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Niederberger M, Schifano J, Deckert S, Hirt J, Homberg A, Köberich S, Kuhn R, Rommel A, Sonnberger M. Delphi studies in social and health sciences-Recommendations for an interdisciplinary standardized reporting (DELPHISTAR). Results of a Delphi study. PLoS One 2024; 19:e0304651. [PMID: 39186713 PMCID: PMC11346927 DOI: 10.1371/journal.pone.0304651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/16/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND While different proposals exist for a guideline on reporting Delphi studies, none of them has yet established itself in the health and social sciences and across the range of Delphi variants. This seems critical because empirical studies demonstrate a diversity of modifications in the conduction of Delphi studies and sometimes even errors in the reporting. The aim of the present study is to close this gap and formulate a general reporting guideline. METHOD In an international Delphi procedure, Delphi experts were surveyed online in three rounds to find consensus on a reporting guideline for Delphi studies in the health and social sciences. The respondents were selected via publications of Delphi studies. The preliminary reporting guideline, containing 65 items on five topics and presented for evaluation, had been developed based on a systematic review of the practice of Delphi studies and a systematic review of existing reporting guidelines for Delphi studies. Starting in the second Delphi round, the experts received feedback in the form of mean values, measures of dispersion, a summary of the open-ended responses and their own response in the previous round. The final draft of the reporting guideline contains the items on which at least 75% of the respondents agreed by assigning scale points 6 and 7 on a 7-point Likert scale. RESULTS 1,072 experts were invited to participate. A total of 91 experts completed the first Delphi round, 69 experts the second round, and 56 experts the third round. Of the 65 items in the first draft of the reporting guideline, consensus was ultimately reached for 38 items addressing the five topics: Title and Abstract (n = 3), Context (n = 7), Method (n = 20), Results (n = 4) and Discussion (n = 4). Items focusing on theoretical research and on dissemination were either rejected or remained subjects of dissent. DISCUSSION We assume a high level of acceptance and interdisciplinary suitability regarding the reporting guideline presented here and referred to as the "Delphi studies in social and health sciences-recommendations for an interdisciplinary standardized reporting" (DELPHISTAR). Use of this reporting guideline can substantially improve the ability to compare and evaluate Delphi studies.
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Affiliation(s)
- Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Julia Schifano
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Stefanie Deckert
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Julian Hirt
- Department of Health, Institute of Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Angelika Homberg
- Department of Medical Education Research, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Stefan Köberich
- Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rainer Kuhn
- DIALOGIK Non-Profit Institute for Communication and Cooperation Research, Stuttgart, Germany
- Center for Interdisciplinary Risk and Innovation Studies (ZIRIUS), University of Stuttgart, Stuttgart, Germany
| | - Alexander Rommel
- Department 2, Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Marco Sonnberger
- Department of Sociology of Technology, Risk and Environment, University of Stuttgart, Stuttgart, Germany
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Krewulak KD, Sheikh F, Heirali A, Marshall JC, Burns KEA, Kupsch S, Maratta C, Murthy S, O'Hearn K, Russell K, Mehta S, Fiest K. Core socioDemographic data variables in ICU Trials (CoDe-IT): a protocol for generating core data variables using a Delphi consensus process. BMJ Open 2024; 14:e082912. [PMID: 39043595 PMCID: PMC11268068 DOI: 10.1136/bmjopen-2023-082912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Sociodemographic variables influence health outcomes, either directly (ie, gender identity) or indirectly (eg, structural/systemic racism based on ethnoracial group). Identification of how sociodemographic variables can impact the health of critically ill adults is important to guide care and research design for this population. However, despite the growing recognition of the importance of collecting sociodemographic measures that influence health outcomes, insufficient and inconsistent data collection of sociodemographic variables persists in critical care studies. We aim to develop a set of core data variables (CoDaV) for social determinants of health specific to studies involving critically ill adults. METHODS AND ANALYSIS We will conduct a scoping review to generate a list of possible sociodemographic measures to be used for round 1 of the modified Delphi processes. We will engage relevant knowledge users (previous intensive care unit patients and family members, critical care researchers, critical care clinicians and research co-ordinators) to participate in the modified Delphi consensus survey to identify the CoDaV. A final consensus meeting will be held with knowledge user representatives to discuss the final CoDaV, how each sociodemographic variable will be collected (eg, level of granularity) and how to disseminate the CoDaV for use in critical care studies. ETHICS AND DISSEMINATION The University of Calgary conjoint health research ethics board has approved this study protocol (REB22-1648).
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Affiliation(s)
- Karla D Krewulak
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Fatima Sheikh
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alya Heirali
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - John C Marshall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Scotty Kupsch
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Christina Maratta
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Srinivas Murthy
- Department of Paediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katie O'Hearn
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kristine Russell
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
| | - Sangeeta Mehta
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Sinai Health System, Toronto, Ontario, Canada
| | - Kirsten Fiest
- Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences & O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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Koontalay A, Botti M, Hutchinson A. Achieving consensus on the key elements of a nurse-led multidisciplinary chronic heart failure service in Thailand: An e-Delphi study. J Adv Nurs 2024. [PMID: 39014994 DOI: 10.1111/jan.16330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/06/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024]
Abstract
AIMS To describe the outcomes of an e(electronic)-Delphi survey used to achieve consensus on the essential elements that should be included in a multidisciplinary, nurse-led service for patients with chronic heart failure (CHF). DESIGN The study design was based on a three-round e-Delphi survey. METHODS A series of three survey rounds were used to gather expert opinions and achieve consensus on the key elements that should be included in a CHF disease management program from a sample of healthcare professionals and organizational leaders with expertise in existing CHF services. Consensus for each item was defined as at least 90% agreement. RESULTS There were 20 participants (18 healthcare professionals and 2 organizational leaders) in round-1, 22 (20 healthcare professionals and 2 organizational leaders) in round-2, and 17 (15 healthcare professionals and 2 organizational leaders) in round-3. Fifteen participants attended a final online meeting (13 healthcare professionals and 2 organizational leaders). Consensus was obtained on five essential components: (i) consumer education, (ii) treatment optimization using a multidisciplinary approach, (iii) discharge planning, (iv) provision of supportive community care and (v) mechanisms to respond to early symptoms of decompensated CHF. CONCLUSION Participants focused on mechanisms to improve treatment effectiveness, patient and family knowledge, communication between healthcare providers and supportive care in the community. The proposed model of care may be useful to other health service providers who are designing or adapting CHF models of care for the South-East Asian environment. IMPACT This research provides a solid basis for using a Delphi method to resolve the challenges and issues of transferring global model-based recommendations in CHF knowledge. The Delphi method proved successful as an important step in developing a culturally acceptable model of chronic care that meets the goals of local healthcare providers.
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Affiliation(s)
- Apinya Koontalay
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Mari Botti
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Anastasia Hutchinson
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
- Institute of Health Transformation, Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Deakin University, Geelong, Victoria, Australia
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Andersen CR, Presseau J, Shea B, Marti ML, McCoy M, Fernie G, McIntyre L, Delaney A, Chassé M, Saigle V, Marshall S, Fergusson DA, Graham I, Brehaut J, Turgeon AF, Lauzier F, Tugwell P, Zha X, Talbot P, Muscedere J, Marshall JC, Thavorn K, Griesdale D, English SW. What to Measure in Aneurysmal Subarachnoid Haemorrhage Research-An International Delphi Survey. Transl Stroke Res 2024:10.1007/s12975-024-01271-8. [PMID: 38997598 DOI: 10.1007/s12975-024-01271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating condition with high mortality and morbidity. The outcome measures used in aSAH clinical research vary making it challenging to compare and combine different studies. Additionally, there may be a mismatch between the outcomes prioritized by patients, caregivers, and health care providers and those selected by researchers. We conducted an international, online, multiple round Delphi study to develop consensus on domains (where a domain is a health concept or aspect) prioritized by key stakeholders including those with lived experience of aSAH, health care providers, and researchers, funders, or industry professionals. One hundred seventy-five people participated in the survey, 59% of whom had lived experience of aSAH. Over three rounds, 32 domains reached the consensus threshold pre-defined as 70% of participants rating the domain as being critically important. During the fourth round, participants ranked the importance of each of these 32 domains. The top ten domains ranked highest to lowest were (1) Cognition and executive function, (2) Aneurysm obliteration, (3) Cerebral infarction, (4) Functional outcomes including ability to walk, (5) Delayed cerebral ischemia, (6) The overall quality of life as reported by the SAH survivor, (7) Changes to emotions or mood (including depression), (8) The basic activities of daily living, (9) Vasospasm, and (10) ICU complications. Our findings confirm that there is a mismatch between domains prioritized by stakeholders and outcomes used in clinical research. Our future work aims to address this mismatch through the development of a core outcome set in aSAH research.
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Affiliation(s)
- Christopher R Andersen
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Justin Presseau
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Bev Shea
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Maria Luisa Marti
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Madeline McCoy
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Gordon Fernie
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Lauralyn McIntyre
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Anthony Delaney
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Michaël Chassé
- Department of Medicine, Division of Critical Care, Centre Hospitalier de L'Université de Montréal, Montréal, Québec, Canada
| | - Victoria Saigle
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Shawn Marshall
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dean A Fergusson
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
| | - Ian Graham
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jamie Brehaut
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Population Health and Optimal Health Practice Research Unit (Trauma - Emergency - Critical Care Medicine) CHU de Québec-Université Laval Research Centre, Québec City, Québec, Canada
| | - François Lauzier
- Population Health and Optimal Health Practice Research Unit (Trauma - Emergency - Critical Care Medicine) CHU de Québec-Université Laval Research Centre, Québec City, Québec, Canada
- Department of Medicine, Department of Anesthesiology and Critical Care, Université Laval, Québec, Canada
| | - Peter Tugwell
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Xiaohui Zha
- Inflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Biochemistry, Immunology & Microbiology, University of Ottawa, Ottawa, Canada
| | - Phil Talbot
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
| | - John C Marshall
- Departments of Surgery and Critical Care Medicine, Unity Health Toronto, Toronto, ON, Canada
| | - Kednapa Thavorn
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Donald Griesdale
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Shane W English
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Rantanen T. What mobility factors are critical to include in a comprehensive mobility discharge assessment framework for older adults transitioning from hospital-to-home in the community? An international e-Delphi study. Disabil Rehabil 2024; 46:2808-2820. [PMID: 37409876 DOI: 10.1080/09638288.2023.2232293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE To prioritize and achieve consensus on mobility determinant factors [cognitive, financial, environmental, personal, physical, psychological, social] considered critical to include in the COmprehensive Mobility Discharge Assessment Framework (COMDAF) for older adults transitioning from hospital-to-home. MATERIALS AND METHODS We conducted a three-round modified e-Delphi process with 60 international experts (seven older adults, nine family caregivers, 24 clinicians, and 20 researchers) from nine countries with universal or near-universal health coverage. Expert members rated 91 factors identified from scoping reviews using a 9-point scale: not important (1-3), important (4-6), and critical (7-9). RESULT A total of 41 of 91 factors (45.1%) met the a-priori consensus criterion after three rounds: five cognitive, five environmental, two personal, 19 physical, six psychological, and six social factors. No financial factors reached a consensus. The older adult steering committee member recommended the addition of two environmental factors, resulting in 43 mobility factors included in the COMDAF. CONCLUSIONS We advanced a comprehensive mobility framework by developing, through consensus, 43 mobility factors to be assessed as part of a COMDAF. However, its use in hospital-to-home may not be feasible. Therefore, future research will determine the core mobility factors for COMDAF and which measurement instruments best measure these factors. RELEVANCE An interdisciplinary discharge rehabilitation team can utilize the COMDAF during hospital-to-home transition.Implications for rehabilitationMobility assessment following a hospital discharge is a complex process requiring an interdisciplinary discharge rehabilitation team.This study provided a comprehensive list of 91 factors across all seven mobility determinants (cognitive, environmental, financial, personal, physical, psychological, and social) for clinicians in other care settings to use as a starting point to determine which mobility factor should be assessed during older adults' hospital-to-home transition.This international e-Delphi study identified 43 factors within mobility determinants (cognitive, environmental, personal, physical, psychological, and social) to be included in a Comprehensive Mobility Discharge Assessment Framework to assess older adults' mobility during the hospital to home transition.Using these 43 factors, clinicians can identify which assessment tool is best suited to assess the factors while reflecting on the logistics and feasibility; this is the next phase of this project.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Science, University of Jyvaskyla, Jyvaskyla, Finland
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Woodbridge HR, McCarthy CJ, Jones M, Willis M, Antcliffe DB, Alexander CM, Gordon AC. Assessing the safety of physical rehabilitation in critically ill patients: a Delphi study. Crit Care 2024; 28:144. [PMID: 38689372 PMCID: PMC11061934 DOI: 10.1186/s13054-024-04919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Physical rehabilitation of critically ill patients is implemented to improve physical outcomes from an intensive care stay. However, before rehabilitation is implemented, a risk assessment is essential, based on robust safety data. To develop this information, a uniform definition of relevant adverse events is required. The assessment of cardiovascular stability is particularly relevant before physical activity as there is uncertainty over when it is safe to start rehabilitation with patients receiving vasoactive drugs. METHODS A three-stage Delphi study was carried out to (a) define adverse events for a general ICU cohort, and (b) to define which risks should be assessed before physical rehabilitation of patients receiving vasoactive drugs. An international group of intensive care clinicians and clinician researchers took part. Former ICU patients and their family members/carers were involved in generating consensus for the definition of adverse events. Round one was an open round where participants gave their suggestions of what to include. In round two, participants rated their agreements with these suggestions using a five-point Likert scale; a 70% consensus agreement threshold was used. Round three was used to re-rate suggestions that had not reached consensus, whilst viewing anonymous feedback of participant ratings from round two. RESULTS Twenty-four multi-professional ICU clinicians and clinician researchers from 10 countries across five continents were recruited. Average duration of ICU experience was 18 years (standard deviation 8) and 61% had publications related to ICU rehabilitation. For the adverse event definition, five former ICU patients and one patient relative were recruited. The Delphi process had a 97% response rate. Firstly, 54 adverse events reached consensus; an adverse event tool was created and informed by these events. Secondly, 50 risk factors requiring assessment before physical rehabilitation of patients receiving vasoactive drugs reached consensus. A second tool was created, informed by these suggestions. CONCLUSIONS The adverse event tool can be used in studies of physical rehabilitation to ensure uniform measurement of safety. The risk assessment tool can be used to inform clinical practise when risk assessing when to start rehabilitation with patients receiving vasoactive drugs. Trial registration This study protocol was retrospectively registered on https://www.researchregistry.com/ (researchregistry2991).
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Affiliation(s)
- Huw R Woodbridge
- Imperial College Healthcare NHS Trust, London, UK.
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | | | | | | | - David B Antcliffe
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Caroline M Alexander
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Anthony C Gordon
- Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Okoh AC, Onyeso OK, Ekemezie W, Oyinlola O, Akinrolie O, Kalu M. Building consensus on priority areas for Sub-Saharan Africa's ageing population research: An e-Delphi study protocol. PLoS One 2024; 19:e0298541. [PMID: 38603688 PMCID: PMC11008814 DOI: 10.1371/journal.pone.0298541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/18/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Improvement in medico-social services has increased life expectancy and population ageing in Sub-Saharan Africa (SSA). It was estimated that about 163 million people aged 65 and older will be resident in SSA by 2050. There is inadequate ageing research capacity in SSA which necessitates this study to (a) identify a decade-long ageing research opportunities, challenges, and solutions, and (b) prioritize critical ageing research areas and methodologies relevant to the SSA. METHODS We designed an e-Delphi protocol following the Reporting Guideline for Priority Setting of Health Research with Stakeholder. The stakeholders will be researchers, practitioners, older adults, and caregivers purposively selected through snowballing quota sampling to complete three rounds of e-Delphi surveys. Round 1 will involve open-ended questions derived from the study objectives. Responses from round 1 will be prepared as a checklist for stakeholders to rate during rounds 2 & 3, using a 9-point scale: low priority (1-3), moderate priority (4-6), and high priority (7-9). The criterion for reaching a consensus will be ≥ 70% of stakeholders rating an item "high priority" and ≤ 15% as "low priority." Quantitative data will be analysed using descriptive statistics, Wilcoxon matched-pairs signed-rank test will be used to assess the stability of stakeholders' responses, and qualitative comments will be analysed using content analysis. DISCUSSION AND IMPLICATIONS Setting aging research/practice priorities will help maximize the benefits of research investment and provide valuable direction for allocating public and private research funds to areas of strategic importance.
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Affiliation(s)
- Augustine Chukwuebuka Okoh
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ogochukwu Kelechi Onyeso
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
- Population Studies in Health, Faculty of Health Science, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Wendy Ekemezie
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
| | - Oluwagbemiga Oyinlola
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
- Medical Social Services Department, University College Hospital, Ibadan, Nigeria
- School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Olayinka Akinrolie
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
- Applied Health Science Program, Faculty of Graduate Studies, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Kalu
- Emerging Researchers & Professionals in Ageing–African Network, Abuja, Nigeria
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
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Moutinho JDA, Fernandes G, Rabechini R. Evaluation in design science: A framework to support project studies in the context of University Research Centres. EVALUATION AND PROGRAM PLANNING 2024; 102:102366. [PMID: 37678061 DOI: 10.1016/j.evalprogplan.2023.102366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/10/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
This paper proposes a discussion of the evaluation of an artefact developed under the Design Science paradigm using the Delphi method. It evaluates the Ecosystem framework of University Research Centres in Project Studies, considering a set of criteria pre-established in the literature. The Delphi method is an evaluation implemented in an electronic platform involving twenty-one participants, among whom were academics, practitioners, and PhD candidates in the field of project management. It reached consensus and stability in two rounds: the results indicate a consensus among the participants in the applicability, novelty, simplicity, completeness, fidelity to modelled phenomena, consistency and internal coherence, scalability, flexibility, interest, elegance, and reusability criteria. Usability was the only criterion that did not attain the predefined percentage of consensus among the participants (70%). Given the framework's characteristics, Delphi participants indicated the need to produce complementary guidelines for its implementation.
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Affiliation(s)
- José da Assunção Moutinho
- State University of Rio de Janeiro - UERJ, Rua São Francisco Xavier, 524 - Maracanã, 20550-013 Rio de Janeiro, RJ, Brazil; University Nove de Julho - UNINOVE, Rua Vergueiro, 235/249 - Liberdade, 01156-080 São Paulo, SP, Brazil.
| | - Gabriela Fernandes
- University of Coimbra, CEMMPRE, Pólo II, Rua Luis Reis Santos, 3030-788 Coimbra, Portugal
| | - Roque Rabechini
- University Nove de Julho - UNINOVE, Rua Vergueiro, 235/249 - Liberdade, 01156-080 São Paulo, SP, Brazil
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Larkin P, Bratiotis C, Woody SR. Assessment of Critical Health and Safety Risks in Homes where Hoarding is Prevalent. J Community Health 2024; 49:8-16. [PMID: 37284917 PMCID: PMC10881672 DOI: 10.1007/s10900-023-01238-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
Hoarding behaviour sometimes requires intervention from community agencies to reduce risks to residents and the nearby community. Human services professionals from a wide range of disciplines are called upon to address hoarding concerns, often in collaboration with each other. No guidelines currently exist to guide staff from those community agencies in a shared understanding of common health and safety risks that occur with severe hoarding behaviour. Using a modified Delphi method, we aimed to generate consensus among a panel of 34 service-provider experts from a range of disciplines on essential risks in the home that would require intervention for health or safety reasons. This process identified 31 environmental risk factors that experts agreed are critical to assess in cases of hoarding. Panelist comments outlined the debates that commonly occur in the field, the complexity of hoarding, and the difficulty with conceptualizing risks in the home. The multi-disciplinary consensus achieved on these risks will facilitate better collaboration between agencies by providing a minimum standard of what to evaluate in hoarded homes to ensure health and safety standards are being met. This can improve communication between agencies, specify the core hazards that should be incorporated into training for professionals who work with hoarding, and facilitate more standardized assessment of health and safety risks in hoarded homes.
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Affiliation(s)
- Persephone Larkin
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | | | - Sheila R Woody
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
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Souza-Silva MVR, Domingues MLDP, Chagas VS, Pereira DN, de Sá LC, Almeida MSS, Sales TLS, Raposo MC, Guimarães NS, Oliveira JADQ, Ribeiro ALP, Cardoso CS, Martins MAP, Enes TB, Soares TBDC, Baldoni AO, Marcolino MS. Implementation of a text messaging intervention to patients on warfarin therapy in Brazilian primary care units: a quasi-experimental study. BMC PRIMARY CARE 2022; 23:54. [PMID: 35321654 PMCID: PMC8942053 DOI: 10.1186/s12875-022-01647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
Background Warfarin remains the most affordable oral anticoagulant in many countries. However, it may have serious side effects, and the success of the therapy depends on the patient’s understanding of the medication and their adherence to treatment. The use of short messages services (SMS) is a strategy that can be used to educate patients, but there are no studies evaluating this intervention in patients taking warfarin. Therefore, we aimed to develop, implement, and assess the feasibility of an intervention using SMS to primary care patients taking warfarin in a medium-sized Brazilian city. Methods A bank of 79 SMS was drafted and validated by an expert panel. During 6 months, three times a week, patients received messages about anticoagulation with warfarin. At baseline and after 3 months, we assessed their knowledge and adherence with validated instruments. At the end of the follow-up, participants answered a satisfaction questionnaire. Subsequently, a scale-up phase was conducted, with another round of the intervention including 82 participants (29 from the first phase and 53 newly recruited). Seven months after the end of the scale-up, we asked the patients for their insights about the long-term effects of this program. All patients signed informed consent. The study was approved by the Research and Ethics committee of the Universidade Federal de Minas Gerais. Results In the pilot, 33 (89.2%) patients completed the follow-up. Among the participants who answered the satisfaction questionnaire (n = 29), 86.2% considered that the intervention motivated a healthy lifestyle and improved their understanding of warfarin therapy. All patients were willing to continue receiving the messages. Adherence measured by the Measure of Adherence to Treatment (MAT) test was high in the pre-intervention assessment and remained high (96.7% vs. 93.3%; p = 1.0000). The proportion of patients who achieved > 75% correct answers on the Oral Anticoagulation Knowledge (OAK) test increased from 6.5% to 25.6, p = 0.0703. In the scale-up, 23 patients answered the long-term assessment questionnaire. The main long-term knowledge reported was dietary information. Nine patients received the messages but did not remember their content. Conclusion The intervention was well-accepted and had a positive impact on patient’s knowledge about oral anticoagulation therapy. The scale-up assessment reinforced the need to constantly monitor digital interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01647-5.
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Niederberger M, Deckert S. [The Delphi technique: Methodology, variants and usage examples]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 174:11-19. [PMID: 36137932 DOI: 10.1016/j.zefq.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/20/2022] [Accepted: 08/23/2022] [Indexed: 12/14/2022]
Abstract
In the field of medicine and health sciences, Delphi methods are applied mainly in the exploratory or evaluative phases of a research process. Explicit and implicit knowledge of respected experts from research and practice is systematically synthesized. Originally developed as a method for structuring a group communication process, Delphi techniques have been established in the health sector as a consensus method. The findings are used to improve the evidence and acceptance of planned interventions or necessary standards or guidelines and to increase the probability of successful implementation in practice. However, different variants of Delphi methods have been developed in recent years, which are systematically contrasted and reflected in this paper with regard to key epistemological and methodological research activities. Based on this overview, researchers should be enabled to select the most suitable Delphi technique for their own research questions and research endeavors.
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Affiliation(s)
- Marlen Niederberger
- Forschungsmethoden in der Gesundheitsförderung und Prävention, Pädagogische Hochschule Schwäbisch Gmünd, Schwäbisch Gmuünd, Deutschland.
| | - Stefanie Deckert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
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Kalu ME, Dal Bello-Haas V, Griffin M, Ploeg J, Richardson J. A comprehensive mobility discharge assessment framework for older adults transitioning from hospital-to-home in the community—What mobility factors are critical to include? Protocol for an international e-Delphi study. PLoS One 2022; 17:e0267470. [PMID: 36137073 PMCID: PMC9499191 DOI: 10.1371/journal.pone.0267470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Mobility deficits have been identified as an independent risk factor for hospital readmission for adults ≥65 years. Despite evidence indicating how determinants additively influence and predict mobility, no hospital-to-home care transition models comprehensively assess all seven mobility determinants, cognitive, financial, environmental, personal, physical, psychological, and social. There is currently a lack of clarity regarding what factors clinicians and researchers should evaluate for each mobility determinant. The purpose of this e-Delphi study is to prioritize and reach consensus on the factors for each mobility determinant that are critical to assess as part of the Comprehensive Mobility Discharge Assessment Framework (CMDAF) when older adults are discharged from hospital-to-home.
Methods
This protocol paper is an international modified e-Delphi study following the Recommendations for the Conducting and Reporting of Delphi Studies. International researchers, clinicians, older adults and family caregivers residing in a country with universal or near-universal health coverage will be invited to participate as ‘experts’ in three e-Delphi rounds administered through DelphiManager©. The e-Delphi Round 1 questionnaire will be developed based on scoping review findings and will be pilot tested. For each round, experts will be asked to rate factors for each determinant that are critical to assess as part of the CMDAF using a 9-point scale: Not Important (1–3), Important but Not Critical (4–6), and Critical (7–9). The scale will include a selection option of "unable to score" and experts will also be asked to provide a rationale for their scoring and suggest missing factors. Experts will receive feedback summaries in Rounds 2 and 3 to guide them in reflecting on their initial responses and re-rating of factors that have not reached consensus. The criteria for reaching consensus will be if ≥70% of experts rate a factor as "critical" (scores ≥7) and ≤ 15% of experts rate a factor as "not important" (scores≤ 3). Quantitative data will be analyzed using median values, frequencies, percentages, interquartile range, and bar graphs; Wilcoxon matched-pairs signed-rank test will be used to assess the stability of participants’ responses. Rationale (qualitative data) provided in the open-ended comments section will be analyzed using content analysis.
Conclusion
This study is a first step in developing the CMDAF and will be used to guide a subsequent e-Delphi survey to decide on the tools that should be used to measure the examples of each factor included in our framework.
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Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University Hamilton, Ontario, Canada
| | - Julie Richardson
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Evaluation and Impact, Faculty of Health Sciences, McMaster University, Ontario, Canada
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Development of a performance standard for physiotherapists delivering exercise and mobilisation to the critically ill: A modified Delphi consensus study. Aust Crit Care 2022:S1036-7314(22)00093-5. [PMID: 36096922 DOI: 10.1016/j.aucc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/08/2022] [Accepted: 07/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The provision of early mobilisation to critically ill patients has the potential to improve long term outcomes, but, is complex to deliver. There is minimal literature detailing the training and expertise required to deliver these interventions safely and effectively. OBJECTIVE The objective of this study was to determine the key elements of a performance standard for assessment of physiotherapists delivering exercise and mobilisation interventions to the critically ill. METHOD This is a modified eDelphi expert consensus study. Fifty-one physiotherapists from Australia and New Zealand with relevant clinical, educational, or research experience were included on the expert panel. Background information and the initial pool of items were developed from review of relevant literature. Five survey rounds were administered across two study phases to determine the elements, performance criteria, and assessment scale of the performance standard. Items were modified, amalgamated, and added based upon panel comments. RESULTS Consensus was achieved for 69 mandatory, and two supplementary performance criteria which were arranged under 15 elements encompassing knowledge, assessment, analysis, intervention, and professional behaviours. A 3-point rating scale was selected to assess item achievement and global performance. CONCLUSION Binational expert consensus was reached to define the assessment criteria for physiotherapists delivering exercise and mobilisation interventions to the critically ill. This standard can be utilised in clinical, educational, and research practice environments to guide training, assessment, and skill recognition in critical care physiotherapy.
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Zaugg C, Berglas NF, Johnson R, Roberts SCM. Reaching Consensus on Politicized Topics: A Convening of Public Health Professionals to Discuss Appropriate Abortion Activities for US Health Departments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:366-374. [PMID: 34750328 DOI: 10.1097/phh.0000000000001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Public health professionals, particularly those in state and local health departments, do not always have clear understandings of their roles related to politically controversial public health topics. A process of consensus development among public health professionals that considers the best available evidence may be able to guide decision making and lay out an appropriate course of action. APPROACH In May 2020, a group of maternal and child health and family planning professionals working in health departments, representatives of schools of public health, and members of affiliated organizations convened to explore values and principles relevant to health departments' engagement in abortion and delineate activities related to abortion that are appropriate for health departments. The convening followed a structured consensus process that included multiple rounds of input and opportunities for feedback and revisions. OUTCOMES Convening participants came to consensus on principles to guide engagement in activities related to abortion, a set of activities related to abortion that are appropriate for health departments, and next steps to support implementation of such activities. LESSONS LEARNED The experience of the convening indicates that consensus processes can be feasible for politically controversial public health topics such as abortion.
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Affiliation(s)
- Claudia Zaugg
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California (Ms Zaugg and Drs Berglas and Roberts); and CityMatCH, University of Nebraska Medical Center, Omaha, Nebraska (Ms Johnson)
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Kalu ME, Oyinlola O, Ibekaku MC, Adandom II, Iwuagwu AO, Ezulike CJ, Nwachukwu EC, Uduonu E. A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5A's Vaccine Taxonomy. Am J Trop Med Hyg 2022; 106:tpmd210515. [PMID: 35533697 PMCID: PMC9209920 DOI: 10.4269/ajtmh.21-0515] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022] Open
Abstract
Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As-acceptability, accessibility, affordability, awareness, and activation-of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.
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Affiliation(s)
- Michael E. Kalu
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Oluwagbemiga Oyinlola
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Medical Social Services Department, University College Hospital Ibadan, Ibadan, Nigeria
| | - Michael C. Ibekaku
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- University of Benin Teaching Hospital, Benin, Nigeria
| | - Israel I. Adandom
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Cedarcrest Hospitals, FCT-Abuja, Nigeria
| | - Anthony O. Iwuagwu
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | - Chigozie J. Ezulike
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Ernest C. Nwachukwu
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Physiotherapy Department, Enugu State University of Science and Technology Teaching Hospital, Parklane-Enugu
| | - Ekezie Uduonu
- Emerging Researchers and Professionals in Ageing–African Network, Hamilton, Ontario, Canada
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus
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Prévost S, Metz JP, Mottet N. [Information tool about labor and delivery designed by Delphi method]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:220-228. [PMID: 34500133 DOI: 10.1016/j.gofs.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The integration of couples in decision making in obstetrics is necessary to improve the experience of giving birth. The objective of this work is to elaborate a new tool to provide information to health professionals. METHODS A 5-round Delphi method was used to define the information points. The 20 multi-disciplinary experts answered 5 surveys on the information to deliver concerning childbirth. The selected items were organized with mind mapping. RESULTS 54 items were identified on the first round. 5 were retained after the second survey while the rest were reformulated and submitted for the third round. Amongst the 47 items submitted, 19 were retained, the rest were removed, merged or reworded. The fourth survey included 22 items of which 11 were retained. The fifth survey concerned the 11 remaining items and 2 new ones. During this round, 7 items were retained. This round made it possible to reach the consensus. In total, 42 items reached the consensus of the experts. They were then split into 5 mind maps allowing their visual organization to form the information tool. CONCLUSION The tool elaborated in a multi-disciplinary manner offers complementary information to that already given during childbirth preparation courses. It is a framework for the information to be given that leaves the content up to each professional.
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Affiliation(s)
- S Prévost
- Service de gynécologie-obstétrique, Centre hospitalier régional universitaire de Besançon, 3, boulevard A. Fleming, 25030 Besançon, France.
| | - J-P Metz
- Cabinet AGYL, 8, rue des Pontonniers, 67000 Strasbourg, France.
| | - N Mottet
- Service de gynécologie-obstétrique, Centre hospitalier régional universitaire de Besançon, 3, boulevard A. Fleming, 25030 Besançon, France.
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Yeung E, Scodras S, Salbach NM, Kothari A, Graham ID. Identifying competencies for integrated knowledge translation: a Delphi study. BMC Health Serv Res 2021; 21:1181. [PMID: 34715872 PMCID: PMC8556977 DOI: 10.1186/s12913-021-07107-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Considerable progress has been made to advance the field of knowledge translation to address the knowledge-to-action gap in health care; however, there remains a growing concern that misalignments persist between research being conducted and the issues faced by knowledge users, such as clinicians and health policy makers, who make decisions in the health care context. Integrated knowledge translation (IKT) is a collaborative research model that has shown promise in addressing these concerns. It takes advantage of the unique and shared competencies amongst researchers and knowledge users to ensure relevance of the research process and its outcomes. To date, core competencies have already been identified to facilitate training in knowledge translation more generally but they have yet to be prioritized for IKT more specifically. The primary aim of this study was to recruit a group of researchers and knowledge users to identify and prioritize core competencies for researchers and knowledge users to engage with IKT. Methods We recruited health care knowledge users (KUs) and researchers with experience and knowledge of IKT for a quantitative, cross-sectional study. We employed a modified Delphi approach consisting of three e-survey rounds to establish consensus on competencies important to IKT for KUs and researchers based on mean rating of importance and agreement between participants. Results Nineteen (73%) of the initial 26 participants were researchers (response rate = 41% in the first round; retention in subsequent rounds > 80%). Participants identified a total of 46 competencies important for IKT (18 competencies for KUs, 28 competencies for researchers) under 3 broad domains. Technical research skills were deemed extremely important for researchers, while both groups require teamwork and knowledge translation skills. Conclusions This study provides important insight into distinct and overlapping IKT competencies for KUs and researchers. Future work could focus on how these can be further negotiated and contextualized for a wide range of IKT contexts, projects and teams. Greater attention could also be paid to establishing competencies of the entire team to support the research co-production process. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07107-7.
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Affiliation(s)
- Euson Yeung
- University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada.
| | - Stephanie Scodras
- University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Nancy M Salbach
- University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Anita Kothari
- Western University, Health Sciences Building, Rm 222, 1151 Richmond St, London, Ontario, N6A 5B9, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cresent, Ottawa, Ontario, K1G 5Z3, Canada.,Centre for Practice-Changing Research, The Ottawa Hospital Research Institute, 501 Smyth Road, Box 711, Ottawa, Ontario, K1H 8L6, Canada
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Karumbi J, Gorst SL, Gathara D, Gargon E, Young B, Williamson PR. Inclusion of participants from low-income and middle-income countries in core outcome sets development: a systematic review. BMJ Open 2021; 11:e049981. [PMID: 34667005 PMCID: PMC8527127 DOI: 10.1136/bmjopen-2021-049981] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Our study aims to describe differences or similarities in the scope, participant characteristics and methods used in core outcome sets (COS) development when only participants from high-income countries (HICs) were involved compared with when participants from low-income and middle-income countries (LMICs) were also involved. DESIGN Systematic review. DATA SOURCES Annual Core Outcome Measures in Effectiveness Trials systematic reviews of COS which are updated based on SCOPUS and MEDLINE, searches. The latest systematic review included studies published up to the end of 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included studies reporting development of a COS for use in research regardless of age, health condition or setting. Studies reporting the development of a COS for patient-reported outcomes or adverse events or complications were also included. DATA EXTRACTION AND SYNTHESIS Data were extracted in relation to scope of the COS study, participant categories and the methods used in outcome selection. RESULTS Studies describing 370 COS were identified in the database. Of these, 75 (20%) included participants from LMICs. Only four COS were initiated from an LMIC setting. More than half of COS with LMIC participants were developed in the last 5 years. Cancer and rheumatology were the dominant disease domains. Overall, over 259 (70%) of COS explicitly reported including clinical experts; this was higher where LMIC participants were also included 340 (92%). Most LMIC participants were from China, Brazil and South Africa. Mixed methods for consensus building were used across the two settings. CONCLUSION Progress has been made in including LMIC participants in the development of COS, however, there is a need to explore how to enable initiation of COS development from a range of LMIC settings, how to ensure prioritisation of COS that better reflects the burden of disease in these contexts and how to improve public participation from LMICs.
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Affiliation(s)
- Jamlick Karumbi
- Health Data Science, University of Liverpool, Liverpool, UK
- Health Systems Research, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Sarah L Gorst
- Health Data Science, University of Liverpool, Liverpool, UK
| | - David Gathara
- Health Systems Research, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | | | - Bridget Young
- Health Data Science, University of Liverpool, Liverpool, UK
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Marson BA, Manning JC, James M, Craxford S, Deshmukh SR, Perry DC, Ollivere BJ. Development of the CORE-Kids core set of outcome domains for studies of childhood limb fractures. Bone Joint J 2021; 103-B:1821-1830. [PMID: 34412506 PMCID: PMC8779948 DOI: 10.1302/0301-620x.103b.bjj-2020-2321.r2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aims The aim of this study is to develop a core set of outcome domains that should be considered and reported in all future trials of childhood limb fractures. Methods A four-phase study was conducted to agree a set of core outcome domains. Identification of candidate outcome domains were identified through systematic review of trials, and outcome domains relevant to families were identified through semi-structured interviews with 20 families (parent-child pairing or group). Outcome domains were prioritized using an international three-round Delphi survey with 205 panellists and then condensed into a core outcome set through a consensus workshop with 30 stakeholders. Results The systematic review and interviews identified 85 outcome domains as relevant to professionals or families. The Delphi survey prioritized 30 upper and 29 lower limb outcome domains at first round, an additional 17 upper and 18 lower limb outcomes at second round, and four additional outcomes for upper and lower limb at the third round as important domains. At the consensus workshop, the core outcome domains were agreed as: 1) pain and discomfort; 2) return to physical and recreational activities; 3) emotional and psychosocial wellbeing; 4) complications from the injury and treatment; 5) rturn to baseline activities daily living; 6) participation in learning; 7) appearance and deformity; and 8) time to union. In addition, 9a) recovery of mobility and 9b) recovery of manual dexterity was recommended as a core outcome for lower and upper limb fractures, respectively. Conclusion This set of core outcome domains is recommended as a minimum set of outcomes to be reported in all trials. It is not an exhaustive set and further work is required to identify what outcome tools should be used to measure each of these outcomes. Adoption of this outcome set will improve the consistency of research for these children that can be combined for more meaningful meta-analyses and policy development. Cite this article: Bone Joint J 2021;103-B(12):1821–1830.
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Affiliation(s)
- Ben A Marson
- Department of Trauma and Orthopaedics, University of Nottingham, Nottingham, UK
| | - Joseph C Manning
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Marilyn James
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Simon Craxford
- Department of Trauma and Orthopaedics, University of Nottingham, Nottingham, UK
| | - Sandeep R Deshmukh
- Department of Trauma and Orthopaedics, University of Nottingham, Nottingham, UK
| | - Daniel C Perry
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Benjamin J Ollivere
- Department of Trauma and Orthopaedics, University of Nottingham, Nottingham, UK
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Varndell W, Fry M, Elliott D. Applying real-time Delphi methods: development of a pain management survey in emergency nursing. BMC Nurs 2021; 20:149. [PMID: 34407815 PMCID: PMC8371887 DOI: 10.1186/s12912-021-00661-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 01/22/2023] Open
Abstract
The modified Delphi technique is widely used to develop consensus on group opinion within health services research. However, digital platforms are offering researchers the capacity to undertake a real-time Delphi, which provides novel opportunities to enhance the process. The aim of this case study is to discuss and reflect on the use of a real-time Delphi method for researchers in emergency nursing and cognate areas of practice. A real-time Delphi method was used to develop a national survey examining knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses. While designing and completing this real-time Delphi study, a number of areas, emerged that demanded careful consideration and provide guidance to future researchers.
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Affiliation(s)
- Wayne Varndell
- Prince of Wales Hospital Emergency Department, NSW, 2031, Randwick, Australia. .,Faculty of Health, University of Technology Sydney, NSW, 2007, Ultimo, Australia. .,College of Emergency Nursing Australasia, PO Box 7345, Victoria, 3193, Beaumaris, Australia.
| | - Margaret Fry
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, 15 Broadway, NSW, 2007, Ultimo, Australia.,Director Research and Practice Development Nursing and Midwifery Directorate NSLHD, Royal North Shore Hospital, Level 7 Kolling Building, NSW, 2065, St Leonards, Australia
| | - Doug Elliott
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, 15 Broadway, NSW, 2007, Ultimo, Australia
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Abstract
Background: To coordinate and align the content for registration of cholesteatoma care. Methods: Systematic Delphi consensus procedure, consisting three rounds: two written sessions followed by a face-to-face meeting. Before this procedure, input on important patient outcomes was obtained. Consensus was defined as at least 80% agreement by participants. Hundred-thirty-six adult patients who had undergone cholesteatoma surgery and all ENT surgeons of the Dutch ENT Society were invited. The consensus rounds were attended by ENT surgeons with cholesteatoma surgery experience. Feasibility and acceptability of outcome measures and reporting agreements were assessed in round 1 by 150 ENT surgeons. In round 2 definitions were narrowed and context information to interpret outcome measure were questioned. In round 3, the results, amendments, and the open-ended points were discussed to reach agreement. Results: Most important outcome measures are: 1) the presence or absence of a cholesteatoma in the first 5 years after surgical removal of cholesteatoma, 2) hearing level after surgical removal of cholesteatoma, and 3) the documented assessment of patient's complaints with a validated patient reported outcome measures questionnaire (PROM). Furthermore, consensus was reached on the registration of cholesteatoma type (residual/recurrent), localization of cholesteatoma, and reporting of the presence of cholesteatoma in the follow-up. Conclusion: Consensus was reached on the content and method of registration of cholesteatoma care based on patient's and ENT surgeons input. Three outcome measures were defined. National agreements on the method and content of registration will facilitate monitoring and feedback to the ENT surgeon about the cholesteatoma care.
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Fish R, MacLennan S, Alkhaffaf B, Williamson PR. "Vicarious thinking" was a key driver of score change in Delphi surveys for COS development and is facilitated by feedback of results. J Clin Epidemiol 2020; 128:118-129. [PMID: 33011214 PMCID: PMC7716748 DOI: 10.1016/j.jclinepi.2020.09.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/23/2020] [Accepted: 09/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objectives of this nested study were to (1) assess whether changes in scores between rounds altered the final degree of consensus achieved in three Delphi surveys conducted as part of COS development projects (anal, gastric, and prostate cancer), and (2) explore participants' reasons for changing scores between rounds. STUDY DESIGN AND SETTING All Delphi surveys were conducted online using DelphiManager software and included healthcare professionals and participating patients. Participants were invited to give a free-text reason whenever they changed their score across an important threshold on a 1-9 Likert scale (1-3 not important, 4-5 important, 7-9 critically important). Reasons for score change were coded by four researchers independently using an inductive-iterative approach. RESULTS In all three Delphi surveys, the number of outcomes reaching criteria for consensus was greater in R2 than R1. Twelve themes and 23 subthemes emerged from 2298 discrete reasons given for score change. The most common reasons for the change were "time to reflect" (482 responses, 23%) and vicarious thinking (424, 21%), with 68% (291) of vicarious thinking attributed to seeing other participant's scores. CONCLUSION Our findings support conducting a Delphi survey over the use of a single questionnaire where building consensus is the objective. Time to reflect and vicarious thinking, facilitated by seeing other participant's scores, were important drivers of score change. How results are presented to participants between rounds and the duration of and time between rounds in a Delphi survey may, therefore, influence the results and should be clearly reported.
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Affiliation(s)
- Rebecca Fish
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Wilmslow Road, Manchester M20 4BX, UK; Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, UK.
| | - Steven MacLennan
- Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, UK
| | - Bilal Alkhaffaf
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Wilmslow Road, Manchester M20 4BX, UK; Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; Department of Oesophago-Gastric Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - Paula R Williamson
- MRC/NIHR Trials Methodology Research Partnership, Department of Biostatistics, Block F Waterhouse Building, University of Liverpool, 1-5 Brownlow Street, Liverpool L69 3GL, UK
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Boel A, Navarro-Compán V, Landewé R, van der Heijde D. Two different invitation approaches for consecutive rounds of a Delphi survey led to comparable final outcome. J Clin Epidemiol 2020; 129:31-39. [PMID: 32991995 DOI: 10.1016/j.jclinepi.2020.09.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/19/2020] [Accepted: 09/24/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There are two different approaches to involve participants in consecutive rounds of a Delphi survey: (1) invitation to every round independent of response to the previous round ("all-rounds") and (2) invitation only when responded to the previous round ("respondents-only"). This study aimed to investigate the effect of invitation approach on the response rate and final outcome of a Delphi survey. STUDY DESIGN AND SETTING Both experts (N = 188) and patients (N = 188) took part in a Delphi survey to update the core outcome set (COS) for axial spondyloarthritis. A study with 1:1 allocation to two experimental groups (ie, "all-rounds" [N = 187] and "respondents-only" [N = 189]) was built-in. RESULTS The overall response rate was lower in the "respondents-only group" (46%) compared to the "all-rounds group" (61%). All domains that were selected for inclusion in the COS by the "respondents-only group" were also selected by the "all-rounds group." Additionally, the four most important domains were identical between groups after the final round, with only minor differences in the other domains. CONCLUSION Inviting panel members who missed a round to a subsequent round will lead to a better representation of opinions of the originally invited panel and reduces the chance of false consensus, while it does not influence the final outcome of the Delphi.
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Affiliation(s)
- Anne Boel
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
| | | | - Robert Landewé
- Department of Rheumatology, Zuyderland Medical Center Heerlen, Heerlen, The Netherlands; Department of Clinical Immunology & Rheumatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Niederberger M, Spranger J. Delphi Technique in Health Sciences: A Map. Front Public Health 2020; 8:457. [PMID: 33072683 PMCID: PMC7536299 DOI: 10.3389/fpubh.2020.00457] [Citation(s) in RCA: 356] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/22/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives: In health sciences, the Delphi technique is primarily used by researchers when the available knowledge is incomplete or subject to uncertainty and other methods that provide higher levels of evidence cannot be used. The aim is to collect expert-based judgments and often to use them to identify consensus. In this map, we provide an overview of the fields of application for Delphi techniques in health sciences in this map and discuss the processes used and the quality of the findings. We use systematic reviews of Delphi techniques for the map, summarize their findings and examine them from a methodological perspective. Methods: Twelve systematic reviews of Delphi techniques from different sectors of the health sciences were identified and systematically analyzed. Results: The 12 systematic reviews show, that Delphi studies are typically carried out in two to three rounds with a deliberately selected panel of experts. A large number of modifications to the Delphi technique have now been developed. Significant weaknesses exist in the quality of the reporting. Conclusion: Based on the results, there is a need for clarification with regard to the methodological approaches of Delphi techniques, also with respect to any modification. Criteria for evaluating the quality of their execution and reporting also appear to be necessary. However, it should be noted that we cannot make any statements about the quality of execution of the Delphi studies but rather our results are exclusively based on the reported findings of the systematic reviews.
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Affiliation(s)
- Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, University of Education Schwaebisch Gmuend, Schwäbisch Gmünd, Germany
| | - Julia Spranger
- Department of Research Methods in Health Promotion and Prevention, University of Education Schwaebisch Gmuend, Schwäbisch Gmünd, Germany
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Abstract
PURPOSE OF REVIEW Given the growing body of critical care clinical research publications, core outcome sets (COSs) are important to help mitigate heterogeneity in outcomes assessed and measurement instruments used, and have potential to reduce research waste. This article provides an update on COS projects in critical care medicine, and related resources and tools for COS developers. RECENT FINDINGS We identified 28 unique COS projects, of which 15 have published results as of May 2020. COS topics relevant to critical care medicine include mechanical ventilation, cardiology, stroke, rehabilitation, and long-term outcomes (LTOs) after critical illness. There are four COS projects for coronavirus disease 2019 (COVID-19), with a 'meta-COS' summarizing common outcomes across these projects. To help facilitate COS development, there are existing resources, standards, guidelines, and tools available from the Core Outcome Measures in Effectiveness Trials Initiative (www.comet-initiative.org/) and the National Institutes of Health-funded Improve LTO project (www.improvelto.com/). SUMMARY Many COS projects have been completed in critical care, with more on-going COS projects, including foci from across the spectrum of acute critical care, COVID-19, critical care rehabilitation, and patient recovery and LTOs. Extensive resources are accessible to help facilitate rigorous COS development.
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Veugelers R, Gaakeer MI, Patka P, Huijsman R. Improving design choices in Delphi studies in medicine: the case of an exemplary physician multi-round panel study with 100% response. BMC Med Res Methodol 2020; 20:156. [PMID: 32539717 PMCID: PMC7294633 DOI: 10.1186/s12874-020-01029-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/24/2020] [Indexed: 11/25/2022] Open
Abstract
Background A proper application of the Delphi technique is essential for obtaining valid research results. Medical researchers regularly use Delphi studies, but reports often lack detailed information on methodology and controlled feedback: in the medical literature, papers focusing on Delphi methodology issues are rare. Since the introduction of electronic surveys, details on response times remain scarce. We aim to bridge a number of gaps by providing a real world example covering methodological choices and response times in detail. Methods The objective of our e(lectronic)-Delphi study was to determine minimum standards for emergency departments (EDs) in the Netherlands. We opted for a two-part design with explicit decision rules. Part 1 focused on gathering and defining items; Part 2 addressed the main research question using an online survey tool. A two-person consensus rule was applied throughout: even after consensus on specific items was reached, panellists could reopen the discussion as long as at least two panellists argued similarly. Per round, the number of reminders sent and individual response times were noted. We also recorded the methodological considerations and evaluations made by the research team prior to as well as during the study. Results The study was performed in eight rounds and an additional confirmation round. Response rates were 100% in all rounds, resulting in 100% consensus in Part 1 and 96% consensus in Part 2. Our decision rules proved to be stable and easily applicable. Items with negative advice required more rounds before consensus was reached. Response delays were mostly due to late starts, but once panellists started, they nearly always finished the questionnaire on the same day. Reminders often yielded rapid responses. Intra-individual differences in response time were large, but quick responders remained quick. Conclusions We advise those considering Delphi study to follow the CREDES guideline, consider a two-part design, invest in personal commitment of the panellists, set clear decision rules, use a consistent lay-out and send out your reminders early. Adopting this overall approach may assist researchers in future Delphi studies and may help to improve the quality of Delphi designs in terms of improved rigor and higher response rates.
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Affiliation(s)
- Rebekka Veugelers
- Emergency Department, Adrz hospital, P.O. Box 15 4460, AA, Goes, the Netherlands.
| | - Menno I Gaakeer
- Emergency Department, Adrz hospital, P.O. Box 15 4460, AA, Goes, the Netherlands
| | - Peter Patka
- Emergency Department, Erasmus MC, P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands
| | - Robbert Huijsman
- Erasmus School of Health Policy & Management, P.O. Box 1738, 3000, DR, Rotterdam, the Netherlands
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Williamson PR, Blazeby JM, Brookes ST, Clarke M, Terwee CB, Young B. Controversy and Debate Series on Core Outcome Sets. Paper 4: Debate on Paper 1 from the perspective of COMET [Core Outcome Measures in Effectiveness Trials]. J Clin Epidemiol 2020; 125:222-224. [PMID: 32413391 DOI: 10.1016/j.jclinepi.2020.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/05/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Paula R Williamson
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK.
| | - Jane M Blazeby
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK
| | - Sara T Brookes
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK
| | - Mike Clarke
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK
| | - Caroline B Terwee
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK
| | - Bridget Young
- MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool L63 3GL, UK
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Biggane AM, Williamson PR, Ravaud P, Young B. Participating in core outcome set development via Delphi surveys: qualitative interviews provide pointers to inform guidance. BMJ Open 2019; 9:e032338. [PMID: 31727660 PMCID: PMC6887093 DOI: 10.1136/bmjopen-2019-032338] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore participants' views of Delphi surveys in core outcome set (COS) development. STUDY DESIGN AND SETTING Patients and health professionals (n=24) from seven recently concluded COS studies that had involved a Delphi survey took part in semistructured qualitative interviews (telephone and email exchange). Interviews explored participants' understanding of COS and their experiences of the Delphi survey. Analysis was thematic. RESULTS Several interviewees had previously participated in two or more COS or Delphi surveys. Those with multiple experiences of participation generally understood the purpose of COS and were satisfied with the Delphi survey. However, some interviewees who were first-time participants struggled to understand the purpose of COS and aspects of the Delphi survey, which limited their contribution and satisfaction with the study. Interviewees also differed in how they interpreted and subsequently used the written documentation provided to COS participants. Some interviewees wanted guidance regarding whose perspective to take into account when scoring outcomes and on how to use the scoring system. Interviewees reported being motivated to take part by the international and expert consensus aspects of the Delphi survey. A few interviewees reported experiencing either positive or negative emotional impacts arising from when they reviewed outcomes and stakeholder feedback. CONCLUSION This study identifies important information that should be communicated to COS Delphi study participants. It also indicates the importance of communicating about COS Delphi studies in ways that are accessible and salient to participants, to enhance their experience of participation and make the process more meaningful for all.
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Affiliation(s)
- Alice M Biggane
- Biostatistics, University of Liverpool, Liverpool, UK
- CRESS, INRA, INSERM, Université de Paris, Paris, France
| | | | - Philippe Ravaud
- CRESS, INRA, INSERM, Université de Paris, Paris, France
- Epidemiology, Columbia University, New York City, New York, USA
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris) Hôpital Hôtel Dieu, Paris, France
| | - Bridget Young
- Health Services Research, University of Liverpool, Liverpool, UK
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Wynn M, Holloway S. A clinimetric analysis of the Pressure Ulcer Risk Primary or Secondary Evaluation Tool: PURPOSE-T. ACTA ACUST UNITED AC 2019; 28:S4-S8. [PMID: 31714836 DOI: 10.12968/bjon.2019.28.20.s4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The assessment of patients' risk for developing pressure ulcers is a routine and fundamental nursing process undertaken to prevent avoidable harm to patients in all care settings. Many risk assessment tools are currently used in clinical practice, however no individual tool is recommended by advisory bodies such as the National Institute for Health and Care Excellence or the European Pressure Ulcer Advisory Panel. The evidence base on the value of structured risk assessment tools in reducing the incidence or severity of pressure ulcers is poor. This purpose of this article is to provide a clinimetric analysis of the recently developed Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) and identify areas for future research to improve the utility of structured risk assessment in identifying patients at risk of developing pressure ulcers.
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Affiliation(s)
- Matthew Wynn
- Infection Control and Tissue Viability Nurse, Manchester University NHS Foundation Trust
| | - Samantha Holloway
- Reader, Centre for Medical Education, and Programme Director, Masters in Wound Healing and Tissue Repair, School of Medicine, Cardiff University
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30
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Tugwell P, Knottnerus A. Should the fragility index be routinely reported for systematic reviews? J Clin Epidemiol 2019; 111:v-vi. [DOI: 10.1016/j.jclinepi.2019.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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De Meyer D, Kottner J, Beele H, Schmitt J, Lange T, Van Hecke A, Verhaeghe S, Beeckman D. Delphi procedure in core outcome set development: rating scale and consensus criteria determined outcome selection. J Clin Epidemiol 2019; 111:23-31. [PMID: 30922885 DOI: 10.1016/j.jclinepi.2019.03.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/04/2019] [Accepted: 03/19/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The objective of this study was to compare two different rating scales within one Delphi study for defining consensus in core outcome set development and to explore the influence of consensus criteria on the outcome selection. STUDY DESIGN AND SETTING Randomized controlled parallel group trial with 1:1 allocation within the first Delphi round of the Core Outcome Set in the Incontinence-Associated Dermatitis project. Outcomes were rated on a three-point or nine-point Likert scale. Decisions about which outcomes to retain were determined by commonly used consensus criteria (i.e., [combinations of] proportions with restricted ranges, central tendency within a specific range, and decrease in variance). RESULTS Fifty-seven participants (group 1 = 28, group 2 = 29) rated 58 outcomes. The use of the nine-point scale resulted in almost twice as many outcomes being rated as "critical" compared with the three-point scale (24 vs. 13). Stricter criteria and combining criteria led to less outcomes being identified as "critical". CONCLUSION The format of rating scales in Delphi studies for core outcome set development and the definition of the consensus criteria influence outcome selection. The use of the nine-point scale might be recommended to inform the consensus process for a subsequent rating or face-to-face meeting. The three-point scale might be preferred when determining final consensus.
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Affiliation(s)
- Dorien De Meyer
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Jan Kottner
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin, Berlin, Germany
| | - Hilde Beele
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus TU Dresden, Dresden, Germany
| | - Toni Lange
- Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus TU Dresden, Dresden, Germany
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department Health Care, VIVES University College, Roeselare, Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Faculty of Medicine & Health Sciences, School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; School of Health Sciences, Örebro University, Örebro, Sweden.
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Humphrey-Murto S, Crew R, Shea B, Bartlett SJ, March L, Tugwell P, Maxwell LJ, Beaton D, Grosskleg S, de Wit M. Consensus Building in OMERACT: Recommendations for Use of the Delphi for Core Outcome Set Development. J Rheumatol 2019; 46:1041-1046. [DOI: 10.3899/jrheum.181094] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2018] [Indexed: 11/22/2022]
Abstract
Objective.Developing international consensus on outcome measures for clinical trials is challenging. The following paper will review consensus building in Outcome Measures in Rheumatology (OMERACT), with a focus on the Delphi.Methods.Based on the literature and feedback from delegates at OMERACT 2018, a set of recommendations is provided in the form of the OMERACT Delphi Consensus Checklist.Results.The OMERACT delegates generally supported the use of the checklist as a guide. The checklist provides guidance for clearly outlining the multiple aspects of the Delphi process.Conclusion.OMERACT is deeply committed to consensus building and these recommendations should be considered a work in progress.
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Gargon E, Crew R, Burnside G, Williamson PR. Higher number of items associated with significantly lower response rates in COS Delphi surveys. J Clin Epidemiol 2018; 108:110-120. [PMID: 30557677 PMCID: PMC6438267 DOI: 10.1016/j.jclinepi.2018.12.010] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The Delphi method is commonly used to achieve consensus in core outcome set (COS) development. It is important to try to maximize response rates to Delphi studies and minimize attrition rates and potential for bias. The factors that impact response rates in a Delphi study used for COS development are unknown. The objective of this study was to explore the impact of design characteristics on response rates in Delphi surveys within COS development. METHODS Published and ongoing studies that included Delphi to develop a COS were eligible. Second round voting response rates were analyzed, and multilevel linear regression was conducted to investigate whether design characteristics were associated with the response rate. RESULTS Thirty-one studies were included. Two characteristics were significantly associated with a lower response rate: larger panels and studies with more items included. CONCLUSION COS developers should pay attention to methods when designing a COS development study; in particular, the size of the panels and the size of the list of outcomes. We identified other potential design characteristics that might influence response rates but were unable to explore them in this analysis. These should be reported in future reports to allow for further investigation.
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Affiliation(s)
- Elizabeth Gargon
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK.
| | - Richard Crew
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Girvan Burnside
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
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Humphrey-Murto S, de Wit M. The Delphi method-more research please. J Clin Epidemiol 2018; 106:136-139. [PMID: 30352274 DOI: 10.1016/j.jclinepi.2018.10.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/24/2018] [Accepted: 10/14/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Susan Humphrey-Murto
- Department of Medicine and Innovation in Medical Education, University of Ottawa, The Ottawa Hospital-Riverside Campus, 1967 Riverside Drive, Ottawa, ON K1H 7W9, Canada.
| | - Maarten de Wit
- Department of Medical Humanities, VU Medical Centre Amsterdam
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