective actions are required in an effort to avoid the adverse effects of ED crowding. Copyright © 2017 Elsevier Ltd. All rights reserved.

A cognitive perspective on health systems integration: results of a Canadian Delphi study

PubMed Central

2014-01-01

Background Ongoing challenges to healthcare integration point toward the need to move beyond structural and process issues. While we know what needs to be done to achieve integrated care, there is little that informs us as to how. We need to understand how diverse organizations and professionals develop shared knowledge and beliefs – that is, we need to generate knowledge about normative integration. We present a cognitive perspective on integration, based on shared mental model theory, that may enhance our understanding and ability to measure and influence normative integration. The aim of this paper is to validate and improve the Mental Models of Integrated Care (MMIC) Framework, which outlines important knowledge and beliefs whose convergence or divergence across stakeholder groups may influence inter-professional and inter-organizational relations. Methods We used a two-stage web-based modified Delphi process to test the MMIC Framework against expert opinion using a random sample of participants from Canada’s National Symposium on Integrated Care. Respondents were asked to rate the framework’s clarity, comprehensiveness, usefulness, and importance using seven-point ordinal scales. Spaces for open comments were provided. Descriptive statistics were used to describe the structured responses, while open comments were coded and categorized using thematic analysis. The Kruskall-Wallis test was used to examine cross-group agreement by level of integration experience, current workplace, and current role. Results In the first round, 90 individuals responded (52% response rate), representing a wide range of professional roles and organization types from across the continuum of care. In the second round, 68 individuals responded (75.6% response rate). The quantitative and qualitative feedback from experts was used to revise the framework. The re-named “Integration Mindsets Framework” consists of a Strategy Mental Model and a Relationships Mental Model, comprising a total of nineteen content areas. Conclusions The Integration Mindsets Framework draws the attention of researchers and practitioners to how various stakeholders think about and conceptualize integration. A cognitive approach to understanding and measuring normative integration complements dominant cultural approaches and allows for more fine-grained analyses. The framework can be used by managers and leaders to facilitate the interpretation, planning, implementation, management and evaluation of integration initiatives. PMID:24885659

Identifying clinical features in primary care electronic health record studies: methods for codelist development.

PubMed

Watson, Jessica; Nicholson, Brian D; Hamilton, Willie; Price, Sarah

2017-11-22

Analysis of routinely collected electronic health record (EHR) data from primary care is reliant on the creation of codelists to define clinical features of interest. To improve scientific rigour, transparency and replicability, we describe and demonstrate a standardised reproducible methodology for clinical codelist development. We describe a three-stage process for developing clinical codelists. First, the clear definition a priori of the clinical feature of interest using reliable clinical resources. Second, development of a list of potential codes using statistical software to comprehensively search all available codes. Third, a modified Delphi process to reach consensus between primary care practitioners on the most relevant codes, including the generation of an 'uncertainty' variable to allow sensitivity analysis. These methods are illustrated by developing a codelist for shortness of breath in a primary care EHR sample, including modifiable syntax for commonly used statistical software. The codelist was used to estimate the frequency of shortness of breath in a cohort of 28 216 patients aged over 18 years who received an incident diagnosis of lung cancer between 1 January 2000 and 30 November 2016 in the Clinical Practice Research Datalink (CPRD). Of 78 candidate codes, 29 were excluded as inappropriate. Complete agreement was reached for 44 (90%) of the remaining codes, with partial disagreement over 5 (10%). 13 091 episodes of shortness of breath were identified in the cohort of 28 216 patients. Sensitivity analysis demonstrates that codes with the greatest uncertainty tend to be rarely used in clinical practice. Although initially time consuming, using a rigorous and reproducible method for codelist generation 'future-proofs' findings and an auditable, modifiable syntax for codelist generation enables sharing and replication of EHR studies. Published codelists should be badged by quality and report the methods of codelist generation including: definitions and justifications associated with each codelist; the syntax or search method; the number of candidate codes identified; and the categorisation of codes after Delphi review. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

pKa predictions for proteins, RNAs, and DNAs with the Gaussian dielectric function using DelPhi pKa.

PubMed

Wang, Lin; Li, Lin; Alexov, Emil

2015-12-01

We developed a Poisson-Boltzmann based approach to calculate the pKa values of protein ionizable residues (Glu, Asp, His, Lys and Arg), nucleotides of RNA and single stranded DNA. Two novel features were utilized: the dielectric properties of the macromolecules and water phase were modeled via the smooth Gaussian-based dielectric function in DelPhi and the corresponding electrostatic energies were calculated without defining the molecular surface. We tested the algorithm by calculating pKa values for more than 300 residues from 32 proteins from the PPD dataset and achieved an overall RMSD of 0.77. Particularly, the RMSD of 0.55 was achieved for surface residues, while the RMSD of 1.1 for buried residues. The approach was also found capable of capturing the large pKa shifts of various single point mutations in staphylococcal nuclease (SNase) from pKa-cooperative dataset, resulting in an overall RMSD of 1.6 for this set of pKa's. Investigations showed that predictions for most of buried mutant residues of SNase could be improved by using higher dielectric constant values. Furthermore, an option to generate different hydrogen positions also improves pKa predictions for buried carboxyl residues. Finally, the pKa calculations on two RNAs demonstrated the capability of this approach for other types of biomolecules. © 2015 Wiley Periodicals, Inc.

Survey indicated that core outcome set development is increasingly including patients, being conducted internationally and using Delphi surveys.

PubMed

Biggane, Alice M; Brading, Lucy; Ravaud, Philippe; Young, Bridget; Williamson, Paula R

2018-02-17

There are numerous challenges in including patients in a core outcome set (COS) study, these can vary depending on the patient group. This study describes current efforts to include patients in the development of COS, with the aim of identifying areas for further improvement and study. Using the COMET database, corresponding authors of COS projects registered or published from 1 January 2013 to 2 February 2017 were invited via a personalised email to participate in a short online survey. The survey and emails were constructed to maximise the response rate by following the academic literature on enhancing survey responses. Personalised reminder emails were sent to non-responders. This survey explored the frequency of patient input in COS studies, who was involved, what methods were used and whether or not the COS development was international. One hundred and ninety-two COS developers were sent the survey. Responses were collected from 21 February 2017 until 7 May 2017. One hundred and forty-six unique developers responded, yielding a 76% response rate and data in relation to 195 unique COSs (as some developers had worked on multiple COSs). Of focus here are their responses regarding 162 COSs at the published, completed or ongoing stages of development. Inclusion of patient participants was indicated in 87% (141/162) of COSs in the published completed or ongoing stages and over 94% (65/69) of ongoing COS projects. Nearly half (65/135) of COSs included patient participants from two or more countries and 22% (30/135) included patient participants from five or more countries. The Delphi survey was reported as being used singularly or in combination with other methods in 85% (119/140) of projects. Almost a quarter (16/65) of ongoing studies reported using a combination of qualitative interviews, Delphi survey and consensus meeting. These findings indicated that the Delphi survey is the most popular method of facilitating patient participation, while the combination of qualitative interviews, Delphi survey and consensus meetings is the most popular combination of methods. The increased inclusion of patient participants in the development of COSs is encouraging, as is the international approach to COS development that some developers are adopting.

MOMENT--Management of Otitis Media with Effusion in Cleft Palate: protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

PubMed

Harman, Nicola L; Bruce, Iain A; Callery, Peter; Tierney, Stephanie; Sharif, Mohammad Owaise; O'Brien, Kevin; Williamson, Paula R

2013-03-12

Cleft palate (CP) has an incidence of approximately 1 in 700. Children with CP are also susceptible to otitis media with effusion (OME), with approximately 90% experiencing nontrivial OME. There are several approaches to the management of OME in children with CP. The Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) study is a feasibility study that includes the development of a core outcome set for use in future trials of the management of OME in children with CP. The MOMENT study will include a systematic review of the literature to identify a list of outcomes that have previously been reported. This list of outcomes will be used in a Delphi study with cleft clinicians. The Delphi study is anticipated to include three rounds. The first round will ask clinicians to score the outcome list and to add any outcomes they think are relevant. The second round involves presentation of scores according to stakeholder group and the opportunity for participants to rescore outcomes. To ensure that the opinion of parents and children are sought, qualitative interviews will be completed with a purposive sample in parallel. In the final round of the Delphi process, participants will be shown the distribution of scores, for each outcome, for all stakeholder groups separately as well as a summary of the results concerning outcomes from the qualitative interviews with parents. A final consensus meeting will be held with all stakeholders, including parents and children, to review outcomes. A core outcome set represents the minimum that should be measured in a clinical trial for a particular condition. The MOMENT study will aim to identify a core outcome set that can be used in future trials of the management of OME, improving the consistency of research in this clinical area.

TREatment of ATopic eczema (TREAT) Registry Taskforce: An international Delphi exercise to identify a core set of domains and domain items for national atopic eczema photo- and systemic therapy registries.

PubMed

Gerbens, L A A; Apfelbacher, C J; Irvine, A D; Barbarot, S; de Booij, R J; Boyce, A E; Deleuran, M; Eichenfield, L F; Hof, M H; Middelkamp-Hup, M A; Roberts, A; Schmitt, J; Vestergaard, C; Wall, D; Weidinger, S; Williamson, P R; Flohr, C; Spuls, P I

2018-05-15

Evidence of immunomodulatory therapies to guide clinical management for atopic eczema (AE) is scarce, despite frequent and often off-label use. Patient registries provide valuable evidence for the effects of treatments under real world conditions which can inform treatment guidelines, give the opportunity for health economic evaluation and the evaluation of quality of care, as well as pharmacogenetic and -dynamic research which cannot be adequately addressed in clinical trials. The TREatment of ATopic eczema (TREAT) Registry Taskforce aims to seek international consensus on a core set of domains and items ('what to measure') for AE research registries, using a Delphi approach. Participants from six stakeholder groups were included: doctors, nurses, non-clinical researchers, patients, industry and regulatory body representatives. The eDelphi comprised 3 sequential online rounds, requesting participants to rate the importance of each proposed domain item. Participants could add domain items to the proposed list in round 1. A final consensus meeting was held to ratify the core set. 479 participants from 36 countries accessed the eDelphi platform, of whom 86%, 79% and 74% completed rounds 1, 2, and 3 respectively. At the face-to-face consensus meeting attended by 42 participants the final core set was established containing 19 domains with 69 domain items (49 baseline and 20 follow-up items). This core set of domains and items to be captured by national AE systemic therapy registries will standardise data collection and thereby allow direct comparability across registries and facilitate data pooling between countries. Ultimately, it will provide greater insight into the effectiveness, safety and cost-effectiveness of photo- and systemic immunomodulatory therapies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Three decision-making aids: brainstorming, nominal group, and Delphi technique.

PubMed

McMurray, A R

1994-01-01

The methods of brainstorming, Nominal Group Technique, and the Delphi technique can be important resources for nursing staff development educators who wish to expand their decision-making skills. Staff development educators may find opportunities to use these methods for such tasks as developing courses, setting departmental goals, and forecasting trends for planning purposes. Brainstorming, Nominal Group Technique, and the Delphi technique provide a structured format that helps increase the quantity and quality of participant responses.

Determining the Essential Components of State and Institution Dual Credit Program Policy in New Mexico: A Delphi Study with High School and College Experts

ERIC Educational Resources Information Center

Carlson, Gregory Dean

2013-01-01

The purpose of this Delphi study was to determine the essential components of dual credit in New Mexico. Dual credit experts from colleges and high schools in New Mexico were asked to participate in a three-round Delphi study to determine what the future policy of dual credit should be, and why it should be that way. Definitions of dual credit may…

Final Report of the AMC Committee-Armament. Armament Development Center Concept Plan. Volume 2

DTIC Science & Technology

1974-12-01

Considerations 111-22 Section C Operational Considerations 111-26 Section D Community Economic Impact 111-35 Statements Section E Delphi Benefit Analysis 111-37...Cost Analysis 111-3 B Personnel Considerations III-22 C Operational Considerations 111-26 D Community Economic Impact Statements 111-35 E Delphi ...sidered to be minimal. 111-36 S SECTION E. Delphi Benefit Analysis 1. Introduction. The assessment and comparison of the relative benefits of the various

Illustration Watermarking for Digital Images: An Investigation of Hierarchical Signal Inheritances for Nested Object-based Embedding

DTIC Science & Technology

2007-02-23

approach for signal-level watermark inheritance. 15. SUBJECT TERMS EOARD, Steganography , Image Fusion, Data Mining, Image ...in watermarking algorithms , a program interface and protocol has been de - veloped, which allows control of the embedding and retrieval processes by the...watermarks in an image . Watermarking algorithm (DLL) Watermarking editor (Delphi) - User marks all objects: ci - class information oi - object instance

Design of a Bahasa Melayu Grammar Online Learning Portal for Form Two Students Using Delphi Technique

ERIC Educational Resources Information Center

Leng, Chin Hai; Siraj, Saedah; Asmawi, Adelina; Dewitt, Dorothy; Ranee, Alina

2013-01-01

This study was aimed at developing a Bahasa Melayu grammar learning portal for Form Two students (BMGLP). A developmental approach was used in this study. Needs analysis was carried out on the Bahasa Melayu teachers and Form Two students. The results of needs analysis on Form Two students showed that they preferred topics such as question…

Development of an Instructional Model for Higher Order Thinking in Science among Secondary School Students: A Fuzzy Delphi Approach

ERIC Educational Resources Information Center

Saido, G. A. M.; Siraj, S.; DeWitt, D.; Al-Amedy, O. S.

2018-01-01

It is important for science students to develop higher order thinking (HOT) so that they can reason like scientists in the field. In this study, a HOT instructional model for secondary school science was developed with experts. The model would focus on reflective thinking (RT) and science process skills (SPS) among Grade 7 students. The Fuzzy…

Developing Competencies for Navy Human Resource Management Specialists: A Delphi Approach.

DTIC Science & Technology

1983-06-01

93] (Expert in Consulting Processes) Organizational Diagnosis (Able to identify and res- pond to an organization’s real needs) (Resolve...consensus were those skills and knowledge generally agreed in the profession as necessary for any OD effort to be successful such as organizational ... diagnosis , designing and executing an intervention, process consultation, entry and contracting, general interpersonal skills, and organization behavior

Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study.

PubMed

Morton, Katie L; Atkin, Andrew J; Corder, Kirsten; Suhrcke, Marc; Turner, David; van Sluijs, Esther M F

2017-01-13

Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement-especially during the intervention prioritisation phase. We present the findings of an online 'Delphi' study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity. Web-based data collection using an online Delphi tool enabling participation of geographically diverse stakeholders. 37 stakeholders participated, including young people (age 13-16 years), parents, teachers, public health practitioners, academics and commissioners; 33 participants completed both rounds. Participants were asked to prioritise a (short-listed) selection of school environment-focused interventions (eg, standing desks, outdoor design changes) based on the criteria of 'reach', 'equality', 'acceptability', 'feasibility', 'effectiveness' and 'cost'. Participants were also asked to rank the criteria and the effectiveness outcomes (eg, physical activity, academic achievement, school enjoyment) from most to least important. Following feedback along with any new information provided, participants completed round 2 4 weeks later. The intervention prioritisation process was feasible to conduct and comments from participants indicated satisfaction with the process. Consensus regarding intervention strategies was achieved among the varied groups of stakeholders, with 'active lessons' being the favoured approach. Participants ranked 'mental health and well-being' as the most important outcome followed by 'enjoyment of school'. The most important criteria was 'effectiveness', followed by 'feasibility'. This novel approach to engaging a wide variety of stakeholders in the research process was feasible to conduct and acceptable to participants. It also provided insightful information relating to how stakeholders prioritise interventions. The approach could be extended beyond the specific project to be a useful tool for researchers and practitioners. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Delphi based consensus study into planning for chemical incidents.

PubMed

Crawford, I W F; Mackway-Jones, K; Russell, D R; Carley, S D

2004-01-01

To achieve consensus in all phases of chemical incident planning and response. A three round Delphi study was conducted using a panel of 39 experts from specialties involved in the management of chemical incidents. Areas that did not reach consensus in the Delphi study were presented as synopsis statements for discussion in four syndicate groups at a conference hosted by the Department of Health Emergency Planning Co-ordination Unit. A total of 183 of 322 statements had reached consensus upon completion of the Delphi study. This represented 56.8% of the total number of statements. Of these, 148 reached consensus at >94% and 35 reached consensus at >89%. The results of the process are presented as a series of synopsis consensus statements that cover all phases of chemical incident planning and response. The use of a Delphi study and subsequent syndicate group discussions achieved consensus in aspects of all phases of chemical incident planning and response that can be translated into practical guidance for use at regional prehospital and hospital level. Additionally, areas of non-consensus have been identified where further work is required.

Taxonomy of the common dolphins of the Eastern Pacific Ocean

USGS Publications Warehouse

Banks, R.C.; Brownell, R.

1969-01-01

Delphinus bairdii Dall is a species of dolphin distinct from D. delphis Linnaeus, with which it has usually been synonymized. D. bairdii has a longer rostrum relative to the zygomatic width of the skull; the ratio of these measurements falls at 1.55 or above for bairdii and 1.53 and below for delphis. In the eastern Pacific Ocean, D. bairdii is found in the Gulf of California and along the west coast of Baja California, Mexico; D. delphis is presently found in the waters off California. Until approximately the beginning of the present century, bairdii occurred farther north in the eastern Pacific Ocean, at least to the Monterey Bay area of California. Restriction of bairdii to more southerly waters, probably as an indirect result of a change in water temperature, may have permitted delphis to move into inshore Californian waters. The Pacific population of D. delphis has a somewhat shorter rostrum than the Atlantic population, and is perhaps subspecifically different. A thorough analysis of the entire genus Delphinus is needed before the relationship of all the populations can be understood and names properly applied.

Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

PubMed

Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

2016-06-01

The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Delphi based consensus study into planning for chemical incidents

PubMed Central

Crawford, I; Mackway-Jones, K; Russell, D; Carley, S

2004-01-01

Objective: To achieve consensus in all phases of chemical incident planning and response. Design: A three round Delphi study was conducted using a panel of 39 experts from specialties involved in the management of chemical incidents. Areas that did not reach consensus in the Delphi study were presented as synopsis statements for discussion in four syndicate groups at a conference hosted by the Department of Health Emergency Planning Co-ordination Unit. Results: A total of 183 of 322 statements had reached consensus upon completion of the Delphi study. This represented 56.8% of the total number of statements. Of these, 148 reached consensus at >94% and 35 reached consensus at >89%. The results of the process are presented as a series of synopsis consensus statements that cover all phases of chemical incident planning and response. Conclusions: The use of a Delphi study and subsequent syndicate group discussions achieved consensus in aspects of all phases of chemical incident planning and response that can be translated into practical guidance for use at regional prehospital and hospital level. Additionally, areas of non-consensus have been identified where further work is required. PMID:14734369

A simulation study of mutations in the genetic regulatory hierarchy for butterfly eyespot focus determination.

PubMed

Marcus, Jeffrey M; Evans, Travis M

2008-09-01

The color patterns on the wings of butterflies have been an important model system in evolutionary developmental biology. A recent computational model tested genetic regulatory hierarchies hypothesized to underlie the formation of butterfly eyespot foci [Evans, T.M., Marcus, J.M., 2006. A simulation study of the genetic regulatory hierarchy for butterfly eyespot focus determination. Evol. Dev. 8, 273-283]. The computational model demonstrated that one proposed hierarchy was incapable of reproducing the known patterns of gene expression associated with eyespot focus determination in wild-type butterflies, but that two slightly modified alternative hierarchies were capable of reproducing all of the known gene expressions patterns. Here we extend the computational models previously implemented in Delphi 2.0 to two mutants derived from the squinting bush brown butterfly (Bicyclus anynana). These two mutants, comet and Cyclops, have aberrantly shaped eyespot foci that are produced by different mechanisms. The comet mutation appears to produce a modified interaction between the wing margin and the eyespot focus that results in a series of comet-shaped eyespot foci. The Cyclops mutation causes the failure of wing vein formation between two adjacent wing-cells and the fusion of two adjacent eyespot foci to form a single large elongated focus in their place. The computational approach to modeling pattern formation in these mutants allows us to make predictions about patterns of gene expression, which are largely unstudied in butterfly mutants. It also suggests a critical experiment that will allow us to distinguish between two hypothesized genetic regulatory hierarchies that may underlie all butterfly eyespot foci.

Alchemy of the Oracle: The Delphi Technique.

ERIC Educational Resources Information Center

Wilhelm, William J.

2001-01-01

Discusses the origins and foundations of the Delphi technique. Outlines procedures for using it in research to obtain the insights of experts. Addresses limitations of the technique. (Contains 44 references.) (SK)

Futurescapes: evidence expectations in the USA for comparative effectiveness research for drugs in 2020.

PubMed

Messner, Donna A; Mohr, Penny; Towse, Adrian

2015-08-01

Explore key factors influencing future expectations for the production of evidence from comparative effectiveness research for drugs in the USA in 2020 and construct three plausible future scenarios. Semistructured key informant interviews and three rounds of modified Delphi with systematic scenario-building methods. Most influential key factors were: health delivery system integration; electronic health record development; exploitation of very large databases and mixed data sources; and proactive patient engagement in research. The scenario deemed most likely entailed uneven development of large integrated health systems with pockets of increased provider risk for patient care, enhanced data collection systems, changing incentives to do comparative effectiveness research and new opportunities for evidence generation partnerships.

Updates in venous thromboembolism management: evidence published in 2017.

PubMed

Bartlett, Matthew A; Bierle, Dennis M; Saadiq, Rayya A; Mauck, Karen F; Daniels, Paul R

2018-06-20

Venous thromboembolism (VTE) management is rapidly evolving and staying up-to-date is challenging. We identified the most practice-informing articles published in 2017 relevant to the nonspecialist provider managing VTE. We performed a systematic search of the literature (Appendix A), limiting the search to a publication date of 2017. Two reviewers screened the 2735 resulting abstracts to identify high-quality, clinically relevant publications related to VTE management. One-hundred and six full-text articles were considered for inclusion. The five authors used a modified Delphi method to reach consensus on inclusion of seven articles for in-depth appraisal, following predetermined criteria of clinical relevance to nonspecialist providers, potential for practice change, and strength of the evidence.

Towards an International Classification for Patient Safety: a Delphi survey.

PubMed

Thomson, Richard; Lewalle, Pierre; Sherman, Heather; Hibbert, Peter; Runciman, William; Castro, Gerard

2009-02-01

Interpretation and comparison of patient safety information have been compromised by the lack of a common understanding of the concepts involved. The World Alliance set out to develop an International Classification for Patient Safety (ICPS) to address this, and to test the relevance and acceptability of the draft ICPS and progressively refine it prior to field testing. Two-stage Delphi survey. Quantitative and qualitative analyses informed the review of the ICPS. International web-based survey of expert opinion. Experts in the fields of patient safety, health policy, reporting systems, safety and quality control, classification theory and development, health informatics, consumer advocacy, law and medicine; 253 responded to the first round survey, 30% of whom responded to the second round. In the first round, 14% felt that the conceptual framework was missing at least one class, although it was apparent that most respondents were actually referring to concepts they felt should be included within the classes rather than the classes themselves. There was a need for clarification of several components of the classification, particularly its purpose, structure and depth. After revision and feedback, round 2 results were more positive, but further significant changes were made to the conceptual framework and to the major classes in response to concerns about terminology and relationships between classes. The Delphi approach proved invaluable, as both a consensus-building exercise and consultation process, in engaging stakeholders to support completion of the final draft version of the ICPS. Further refinement will occur.

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach.

PubMed

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-04-10

Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach

PubMed Central

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-01-01

Introduction: Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. Methods: The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. Results: According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. Conclusions: The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Key words: Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards PMID:28480124

Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument.

PubMed

Baker, Paul M A; Moon, Nathan W

2008-01-01

The near universal deployment in the United States of a wide variety of information and communications technologies, both wired and wireless, creates potential barriers to use for several key populations, including the poor, people with disabilities, and the aging. Equal access to wireless technologies and services can be achieved through a variety of mechanisms, including legislation and regulations, market-based solutions, and awareness and outreach-based approaches. This article discusses the results of policy research conducted by the Rehabilitation Engineering Research Center on Wireless Technologies (Wireless RERC) using policy Delphi polling methodology to probe stakeholders' opinions on key access barrier issues and to explore potential policy responses. Participants included disability advocates, disability/wireless technology policy makers, and product developers/manufacturers. Respondent input informed subsequent development of potential policy initiatives to increase access to these technologies. The findings from the Delphi suggest that awareness issues remain most important, especially manufacturer awareness of user needs and availability of consumer information for selecting the most appropriate wireless devices and services. Other key issues included the ability of people with disabilities to afford technologies and inadequacies in legislation and policy making for ensuring their general accessibility, as well as usefulness in emergencies. Technical issues, including interoperability, speech-to-text conversion, and hearing aid compatibility, were also identified by participating stakeholders as important. To address all these issues, Delphi respondents favored goals and options congruent with voluntary market-driven solutions where possible but also supported federal involvement, where necessary, to aid this process.

Identification of relevant functional issues for the care of patients with acute arthritis by health professionals, using the ICF framework and a multi-disciplinary focus group approach.

PubMed

Zochling, J; Grill, E; Alten, R; Ernst, J; Stucki, G; Braun, J

2007-01-01

To identify the most relevant problems to be addressed in the multi-disciplinary care of patients with acute arthritis using focus groups of health professionals followed by a Delphi process. Focus group and Delphi methodology were applied. The focus groups were conducted at three specialist rheumatology hospital clinics in Germany, each group comprising rheumatologists, nurses, physiotherapists, occupational therapists, psychologists and social workers. The participants were asked to decide which categories of the International Classification of Functioning, Disability and Health (ICF) are relevant to the care of patients with acute inflammatory arthritis. The results from the focus groups were then followed by an anonymous Delphi process. Twenty-six health professionals participated in the 3 focus groups. 167 of the second-level ICF categories (63% of all second-level categories) were considered as relevant by the rheumatology health professionals. Items from all four components, Body Functions, Body Structures, Activities and Participation and Environmental Factors were represented. Agreement between focus groups and between different health professional groups was substantial for all components with the exception of Environmental Factors (Cohen's kappa 0.23). The involvement of experts from different health professions is a valuable tool to identify typical patient characteristics, expressed as distinct ICF categories, to aid in patient care in the acute rheumatology setting. Acute patient care cannot and should not be separated from ongoing long-term management.

Electric and hybrid electric vehicles: A technology assessment based on a two-stage Delphi study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vyas, A.D.; Ng, H.K.; Santini, D.J.

1997-12-01

To address the uncertainty regarding future costs and operating attributes of electric and hybrid electric vehicles, a two stage, worldwide Delphi study was conducted. Expert opinions on vehicle attributes, current state of the technology, possible advancements, costs, and market penetration potential were sought for the years 2000, 2010, and 2020. Opinions related to such critical components as batteries, electric drive systems, and hybrid vehicle engines, as well as their respective technical and economic viabilities, were also obtained. This report contains descriptions of the survey methodology, analytical approach, and results of the analysis of survey data, together with a summary ofmore » other factors that will influence the degree of market success of electric and hybrid electric vehicle technologies. Responses by industry participants, the largest fraction among all the participating groups, are compared with the overall responses. An evaluation of changes between the two Delphi stages is also summarized. An analysis of battery replacement costs for various types is summarized, and variable operating costs for electric and hybrid vehicles are compared with those of conventional vehicles. A market penetration analysis is summarized, in which projected market shares from the survey are compared with predictions of shares on the basis of two market share projection models that use the cost and physical attributes provided by the survey. Finally, projections of market shares beyond the year 2020 are developed by use of constrained logit models of market shares, statistically fitted to the survey data.« less

Towards an International Classification for Patient Safety: a Delphi survey

PubMed Central

Thomson, Richard; Lewalle, Pierre; Sherman, Heather; Hibbert, Peter; Runciman, William; Castro, Gerard

2009-01-01

Objective Interpretation and comparison of patient safety information have been compromised by the lack of a common understanding of the concepts involved. The World Alliance set out to develop an International Classification for Patient Safety (ICPS) to address this, and to test the relevance and acceptability of the draft ICPS and progressively refine it prior to field testing. Design Two-stage Delphi survey. Quantitative and qualitative analyses informed the review of the ICPS. Setting International web-based survey of expert opinion. Participants Experts in the fields of patient safety, health policy, reporting systems, safety and quality control, classification theory and development, health informatics, consumer advocacy, law and medicine; 253 responded to the first round survey, 30% of whom responded to the second round. Results In the first round, 14% felt that the conceptual framework was missing at least one class, although it was apparent that most respondents were actually referring to concepts they felt should be included within the classes rather than the classes themselves. There was a need for clarification of several components of the classification, particularly its purpose, structure and depth. After revision and feedback, round 2 results were more positive, but further significant changes were made to the conceptual framework and to the major classes in response to concerns about terminology and relationships between classes. Conclusions The Delphi approach proved invaluable, as both a consensus-building exercise and consultation process, in engaging stakeholders to support completion of the final draft version of the ICPS. Further refinement will occur. PMID:19147596

Recovery in Psychosis: A Delphi Study With Experts by Experience

PubMed Central

Law, Heather; Morrison, Anthony P.

2014-01-01

This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed. PMID:24727194