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Sample records for delphi consensus studies

  1. Expert Consensus on Characteristics of Wisdom: A Delphi Method Study

    Science.gov (United States)

    Jeste, Dilip V.; Ardelt, Monika; Blazer, Dan; Kraemer, Helena C.; Vaillant, George; Meeks, Thomas W.

    2010-01-01

    Purpose: Wisdom has received increasing attention in empirical research in recent years, especially in gerontology and psychology, but consistent definitions of wisdom remain elusive. We sought to better characterize this concept via an expert consensus panel using a 2-phase Delphi method. Design and Methods: A survey questionnaire comprised 53…

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

    Science.gov (United States)

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

    2015-01-01

    The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger's Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss' Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts' opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency = 0

  3. An exploration of the use of simple statistics to measure consensus and stability in Delphi studies

    Directory of Open Access Journals (Sweden)

    Dixon John

    2007-11-01

    Full Text Available Abstract Background The criteria for stopping Delphi studies are often subjective. This study aimed to examine whether consensus and stability in the Delphi process can be ascertained by descriptive evaluation of trends in participants' views. Methods A three round email-based Delphi required participants (n = 12 to verify their level of agreement with 8 statements, write comments on each if they considered it necessary and rank the statements for importance. Each statement was analysed quantitatively by the percentage of agreement ratings, importance rankings and the amount of comments made for each statement, and qualitatively using thematic analysis. Importance rankings between rounds were compared by calculating Kappa values to observe trends in how the process impacts on subject's views. Results Evolution of consensus was shown by increase in agreement percentages, convergence of range with standard deviations of importance ratings, and a decrease in the number of comments made. Stability was demonstrated by a trend of increasing Kappa values. Conclusion Following the original use of Delphi in social sciences, Delphi is suggested to be an effective way to gain and measure group consensus in healthcare. However, the proposed analytical process should be followed to ensure maximum validity of results in Delphi methodology for improved evidence of consensual decision-making.

  4. Transatlantic Multispecialty Consensus on Fundamental Endovascular Skills: Results of a Delphi Consensus Study.

    Science.gov (United States)

    Maertens, H; Aggarwal, R; Macdonald, S; Vermassen, F; Van Herzeele, I

    2016-01-01

    The aim of this study was to establish a consensus on Fundamental Endovascular Skills (FES) for educational purposes and development of training curricula for endovascular procedures. The term "Fundamental Endovascular Skills" is widely used; however, the current literature does not explicitly describe what skills are included in this concept. Endovascular interventions are performed by several specialties that may have opposing perspectives on these skills. A two round Delphi questionnaire approach was used. Experts from interventional cardiology, interventional radiology, and vascular surgery from the United States and Europe were invited to participate. An electronic questionnaire was generated by endovascular therapists with an appropriate educational background but who would not participate in subsequent rounds. The questionnaire consisted of 50 statements describing knowledge, technical, and behavioral skills during endovascular procedures. Experts received the questionnaires by email. They were asked to rate the importance of each skill on a Likert scale from 1 to 5. A statement was considered fundamental when more than 90% of the experts rated it 4 or 5 out of 5. Twenty-three of 53 experts invited agreed to participate: six interventional radiologists (2 USA, 4 Europe), 10 vascular surgeons (4 USA, 6 Europe), and seven interventional cardiologists (4 USA, 3 Europe). There was a 100% response rate in the first round and 87% in the second round. Results showed excellent consensus among responders (Cronbach's alpha = .95 first round; .93 second round). Ninety percent of all proposed skills were considered fundamental. The most critical skills were determined. A transatlantic multispecialty consensus was achieved about the content of "FES" among interventional radiologists, interventional cardiologists, and vascular surgeons from Europe and the United States. These results can serve as directive principles for developing endovascular training curricula

  5. Developing consensus-based policy solutions for medicines adherence for Europe: a delphi study

    Science.gov (United States)

    2012-01-01

    Background Non-adherence to prescribed medication is a pervasive problem that can incur serious effects on patients’ health outcomes and well-being, and the availability of resources in healthcare systems. This study aimed to develop practical consensus-based policy solutions to address medicines non-adherence for Europe. Methods A four-round Delphi study was conducted. The Delphi Expert Panel comprised 50 participants from 14 countries and was representative of: patient/carers organisations; healthcare providers and professionals; commissioners and policy makers; academics; and industry representatives. Participants engaged in the study remotely, anonymously and electronically. Participants were invited to respond to open questions about the causes, consequences and solutions to medicines non-adherence. Subsequent rounds refined responses, and sought ratings of the relative importance, and operational and political feasibility of each potential solution to medicines non-adherence. Feedback of individual and group responses was provided to participants after each round. Members of the Delphi Expert Panel and members of the research group participated in a consensus meeting upon completion of the Delphi study to discuss and further refine the proposed policy solutions. Results 43 separate policy solutions to medication non-adherence were agreed by the Panel. 25 policy solutions were prioritised based on composite scores for importance, and operational and political feasibility. Prioritised policy solutions focused on interventions for patients, training for healthcare professionals, and actions to support partnership between patients and healthcare professionals. Few solutions concerned actions by governments, healthcare commissioners, or interventions at the system level. Conclusions Consensus about practical actions necessary to address non-adherence to medicines has been developed for Europe. These actions are also applicable to other regions. Prioritised

  6. A core undergraduate curriculum in plastic surgery - a Delphi consensus study in Scandinavia

    DEFF Research Database (Denmark)

    Almeland, Stian K; Lindford, Andrew; Berg, Jais Oliver

    2017-01-01

    .00 on a 1-4 Likert scale. Final agreement in the third round resulted in a list of 68 competences with agreement above 80% (31 skills and 37 knowledge items). CONCLUSIONS: This study proposes the first scientifically developed undergraduate core curriculum in plastic surgery. It comprises of a consensus......, there appears to be a need to define the core competences that are to be taught. The aim of this study was to establish a Scandinavian core undergraduate curriculum of competences in plastic surgery, using scientific methods. METHODS: The Delphi technique for group consensus was employed. An expert panel...... of anonymous questionnaires; a final core curriculum competency list was agreed upon based on a consensus agreement level of 80%. RESULTS: Two hundred and ninety-five competences were suggested in the first round. In the second round, 76 competences (33 skills and 43 knowledge items) received a score ≥3...

  7. Providing mental health first aid in the workplace: a Delphi consensus study

    OpenAIRE

    Bovopoulos, Nataly; Jorm, Anthony F.; Bond, Kathy S.; LaMontagne, Anthony D.; Reavley, Nicola J.; Kelly, Claire M.; Kitchener, Betty A.; Martin, Angela

    2016-01-01

    Background Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one?s approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace con...

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

    Science.gov (United States)

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

    2018-03-23

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

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

    DEFF Research Database (Denmark)

    Primdahl, Stine C; Todsen, Tobias; Clemmesen, Marie Louise

    2016-01-01

    a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. METHODS: We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted...... based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4...... on the Likert scale. RESULTS: Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second...

  10. Performance indicators for clinical practice management in primary care in Portugal: consensus from a Delphi study.

    Science.gov (United States)

    Basto-Pereira, Miguel; Furtado, Sara Isabel Félix; Silva, Ricardo Jorge Pereira; Fachado González, Francisco; Vara Fernandes, Tito Manuel; Correia de Sousa, Jaime; Yaphe, John

    2015-03-01

    Performance indicators assessing the quality of medical care and linked to pay for performance may cause disagreement. Portuguese indicators included in recent health care reform are controversial. To obtain consensus from opinion leaders in family medicine regarding the performance indicators for practice management used in the evaluation of Family Health Units in Portugal. Eighty-nine specialists in primary care were invited to answer the following question in an online Delphi study: 'Which performance indicators should be assessed regarding the organization and management of clinical practice in primary care in Portugal?' A Likert scale was used to evaluate validity, reliability, feasibility and sensitivity to change. Twenty-seven experts participated in the second round and achieved a high degree of consensus. Eight categories were created for analysis. The experts suggested the use of existing indicators as well as new indicators. Thirty-nine indicators suggested by the experts are currently in use in Portugal. The assessment of the number of clinical acts performed, the number of administrative acts, and evaluation of the clinical demographic profile achieved a high degree of consensus. The expert panel suggested fifty new indicators. Five categories of these new indicators had a high degree of consensus, and three categories had a low degree of consensus. The expert panel recommended that performance indicators of practice management should first assess the quantity of clinical and administrative activities undertaken. These indicators must take into account the human and financial resources available to the clinic and its demographic context.

  11. Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

    Science.gov (United States)

    Zambaldi, Mattia; Beasley, Ian; Rushton, Alison

    2017-08-01

    Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Defining the Key Competencies in Radiation Protection for Endovascular Procedures: A Multispecialty Delphi Consensus Study.

    Science.gov (United States)

    Doyen, Bart; Maurel, Blandine; Cole, Jonathan; Maertens, Heidi; Mastracci, Tara; Van Herzeele, Isabelle

    2018-02-01

    Radiation protection training courses currently focus on broad knowledge topics which may not always be relevant in daily practice. The goal of this study was to determine the key competencies in radiation protection that every endovascular team member should possess and apply routinely, through multispecialty clinical content expert consensus. Consensus was obtained through a two round modified Delphi methodology. The expert panel consisted of European vascular surgeons, interventional radiologists, and interventional cardiologists/angiologists experienced in endovascular procedures. An initial list of statements, covering knowledge skills, technical skills and attitudes was created, based on a literature search. Additional statements could be suggested by the experts in the first Delphi round. Each of the statements had to be rated on a 5- point Likert scale. A statement was considered to be a key competency when the internal consistency was greater than alpha = 0.80 and at least 80% of the experts agreed (rating 4/5) or strongly agreed (rating 5/5) with the statement. Questionnaires were emailed to panel members using the Surveymonkey service. Forty-one of 65 (63.1%) invited experts agreed to participate in the study. The response rates were 36 out of 41 (87.8%): overall 38 out of 41(92.6%) in the first round and 36 out of 38 (94.7%) in the second round. The 71 primary statements were supplemented with nine items suggested by the panel. The results showed excellent consensus among responders (Cronbach's alpha = 0.937 first round; 0.958 s round). Experts achieved a consensus that 30 of 33 knowledge skills (90.9%), 23 of 27 technical skills (82.1%), and 15 of 20 attitudes (75.0%) should be considered as key competencies. A multispecialty European endovascular expert panel reached consensus about the key competencies in radiation protection. These results may serve to create practical and relevant radiation protection training courses in the future, enhancing

  13. Optimising perioperative care for hip and knee arthroplasty in South Africa: a Delphi consensus study.

    Science.gov (United States)

    Plenge, U; Nortje, M B; Marais, L C; Jordaan, J D; Parker, R; van der Westhuizen, N; van der Merwe, J F; Marais, J; September, W V; Davies, G L; Pretorius, T; Solomon, C; Ryan, P; Torborg, A M; Farina, Z; Smit, R; Cairns, C; Shanahan, H; Sombili, S; Mazibuko, A; Hobbs, H R; Porrill, O S; Timothy, N E; Siebritz, R E; van der Westhuizen, C; Troskie, A J; Blake, C A; Gray, L A; Munting, T W; Steinhaus, H K S; Rowe, P; van der Walt, J G; Isaacs Noordien, R; Theron, A; Biccard, B M

    2018-05-09

    A structured approach to perioperative patient management based on an enhanced recovery pathway protocol facilitates early recovery and reduces morbidity in high income countries. However, in low- and middle-income countries (LMICs), the feasibility of implementing enhanced recovery pathways and its influence on patient outcomes is scarcely investigated. To inform similar practice in LMICs for total hip and knee arthroplasty, it is necessary to identify potential factors for inclusion in such a programme, appropriate for LMICs. Applying a Delphi method, 33 stakeholders (13 arthroplasty surgeons, 12 anaesthetists and 8 physiotherapists) from 10 state hospitals representing 4 South African provinces identified and prioritised i) risk factors associated with poor outcomes, ii) perioperative interventions to improve outcomes and iii) patient and clinical outcomes necessary to benchmark practice for patients scheduled for primary elective unilateral total hip and knee arthroplasty. Thirty of the thirty-three stakeholders completed the 3 months Delphi study. The first round yielded i) 36 suggestions to preoperative risk factors, ii) 14 (preoperative), 18 (intraoperative) and 23 (postoperative) suggestions to best practices for perioperative interventions to improve outcomes and iii) 25 suggestions to important postsurgical outcomes. These items were prioritised by the group in the consecutive rounds and consensus was reached for the top ten priorities for each category. The consensus derived risk factors, perioperative interventions and important outcomes will inform the development of a structured, perioperative multidisciplinary enhanced patient care protocol for total hip and knee arthroplasty. It is anticipated that this study will provide the construct necessary for developing pragmatic enhanced care pathways aimed at improving patient outcomes after arthroplasty in LMICs.

  14. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan

    Science.gov (United States)

    2011-01-01

    Background This study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal. Methods The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. Results The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article. Conclusions There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training. PMID:21592409

  15. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in India

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2010-02-01

    Full Text Available Abstract Background This study aimed to develop guidelines for how a member of the Indian public should provide mental health first aid to a person who is suicidal. Methods The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of Indian mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. Experts were recruited by SC, EC and HM. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms.. Responses to the open-ended questions were used to generate new items. Results The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 30 new items were written based on suggestions from panel members and, of these 168 items, 71 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. Translated versions of the guidelines will be produced and used for training. Conclusions There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.

  16. Suicide first aid guidelines for Sri Lanka: a Delphi consensus study.

    Science.gov (United States)

    De Silva, Saranga A; Colucci, Erminia; Mendis, Jayan; Kelly, Claire M; Jorm, Anthony F; Minas, Harry

    2016-01-01

    Sri Lanka has one of the highest suicide rates in the world. Gatekeeper programs aimed at specific target groups could be a promising suicide prevention strategy in the country. The aim of this study was to develop guidelines that help members of the public to provide first aid to persons in Sri Lanka who are at risk of suicide. The Delphi method was used to elicit consensus on potential helping statements to include in the guidelines. These statements describe information members of the public should have and actions they can take to help a person who is experiencing suicidal thoughts. An expert panel, comprised of mental health and suicide experts in Sri Lanka, rated each statement. The panellists were encouraged to suggest any additional action that was not included in the original questionnaire and, in particular, to include items that were culturally appropriate or gender specific. Responses to open-ended questions were used to generate new items. These items were included in the subsequent Delphi rounds. Three Delphi rounds were carried out. Statements were accepted for inclusion in the guidelines if they were endorsed (rated as essential or important) by at least 80 % of the panel. Statements endorsed by 70-79 % of the panel were re-rated in the following round. Statements with less than 70 % endorsement, or re-rated items that did not receive 80 % or higher endorsement were rejected. The output from the Delphi process was a set of endorsed statements. In the first round questionnaire 473 statements were presented to the panel and 58 new items were generated from responses to the open-ended questions. Of the total 531 statements presented, 304 were endorsed. These statements were used to develop the suicide first aid guidelines for Sri Lanka. By engaging Sri Lankans who are experts in the field of mental health or suicide this research developed culturally appropriate guidelines for providing mental health first aid to a person at risk of suicide in Sri

  17. Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management.

    Science.gov (United States)

    Rickard, Annette C; Vassallo, James; Nutbeam, Tim; Lyttle, Mark D; Maconochie, Ian K; Enki, Doyo G; Smith, Jason E

    2018-04-28

    Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA. Participants were invited from paediatric and adult emergency medicine, paediatric anaesthetics, paediatric ICU and paediatric surgery, as well as Paediatric Major Trauma Centre leads and representatives from the Resuscitation Council UK. Statements were informed by literature reviews and were based on elements of APLS resuscitation algorithms as well as some concepts used in the management of adult TCA; they ranged from confirmation of cardiac arrest to the indications for thoracotomy. 73 experts completed all three rounds between June and November 2016. Consensus was reached on 14 statements regarding the diagnosis and management of paediatric TCA; oxygenation and ventilatory support, along with rapid volume replacement with warmed blood, improve survival. The duration of cardiac arrest and the lack of a response to intervention, along with cardiac standstill on ultrasound, help to guide the decision to terminate resuscitation. This study has given a consensus-based framework to guide protocol development in the management of paediatric TCA, though further work is required in other key areas including its acceptability to clinicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study

    Science.gov (United States)

    Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

    2018-01-01

    Background The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. Objective We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. Methods We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. Results In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. Conclusions This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. PMID:29699970

  19. Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study.

    Science.gov (United States)

    de Leeuw, Robert Adrianus; Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

    2018-04-26

    The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. ©Robert Adrianus de Leeuw, Kieran Walsh, Michiel Westerman, Fedde Scheele. Originally published in JMIR Medical Education (http://mededu.jmir.org), 26.04.2018.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    D V M Bishop

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

  2. Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study.

    Science.gov (United States)

    Turner, Sandra; Seel, Matthew; Trotter, Theresa; Giuliani, Meredith; Benstead, Kim; Eriksen, Jesper G; Poortmans, Philip; Verfaillie, Christine; Westerveld, Henrike; Cross, Shamira; Chan, Ming-Ka; Shaw, Timothy

    2017-05-01

    The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al., 2012). The objective of this study was to define a globally applicable competency set specific to radiation oncology for the CanMEDS Leader Role (Frank et al., 2015). A modified Delphi consensus process delivering two rounds of on-line surveys was used. Participants included trainees, radiation/clinical oncologists and other RO team members (radiation therapists, physicists, and nurses), professional educators and patients. 72 of 95 (76%) invitees from nine countries completed the Round 1 (R1) survey. Of the 72 respondents to RI, 70 completed Round 2 (R2) (97%). In R1, 35 items were deemed for 'inclusion' and 21 for 'exclusion', leaving 41 'undetermined'. After review of items, informed by participant comments, 14 competencies from the 'inclusion' group went into the final curriculum; 12 from the 'undetermined' group went to R2. In R2, 6 items reached consensus for inclusion. This process resulted in 20 RO Leader Role competencies with apparent global applicability. This is the first step towards developing learning, teaching and assessment tools for this important area of training. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The Delphi Technique: Making Sense of Consensus

    Directory of Open Access Journals (Sweden)

    Chia-Chien Hsu

    2007-08-01

    Full Text Available The Delphi technique is a widely used and accepted method for gathering data from respondents within their domain of expertise. The technique is designed as a group communication process which aims to achieve a convergence of opinion on a specific real-world issue. The Delphi process has been used in various fields of study such as program planning, needs assessment, policy determination, and resource utilization to develop a full range of alternatives, explore or expose underlying assumptions, as well as correlate judgments on a topic spanning a wide range of disciplines. The Delphi technique is well suited as a method for consensus-building by using a series of questionnaires delivered using multiple iterations to collect data from a panel of selected subjects. Subject selection, time frames for conducting and completing a study, the possibility of low response rates, and unintentionally guiding feedback from the respondent group are areas which should be considered when designing and implementing a Delphi study.

  4. Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists.

    Science.gov (United States)

    Blikkendaal, Mathijs D; Twijnstra, Andries R H; Stiggelbout, Anne M; Beerlage, Harrie P; Bemelman, Willem A; Jansen, Frank Willem

    2013-12-01

    In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a uniform definition of conversion. On the basis of definitions currently used in the literature, a web-based Delphi consensus study was conducted among members of all four Dutch endoscopic societies. The rate of agreement (RoA) was calculated; a RoA of >70% suggested consensus. The survey was completed by 268 respondents in the first Delphi round (response rate, 45.6%); 43% were general surgeons, 49% gynecologists, and 8% urologists. Average ± standard deviation laparoscopic experience was 12.5 ± 7.2 years. On the basis of the results of round 1, a consensus definition was compiled. Conversion to laparotomy is an intraoperative switch from a laparoscopic to an open abdominal approach that meets the criteria of one of the two subtypes: strategic conversion, a standard laparotomy that is made directly after the assessment of the feasibility of completing the procedure laparoscopically and because of anticipated operative difficulty or logistic considerations; and reactive conversion, the need for a laparotomy because of a complication or (extension of an incision) because of (anticipated) operative difficulty after a considerable amount of dissection (i.e., >15 min in time). A laparotomy after a diagnostic laparoscopy (i.e., to assess the curability of the disease) should not be considered a conversion. In the second Delphi round, a RoA of 90% was achieved with this definition. After two Delphi rounds, consensus on a uniform multidisciplinary definition of conversion was achieved within a representative group of general surgeons, gynecologists, and urologists. An unambiguous interpretation will result in a more reliable clinical registration of conversion and scientific

  5. Identification of pain indicators for infants at risk for neurological impairment: A Delphi consensus study

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    Camfield Carol

    2006-02-01

    Full Text Available Abstract Background A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI. The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI. Methods A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI. Results The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated. Conclusion These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a health care providers about the importance and usefulness of infant pain indicators and (b the pain responses of infants at mild, moderate and high risk for NI.

  6. ISSLS Prize Winner: Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study.

    Science.gov (United States)

    Tomkins-Lane, Christy; Melloh, Markus; Lurie, Jon; Smuck, Matt; Battié, Michele C; Freeman, Brian; Samartzis, Dino; Hu, Richard; Barz, Thomas; Stuber, Kent; Schneider, Michael; Haig, Andrew; Schizas, Constantin; Cheung, Jason Pui Yin; Mannion, Anne F; Staub, Lukas; Comer, Christine; Macedo, Luciana; Ahn, Sang-Ho; Takahashi, Kazuhisa; Sandella, Danielle

    2016-08-01

    Delphi. The aim of this study was to obtain an expert consensus on which history factors are most important in the clinical diagnosis of lumbar spinal stenosis (LSS). LSS is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians. Phase 1 (Delphi Items): 20 members of the International Taskforce on the Diagnosis and Management of LSS confirmed a list of 14 history items. An online survey was developed that permits specialists to express the logical order in which they consider the items, and the level of certainty ascertained from the questions. Phase 2 (Delphi Study) Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine. Round 2: Meeting of 9 members of Taskforce where consensus was reached on a final list of 10 items. Round 3: Final survey was distributed internationally. Phase 3: Final Taskforce consensus meeting. A total of 279 clinicians from 29 different countries, with a mean of 19 (±SD: 12) years in practice participated. The six top items were "leg or buttock pain while walking," "flex forward to relieve symptoms," "feel relief when using a shopping cart or bicycle," "motor or sensory disturbance while walking," "normal and symmetric foot pulses," "lower extremity weakness," and "low back pain." Significant change in certainty ceased after six questions at 80% (P < .05). This is the first study to reach an international consensus on the clinical diagnosis of LSS, and suggests that within six questions clinicians are 80% certain of diagnosis. We propose a consensus-based set of "seven history items" that can act as a pragmatic criterion for defining LSS in both clinical and research settings, which in the long term may lead to more cost-effective treatment, improved health care utilization, and enhanced patient outcomes. 2.

  7. [Delphi consensus on management of dyslipidaemia in patients with impaired glucose metabolism: Diana study].

    Science.gov (United States)

    Pedro-Botet, Juan; Barrios, Vivencio; Pascual, Vicente; Ascaso, Juan F; Cases, Aleix; Millán, Jesús; Serrano, Adalberto; Pintó, Xavier

    2016-01-01

    The aim of the present study was to develop a multidisciplinary consensus based on the Delphi system to establish clinical recommendations for the management of dyslipidaemia when hyperglycaemia is present, and the relevant factors that should be taken into consideration when prescribing and monitoring treatment with statins. The questionnaire developed by the scientific committee included four blocks of questions about dyslipidaemia in patients with impaired glucose metabolism. The results of the first two blocks are presented here: a) management of dyslipidaemia; b) relevant factors that should be taken into consideration when prescribing and monitoring treatment with statins. Among the 497 experts who participated in the study, an agreement of over 90% was attained for recommending screening for dyslipidaemia in patients with diabetes or pre-diabetes and/or cardiovascular disease or a family history and/or abdominal obesity and/or hypertension. There was a high degree of agreement that a statin is the lipid-lowering treatment of choice, and that it should be switched when side effects develop. Also, the choice of statin and dose should be made according to baseline LDL cholesterol levels, the target to achieve, and the possible drug-drug interactions. The screening of dyslipidaemia is primarily conducted in patients with cardiovascular disease, or any major cardiovascular risk factor. When prescribing a statin, physicians mainly focus on the ability to reduce LDL cholesterol and the risk of drug interactions. Copyright © 2016 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  8. Providing mental health first aid in the workplace: a Delphi consensus study.

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    Bovopoulos, Nataly; Jorm, Anthony F; Bond, Kathy S; LaMontagne, Anthony D; Reavley, Nicola J; Kelly, Claire M; Kitchener, Betty A; Martin, Angela

    2016-08-02

    Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.

  9. Construction of Nutrition Literacy Indicators for College Students in Taiwan: A Delphi Consensus Study.

    Science.gov (United States)

    Liao, Li-Ling; Lai, I-Ju

    2017-10-01

    To use the Delphi process to select nutrition literacy (NL) indicators for Taiwan college students. Initial formulation of 8 principal indicators and 77 subindicators, followed by a 2-round Delphi survey and final selection of indicators. A total of 28 nutrition experts selected through snowball sampling; 100% response rate. An expert panel scored and ranked NL themes and indicators for relevance, representativeness, and importance. Quantitative analysis. For principal indicators, the defined cutoff was mean (relevance and representativeness) > 4 and SD 20 experts ranked the nutrition theme's importance in the top 50% of the 12 themes; (2) mean (relevance and representativeness) > 4 and SD 20 experts ranked the indicator's importance in the top 50% of all indicators within a domain. Consensus was reached on 8 principal indicators and 28 subindicators in 8 themes, including 10 in understand, 8 in analyze, 5 in appraise, and 5 in apply. An initial set of NL indicators was developed for Taiwan college students, serving as a basis to develop Taiwan College's Nutrition Literacy Scale and providing information on nutrition education. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  10. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions : A Delphi study

    NARCIS (Netherlands)

    Peters, S. E.; Johnston, V.; Ross, M.; Coppieters, M. W.

    2017-01-01

    This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts (n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (3/485% agreement) was achieved for

  11. Using the Delphi expert consensus method in mental health research.

    Science.gov (United States)

    Jorm, Anthony F

    2015-10-01

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

  12. Consensus on measurement properties and feasibility of performance tests for the exercise and sport sciences: a Delphi study.

    Science.gov (United States)

    Robertson, Sam; Kremer, Peter; Aisbett, Brad; Tran, Jacqueline; Cerin, Ester

    2017-12-01

    Performance tests are used for multiple purposes in exercise and sport science. Ensuring that a test displays an appropriate level of measurement properties for use within a population is important to ensure confidence in test findings. The aim of this study was to obtain subject matter expert consensus on the measurement and feasibility properties that should be considered for performance tests used in the exercise and sport sciences and how these should be defined. This information was used to develop a checklist for broader dissemination. A two-round Delphi study was undertaken including 33 exercise scientists, academics and sport scientists. Participants were asked to rate the importance of a range of measurement properties relevant to performance tests in exercise and sport science. Responses were obtained in binary and Likert-scale formats, with consensus defined as achieving 67% agreement on each question. Consensus was reached on definitions and terminology for all items. Ten level 1 items (those that achieved consensus on all four questions) and nine level 2 items (those achieving consensus on ≥2 questions) were included. Both levels were included in the final checklist. The checklist developed from this study can be used to inform decision-making and test selection for practitioners and researchers in the exercise and sport sciences. This can facilitate knowledge sharing and performance comparisons across sub-disciplines, thereby improving existing field practice and research methodological quality.

  13. Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study

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    Maria-Rosario Luquin

    2017-01-01

    Full Text Available To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD. To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study. An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of “definitive,” “probable,” and “possible” APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.

  14. Which information on women's issues in epilepsy does a community pharmacist need to know? A Delphi consensus study.

    Science.gov (United States)

    Shawahna, Ramzi

    2017-12-01

    The aim of this study was to develop and achieve consensus on a core list of important knowledge items that community pharmacists should know on women's issues in epilepsy. This was a consensual study using a modified Delphi technique. Knowledge items were collected from the literature and from nine key contacts who were interviewed on their views on what information community pharmacists should have on women's issues in epilepsy. More knowledge items were suggested by five researchers with interest in women's issues who were contacted to rate and comment on the knowledge items collected. Two iterative Delphi rounds were conducted among a panel of pharmacists (n=30) to achieve consensus on the knowledge items to be included in the core list. Ten panelists ranked the knowledge items by their importance using the Analytical Hierarchy Process (AHP). Consensus was achieved to include 68 knowledge under 13 categories in the final core list. Items ranked by their importance were related to the following: teratogenicity (10.3%), effect of pregnancy on epilepsy (7.4%), preconception counseling (10.3%), bone health (5.9%), catamenial epilepsy (7.4%), menopause and hormonal replacement therapy (2.9%), contraception (14.7%), menstrual disorders and infertility (8.8%), eclampsia (2.9%), breastfeeding (4.4%), folic acid and vitamin K (5.9%), counseling on general issues (14.7%), and sexuality (4.4%). Using consensual knowledge lists might promote congruence in educating and/or training community pharmacists on women's issues in epilepsy. Future studies are needed to investigate if such lists can improve health services provided to women with epilepsy (WWE). Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Measuring organisational readiness for patient engagement (MORE): an international online Delphi consensus study.

    Science.gov (United States)

    Oostendorp, Linda J M; Durand, Marie-Anne; Lloyd, Amy; Elwyn, Glyn

    2015-02-14

    Widespread implementation of patient engagement by organisations and clinical teams is not a reality yet. The aim of this study is to develop a measure of organisational readiness for patient engagement designed to monitor and facilitate a healthcare organisation's willingness and ability to effectively implement patient engagement in healthcare. The development of the MORE (Measuring Organisational Readiness for patient Engagement) scale was guided by Weiner's theory of organisational readiness for change. Weiner postulates that an organisation's readiness is determined by both the willingness and ability to implement the change (i.e. in this context: patient engagement). A first version of the scale was developed based on a literature search and evaluation of pre-existing tools. We invited multi-disciplinary stakeholders to participate in a two-round online Delphi survey. Respondents were asked to rate the importance of each proposed item, and to comment on the proposed domains and items. Second round participants received feedback from the first round and were asked to re-rate the importance of the revised, new and unchanged items, and to provide comments. The first version of the scale contained 51 items divided into three domains: (1) Respondents' characteristics; (2) the organisation's willingness to implement patient engagement; and (3) the organisation's ability to implement patient engagement. 131 respondents from 16 countries (health care managers, policy makers, clinicians, patients and patient representatives, researchers, and other stakeholders) completed the first survey, and 72 of them also completed the second survey. During the Delphi process, 34 items were reworded, 8 new items were added, 5 items were removed, and 18 were combined. The scale's instructions were revised. The final version of MORE totalled 38 items; 5 on stakeholders, 13 on an organisation's willingness to implement, and 20 on an organisation's ability to implement patient

  16. Consensus strategies for the nonoperative management of patients with blunt splenic injury: A Delphi study

    NARCIS (Netherlands)

    Olthof, Dominique C.; van der Vlies, Cornelius H.; Joosse, Pieter; van Delden, Otto M.; Jurkovich, Gregory J.; Goslings, J. C.; Angle, J. F.; Chakraverty, S.; Coimbra, R.; Demetriades, D.; Denys, A.; Duchesne, J. C.; Fabian, T. C.; Feliciano, D. V.; Fingerhut, A.; Gaarder, C.; Haan, J. M.; Hanks, S. E.; Hauser, C. J.; Heuer, M.; Hoffer, E. K.; Hoyt, D. B.; Ivatury, R. R.; Jurkovich, G. J.; Leenen, L. P.; Leppaniemi, A.; Maegele, M.; Michel, L. A.; Moore, E. E.; Peitzman, A. B.; Reekers, J. A.; Scalea, T. M.; Velmahos, G. C.; de Waele, J. J.; Wisner, D. H.

    2013-01-01

    BACKGROUND: Nonoperative management is the standard of care in hemodynamically stable patients with blunt splenic injury. However, a number of issues regarding the management of these patients are still unresolved. The aim of this study was to reach consensus among experts concerning optimal

  17. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines.

    Science.gov (United States)

    Colucci, Erminia; Kelly, Claire M; Minas, Harry; Jorm, Anthony F; Nadera, Dinah

    2010-12-20

    This study aimed to develop guidelines for how a member of the Filipino public should provide mental health first aid to a person who is suicidal. The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 34 Filipino mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 48 new items were written based on suggestions from panel members and, of these 186 items, 102 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. The guidelines are currently being translated into local languages. There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.

  18. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2010-12-01

    Full Text Available Abstract Background This study aimed to develop guidelines for how a member of the Filipino public should provide mental health first aid to a person who is suicidal. Methods The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 34 Filipino mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms. Responses to these open-ended questions were used to generate new items. Results The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 48 new items were written based on suggestions from panel members and, of these 186 items, 102 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. The guidelines are currently being translated into local languages. Conclusions There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.

  19. Expert consensus statement to guide the evidence-based classification of Paralympic athletes with vision impairment: a Delphi study.

    Science.gov (United States)

    Ravensbergen, H J C Rianne; Mann, D L; Kamper, S J

    2016-04-01

    Paralympic sports are required to develop evidence-based systems that allocate athletes into 'classes' on the basis of the impact of their impairment on sport performance. However, sports for athletes with vision impairment (VI) classify athletes solely based on the WHO criteria for low vision and blindness. One key barrier to evidence-based classification is the absence of guidance on how to address classification issues unique to VI sport. The aim of this study was to reach expert consensus on how issues specific to VI sport should be addressed in evidence-based classification. A four-round Delphi study was conducted with 25 participants who had expertise as a coach, athlete, classifier and/or administrator in Paralympic sport for VI athletes. The experts agreed that the current method of classification does not fulfil the requirements of Paralympic classification, and that the system should be different for each sport to account for the sports' unique visual demands. Instead of relying only on tests of visual acuity and visual field, the panel agreed that additional tests are required to better account for the impact of impairment on sport performance. There was strong agreement that all athletes should not be required to wear a blindfold as a means of equalising the impairment during competition. There is strong support within the Paralympic movement to change the way that VI athletes are classified. This consensus statement provides clear guidance on how the most important issues specific to VI should be addressed, removing key barriers to the development of evidence-based classification. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. A case study on use of modified delphi technique for developing consensus on designing contents of a module for imparting sex education to adolescents in schools, in India

    Directory of Open Access Journals (Sweden)

    Deepak B. Saxena

    2012-06-01

    Full Text Available In the year 2007, eleven (11 of India’s 29 states suspended the federal initiative, ‘Adolescence Education Program’, under the name of School AIDS awareness education program (SAEP designed for 15- to 17-year-olds in all staterun schools and devised by the Ministry of Human Resource Development (HRD and National AIDS Control Organization (NACO on grounds that the flip charts used for training teachers contained explicit images of male and female reproductive systems, conception, and contraception. The aim of the present study is to understand usefulness of Delphi technique as a tool to develop contents and make consensus over a suitable module that can be utilized for imparting Sex Education to the Adolescents in school. The study present below used Delphi technique in transaction of the module recommended by National Council of Education Research and Training (NCERT for imparting Sex education under SAEP. Although the technique was successful in building consensus amongst different stake holders, within the limitations of Delphi like potential drop outs, loss to follow up and lack of clear verbal labels. It is concluded from the results of present study that Delphi technique, when rigorously administered, analyzed and reported, is a valuable method to help policy planners in developing the process for a suitable module that can be utilized for imparting sex education to adolescents in school.

  1. A case study on use of modified delphi technique for developing consensus on designing contents of a module for imparting sex education to adolescents in schools, in India

    Directory of Open Access Journals (Sweden)

    Deepak B. Saxena

    2012-01-01

    Full Text Available In the year 2007, eleven (11 of India’s 29 states suspended the federal initiative, ‘Adolescence Education Program’, under the name of School AIDS awareness education program (SAEP designed for 15- to 17-year-olds in all state- run schools and devised by the Ministry of Human Resource Development (HRD and National AIDS Control Organization (NACO on grounds that the flip charts used for training teachers contained explicit images of male and female reproductive systems, conception, and contraception. The aim of the present study is to understand usefulness of Delphi technique as a tool to develop contents and make consensus over a suitable module that can be utilized for imparting Sex Education to the Adolescents in school. The study present below used Delphi technique in transaction of the module recommended by National Council of Education Research and Training (NCERT for imparting Sex education under SAEP. Although the technique was successful in building consensus amongst different stake holders, within the limitations of Delphi like potential drop outs, loss to follow up and lack of clear verbal labels. It is concluded from the results of present study that Delphi technique, when rigorously administered, analyzed and reported, is a valuable method to help policy planners in developing the process for a suitable module that can be utilized for imparting sex education to adolescents in school

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Helping someone with problem drug use: a delphi consensus study of consumers, carers, and clinicians

    Directory of Open Access Journals (Sweden)

    Kelly Claire M

    2011-01-01

    Full Text Available Abstract Background Problem use of illicit drugs (i.e. drug abuse or dependence is associated with considerable health and social harms, highlighting the need for early intervention and engagement with health services. Family members, friends and colleagues play an important role in supporting and assisting individuals with problem drug use to seek professional help, however there are conflicting views about how and when such support should be offered. This paper reports on the development of mental health first aid guidelines for problem drug use in adults, to help inform community members on how to assist someone developing problem drug use or experiencing a drug-related crisis. Methods A systematic review of the scientific and lay literature was conducted to develop a 228-item survey containing potential first-aid strategies to help someone developing a drug problem or experiencing a drug-related crisis. Three panels of experts (29 consumers, 31 carers and 27 clinicians were recruited from Australia, Canada, New Zealand, the United Kingdom, and the United States. Panel members independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results The overall response rate across three rounds was 80% (86% consumers, 81% carers, 74% clinicians. 140 first aid strategies were endorsed as essential or important by 80% or more of panel members. The endorsed strategies provide information and advice on what is problem drug use and its consequences, how to approach a person about their problem drug use, tips for effective communication, what to do if the person is unwilling to change their drug use, what to do if the person does (or does not want professional help, what are drug-affected states and how to deal with them, how to deal with adverse reactions leading to a medical emergency, and what to do if the person is aggressive. Conclusions The guidelines provide a consensus

  4. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    Science.gov (United States)

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  5. What should be included in the assessment of laypersons' paediatric basic life support skills? Results from a Delphi consensus study.

    Science.gov (United States)

    Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim; Bohnstedt, Cathrine; Sønderskov, Claus; Østergaard, Doris; Tolsgaard, Martin Grønnebæk

    2018-01-18

    Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts completed a re-rating. Items with a score above 3 by more than 80% of the experts in the third round were included in an assessment instrument. In the first round, 19 and 15 items were identified to assess PBLS and FBAOM skills, respectively. The ratings and comments from the last two rounds resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify different stages of foreign body airway obstruction", "Identify consciousness", "Call for help", "Back blows", "Chest thrusts/abdominal thrusts according to age", "Identify loss of consciousness and change to CPR", "Assessment of breathing" and "Ventilation". For assessment of laypersons some PBLS and FBAOM skills described in guidelines are more important than others. Four out of nine of PBLS skills focus on airway and breathing skills, supporting the major importance of these skills for

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

    Science.gov (United States)

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

    2017-01-28

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

  7. Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems

    Directory of Open Access Journals (Sweden)

    Kelly Claire M

    2009-08-01

    Full Text Available Abstract Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations. The methodology and the guidelines themselves were found to be useful

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

    Science.gov (United States)

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

    2011-01-01

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

  9. Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists

    NARCIS (Netherlands)

    Blikkendaal, Mathijs D.; Twijnstra, Andries R. H.; Stiggelbout, Anne M.; Beerlage, Harrie P.; Bemelman, Willem A.; Jansen, Frank Willem

    2013-01-01

    In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a

  10. Development of a decision aid for the treatment of benign prostatic hyperplasia : A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M.; Bosch, J. L H Ruud; Kil, Paul J M

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  11. Which benefits and harms of preoperative radiotherapy should be addressed? A Delphi consensus study among rectal cancer patients and radiation oncologists

    International Nuclear Information System (INIS)

    Kunneman, Marleen; Pieterse, Arwen H.; Stiggelbout, Anne M.; Marijnen, Corrie A.M.

    2015-01-01

    Background and purpose: We previously found considerable variation in information provision on preoperative radiotherapy (PRT) in rectal cancer. Our aims were to reach consensus among patients and oncologists on which benefits/harms of PRT should be addressed during the consultation, and to assess congruence with daily clinical practice. Materials and methods: A four-round Delphi-study was conducted with two expert panels: (1) 31 treated rectal cancer patients and (2) 35 radiation oncologists. Thirty-seven possible benefits/harms were shown. Participants indicated whether addressing the benefit/harm was (1) essential, (2) desired, (3) not necessary, or (4) to be avoided. Consensus was assumed when ⩾80% of the panel agreed. Results were compared to 81 audio-taped consultations. Results: The panels reached consensus that six topics should be addressed in all patients (local control, survival, long term altered defecation pattern and faecal incontinence, perineal wound healing problems, advice to avoid pregnancy), three in male patients (erectile dysfunction, ejaculation disorder, infertility), and four in female patients (vaginal dryness, pain during intercourse, menopause, infertility). On average, less than half of these topics were addressed in daily clinical practice. Conclusions: This study showed substantial overlap between benefits/harms that patients and oncologists consider important to address during the consultation, and at the same time poor congruence with daily clinical practice

  12. Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study.

    Science.gov (United States)

    Morar, Pritesh S; Hollingshead, James; Bemelman, Willem; Sevdalis, Nick; Pinkney, Thomas; Wilson, Graeme; Dunlop, Malcolm; Davies, R Justin; Guy, Richard; Fearnhead, Nicola; Brown, Steven; Warusavitarne, Janindra; Edwards, Cathryn; Faiz, Omar

    2017-10-27

    Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion. A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  13. Expert surgical consensus for prenatal counseling using the Delphi method.

    Science.gov (United States)

    Berman, Loren; Jackson, Jordan; Miller, Kristen; Kowalski, Rebecca; Kolm, Paul; Luks, Francois I

    2017-11-28

    Pediatric surgeons frequently offer prenatal consultation for congenital pulmonary airway malformation (CPAM) and congenital diaphragmatic hernia (CDH); however, there is no evidence-based consensus to guide prenatal decision making and counseling for these conditions. Eliciting feedback from experts is integral to defining best practice regarding prenatal counseling and intervention. A Delphi consensus process was undertaken using a panel of pediatric surgeons identified as experts in fetal therapy to address current limitations. Areas of discrepancy in the literature on CPAM and CDH were identified and used to generate a list of content and intervention questions. Experts were invited to participate in an online Delphi survey. Items that did not reach first-round consensus were broken down into additional questions, and consensus was achieved in the second round. Fifty-four surgeons (69%) responded to at least one of the two survey rounds. During round one, consensus was reached on 54 of 89 survey questions (61%), and 45 new questions were developed. During round two, consensus was reached on 53 of 60 survey questions (88%). We determined expert consensus to establish guidelines regarding perinatal management of CPAM and CDH. Our results can help educate pediatric surgeons participating in perinatal care of these patients. V. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

    Science.gov (United States)

    Peters, S E; Johnston, V; Ross, M; Coppieters, M W

    2017-02-01

    This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

  15. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study.

    Science.gov (United States)

    Duncan, Edward A S; Colver, Keith; Dougall, Nadine; Swingler, Kevin; Stephenson, John; Abhyankar, Purva

    2014-02-22

    Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item's importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. This study is the first to produce an expert consensus on the items and quantities of clinical equipment

  16. Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds® Consensus Exercises

    DEFF Research Database (Denmark)

    de Lautour, Hugh; Taylor, William J; Adebajo, Ade

    2016-01-01

    OBJECTIVES: The aim of this study was to establish consensus for potential remission criteria for use in clinical trials of gout. METHODS: Experts (n=88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were...... months (51%) and one year (49%). In the discrete choice experiment, there was a preference towards 12 months as a timeframe for remission. CONCLUSION: These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises...

  17. Paratonia: a Delphi procedure for consensus definition.

    NARCIS (Netherlands)

    Hobbelen, J.S.; Koopmans, R.T.C.M.; Verhey, F.R.J.; Peppen, R.P. van; Bie, R.A. de

    2006-01-01

    BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a

  18. Paratonia : a Delphi procedure for consensus definition

    NARCIS (Netherlands)

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

    2006-01-01

    BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a

  19. Exploring areas of consensus and conflict around values underpinning public involvement in health and social care research: a modified Delphi study

    Science.gov (United States)

    Snape, D; Kirkham, J; Preston, J; Popay, J; Britten, N; Collins, M; Froggatt, K; Gibson, A; Lobban, F; Wyatt, K; Jacoby, A

    2014-01-01

    Objective There is growing interest in the potential benefits of public involvement (PI) in health and social care research. However, there has been little examination of values underpinning PI or how these values might differ for different groups with an interest in PI in the research process. We aimed to explore areas of consensus and conflict around normative, substantive and process-related values underpinning PI. Design Mixed method, three-phase, modified Delphi study, conducted as part of a larger multiphase project. Setting The UK health and social care research community. Participants Stakeholders in PI in research, defined as: clinical and non-clinical academics, members of the public, research managers, commissioners and funders; identified via research networks, online searches and a literature review. Results We identified high levels of consensus for many normative, substantive and process-related issues. However, there were also areas of conflict in relation to issues of bias and representativeness, and around whether the purpose of PI in health and social care research is to bring about service change or generate new knowledge. There were large differences by group in the percentages endorsing the ethical justification for PI and the argument that PI equalises power imbalances. With regard to practical implementation of PI, research support infrastructures were reported as lacking. Participants reported shortcomings in the uptake and practice of PI. Embedding PI practice and evaluation in research study designs was seen as fundamental to strengthening the evidence base. Conclusions Our findings highlight the extent to which PI is already embedded in research. However, they also highlight a need for ‘best practice’ standards to assist research teams to understand, implement and evaluate PI. These findings have been used in developing a Public Involvement Impact Assessment Framework (PiiAF), which offers guidance to researchers and members of the

  20. Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers

    Directory of Open Access Journals (Sweden)

    Nicola J. Reavley

    2013-02-01

    Full Text Available Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students’ academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts.Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines.Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals. 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation.Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to

  1. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study.

    Science.gov (United States)

    Luedtke, K; Boissonnault, W; Caspersen, N; Castien, R; Chaibi, A; Falla, D; Fernández-de-Las-Peñas, C; Hall, T; Hirsvang, J R; Horre, T; Hurley, D; Jull, G; Krøll, L S; Madsen, B K; Mallwitz, J; Miller, C; Schäfer, B; Schöttker-Königer, T; Starke, W; von Piekartz, H; Watson, D; Westerhuis, P; May, A

    2016-06-01

    A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Career and Technical Education at a Crossroads: A Delphi Study

    Science.gov (United States)

    Cutright, Michael W.

    2011-01-01

    Career and technical education in the United States has reached a critical juncture. A three round Delphi method was used to determine a consensus on the future events of career and technical education to better inform educational decision makers. Forty-one individual experts in the field were invited to serve as panelists for the Delphi study and…

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study.

    Science.gov (United States)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M; de Vries, Marieke; Bosch, J L H Ruud; Kil, Paul J M

    2016-07-01

    To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients' needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients. 1 (N=15): Dutch urologists reached consensus on 61% of the statements concerning users' criteria, decision options, structure, and medical content. 2 (N=24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients' preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N=10): Pros of the DA were clear information provision, systematic design and easy to read and re-read. A LUTS/BPH DA containing VCEs(**) was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted. This method can be adopted for the development of DAs to support other medical decision issues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chirurgia d'Urgenza e del Trauma).

    Science.gov (United States)

    Costa, Gianluca; Ruscelli, Paolo; Balducci, Genoveffa; Buccoliero, Francesco; Lorenzon, Laura; Frezza, Barbara; Chirletti, Piero; Stagnitti, Franco; Miniello, Stefano; Stella, Francesco

    2016-01-01

    Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment. A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major criteria of diagnosis including absence of flatus, presence of >3.5 cm ileal levels or >6 cm colon dilatation and abdominal distension. Panel also recommended a surgical admission, a multidisciplinary approach, and a gastrografin swallow for patients presenting occlusions. Criteria for immediate surgery included: presence of strangulated hernia, a >10 cm cecal dilatation, signs of vascular pedicles obstructions and persistence of metabolic acidosis. Moreover, rules for non-operative management (to be conducted for maximum 72 hours) included a naso-gastric drainage placement and clinical and laboratory controls each 12 hours. Non-operative treatment should be suspended if any suspects of intra-abdominal complications, high level of lactates, leukocytosis (>18.000/mm3 or Neutrophils >85%) or a doubling of creatinine level comparing admission. Conversely, consensus was not reached regarding the exact timing of CT scan and the appropriateness of colonic stenting. This consensus is in line with current international strategies and guidelines, and it could be a useful tool in the safe basic daily management of these common and peculiar diseases. Delphi study, Intestinal obstruction, Large bowel obstruction, Pseudo-obstruction, Small bowel.

  9. How to evaluate the quality of fracture reduction and fixation of the wrist and ankle in clinical practice: a Delphi consensus

    NARCIS (Netherlands)

    Beerekamp, M. S.; Haverlag, R.; Ubbink, D. T.; Luitse, J. S.; Ponsen, K. J.; Goslings, J. C.

    2011-01-01

    METHOD: A Delphi study was conducted to obtain consensus on the most important criteria for the radiological evaluation of the reduction and fixation of the wrist and ankle. The Delphi study consisted of a bipartite online questionnaire, focusing on the interpretation of radiographs and CT scans of

  10. Consensus principles for wound care research obtained using a Delphi process.

    Science.gov (United States)

    Serena, Thomas; Bates-Jensen, Barbara; Carter, Marissa J; Cordrey, Renee; Driver, Vickie; Fife, Caroline E; Haser, Paul B; Krasner, Diane; Nusgart, Marcia; Smith, Adrianne P S; Snyder, Robert J

    2012-01-01

    Too many wound care research studies are poorly designed, badly executed, and missing crucial data. The objective of this study is to create a series of principles for all stakeholders involved in clinical or comparative effectiveness research in wound healing. The Delphi approach was used to reach consensus, using a web-based survey for survey participants and face-to-face conferences for expert panel members. Expert panel (11 members) and 115 wound care researchers (respondents) drawn from 15 different organizations. Principles were rated for validity using 5-point Likert scales and comments. A 66% response rate was achieved in the first Delphi round from the 173 invited survey participants. The response rate for the second Delphi round was 46%. The most common wound care researcher profile was age 46-55 years, a wound care clinic setting, and >10 years' wound care research and clinical experience. Of the initial 17 principles created by the panel, only four principles were not endorsed in Delphi round 1 with another four not requiring revision. Of the 14 principles assessed by respondents in the second Delphi round, only one principle was not endorsed and it was revised; four other principles also needed revision based on the use of specific words or contextual use. Of the 19 final principles, three included detailed numbered lists. With the wide variation in design, conduct, and reporting of wound care research studies, it is hoped that these principles will improve the standard and practice of care in this field. © 2012 by the Wound Healing Society.

  11. Key Features of Academic Detailing: Development of an Expert Consensus Using the Delphi Method.

    Science.gov (United States)

    Yeh, James S; Van Hoof, Thomas J; Fischer, Michael A

    2016-02-01

    Academic detailing is an outreach education technique that combines the direct social marketing traditionally used by pharmaceutical representatives with unbiased content summarizing the best evidence for a given clinical issue. Academic detailing is conducted with clinicians to encourage evidence-based practice in order to improve the quality of care and patient outcomes. The adoption of academic detailing has increased substantially since the original studies in the 1980s. However, the lack of standard agreement on its implementation makes the evaluation of academic detailing outcomes challenging. To identify consensus on the key elements of academic detailing among a group of experts with varying experiences in academic detailing. This study is based on an online survey of 20 experts with experience in academic detailing. We used the Delphi process, an iterative and systematic method of developing consensus within a group. We conducted 3 rounds of online surveys, which addressed 72 individual items derived from a previous literature review of 5 features of academic detailing, including (1) content, (2) communication process, (3) clinicians targeted, (4) change agents delivering intervention, and (5) context for intervention. Nonrespondents were removed from later rounds of the surveys. For most questions, a 4-point ordinal scale was used for responses. We defined consensus agreement as 70% of respondents for a single rating category or 80% for dichotomized ratings. The overall survey response rate was 95% (54 of 57 surveys) and nearly 92% consensus agreement on the survey items (66 of 72 items) by the end of the Delphi exercise. The experts' responses suggested that (1) focused clinician education offering support for clinical decision-making is a key component of academic detailing, (2) detailing messages need to be tailored and provide feasible strategies and solutions to challenging cases, and (3) academic detailers need to develop specific skill sets

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

    Science.gov (United States)

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

    2015-06-01

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

  13. A Delphi Consensus of the Crucial Steps in Gastric Bypass and Sleeve Gastrectomy Procedures in the Netherlands.

    Science.gov (United States)

    Kaijser, Mirjam A; van Ramshorst, Gabrielle H; Emous, Marloes; Veeger, Nic J G M; van Wagensveld, Bart A; Pierie, Jean-Pierre E N

    2018-04-09

    Bariatric procedures are technically complex and skill demanding. In order to standardize the procedures for research and training, a Delphi analysis was performed to reach consensus on the practice of the laparoscopic gastric bypass and sleeve gastrectomy in the Netherlands. After a pre-round identifying all possible steps from literature and expert opinion within our study group, questionnaires were send to 68 registered Dutch bariatric surgeons, with 73 steps for bypass surgery and 51 steps for sleeve gastrectomy. Statistical analysis was performed to identify steps with and without consensus. This process was repeated to reach consensus of all necessary steps. Thirty-eight participants (56%) responded in the first round and 32 participants (47%) in the second round. After the first Delphi round, 19 steps for gastric bypass (26%) and 14 for sleeve gastrectomy (27%) gained full consensus. After the second round, an additional amount of 10 and 12 sub-steps was confirmed as key steps, respectively. Thirteen steps in the gastric bypass and seven in the gastric sleeve were deemed advisable. Our expert panel showed a high level of consensus expressed in a Cronbach's alpha of 0.82 for the gastric bypass and 0.87 for the sleeve gastrectomy. The Delphi consensus defined 29 steps for gastric bypass and 26 for sleeve gastrectomy as being crucial for correct performance of these procedures to the standards of our expert panel. These results offer a clear framework for the technical execution of these procedures.

  14. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people.

    Science.gov (United States)

    Stewart, Derek; Gibson-Smith, Kathrine; MacLure, Katie; Mair, Alpana; Alonso, Albert; Codina, Carles; Cittadini, Antonio; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Junius-Walker, Ulrike; Kardas, Przemysław; Kempen, Thomas; Kinnear, Moira; Lewek, Pawel; Malva, Joao; McIntosh, Jennifer; Scullin, Claire; Wiese, Birgitt

    2017-01-01

    Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners) from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being provided with summative results and collated, anonymised comments at the commencement of Rounds 2 and 3. Ninety panel members were recruited (64.3% of target), with high participation levels throughout the three Delphi rounds (91.1%, 83.3%, 72.2%). During Round 1, consensus was obtained for 27/46 statements (58.7%), with an additional two statements in Round 2 and none in Round 3. Consensus was obtained for statements relating to: potential gain arising from polypharmacy management (3/4 statements); strategic development (7/7); change management (5/7) indicator measures (4/6); legislation (0/3); awareness raising (5/5); polypharmacy reviews (5/7); and EU vision (0/7). Analysis of free text comments indicated that the vision statements were too ambitious and not achievable by the specified timeframe of 2025. Consensus was obtained amongst key EU strategists around many aspects of polypharmacy management in older people. Notably, no consensus was achieved in relation to statements relating to the need to alter legislation in areas of healthcare delivery, remuneration and practitioner scope of practice. While the vision for the EU by 2025 was considered rather

  15. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people.

    Directory of Open Access Journals (Sweden)

    Derek Stewart

    Full Text Available Inappropriate use of multiple medicines (inappropriate polypharmacy is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU in relation to aspects of the management of polypharmacy in older people.Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being provided with summative results and collated, anonymised comments at the commencement of Rounds 2 and 3.Ninety panel members were recruited (64.3% of target, with high participation levels throughout the three Delphi rounds (91.1%, 83.3%, 72.2%. During Round 1, consensus was obtained for 27/46 statements (58.7%, with an additional two statements in Round 2 and none in Round 3. Consensus was obtained for statements relating to: potential gain arising from polypharmacy management (3/4 statements; strategic development (7/7; change management (5/7 indicator measures (4/6; legislation (0/3; awareness raising (5/5; polypharmacy reviews (5/7; and EU vision (0/7. Analysis of free text comments indicated that the vision statements were too ambitious and not achievable by the specified timeframe of 2025.Consensus was obtained amongst key EU strategists around many aspects of polypharmacy management in older people. Notably, no consensus was achieved in relation to statements relating to the need to alter legislation in areas of healthcare delivery, remuneration and practitioner scope of practice. While the vision for the EU by 2025 was considered

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

    Science.gov (United States)

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

    2018-02-01

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

  17. Defining an anaesthetic curriculum for medical undergraduates. A Delphi study.

    LENUS (Irish Health Repository)

    Rohan, Denise

    2009-01-01

    Anaesthesia is commonly taught to medical students. The duration and content of such teaching varies however and no consensus exists as to what constitutes an optimal curriculum. Anaesthetists possess the necessary knowledge and skills and operate in clinical settings suitable to provide training for medical undergraduates, especially in areas where deficiencies have been identified. This Delphi study was directed towards developing a consensus on an optimal anaesthesia, intensive care and pain medicine curriculum for medical undergraduates.

  18. Towards consensus in operational definitions in functional capacity evaluation: a Delphi Survey.

    Science.gov (United States)

    Soer, Remko; van der Schans, Cees P; Groothoff, Johan W; Geertzen, Jan H B; Reneman, Michiel F

    2008-12-01

    The problem of inconsistent terminology in functional capacity evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. A Delphi Survey with FCE experts was conducted which consisted of three rounds of questioning, using semi and full structured questions. The expert group was formed from international experts in FCE. Experts were selected if they met any of the following criteria: at least one international publication as first author and one as co-author in the field of FCE; or an individual who had developed an FCE that was subject of investigation in at least one publication in international literature. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of FCE, for which two potential eligible definitions remained. Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.

  19. Development of guidelines to assist organisations to support employees returning to work after an episode of anxiety, depression or a related disorder: a Delphi consensus study with Australian professionals and consumers

    Directory of Open Access Journals (Sweden)

    Reavley Nicola J

    2012-09-01

    Full Text Available Abstract Background Mental disorders are a significant cause of disability and loss of workplace productivity. The scientific evidence for how organisations should best support those returning to work after common mental disorders is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts. Methods A systematic review of websites, books and journal articles was conducted to develop a 387 item survey containing strategies that organisations might use to support those returning to work after common mental disorders. Three panels of Australian experts (66 health professionals, 30 employers and 80 consumers were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results The participation rate across all three rounds was 60.2% (57.6% health professionals, 76.7% employers, 56.3% consumers. 308 strategies were endorsed as essential or important by at least 80% of all three panels. The endorsed strategies provided information on policy and procedures, the roles of supervisors, employees and colleagues in managing absence and return to work, and provision of mental health information and training. Conclusions The guidelines outline strategies for organisations supporting those returning to work after common mental disorders. It is hoped that they may be used to inform policy and practice in a variety of workplaces.

  20. Lifelong learning in nursing: a Delphi study.

    Science.gov (United States)

    Davis, Lisa; Taylor, Heidi; Reyes, Helen

    2014-03-01

    In order to foster a culture of lifelong learning in nursing, it is important to identify what the concept means in the nursing profession as well as the characteristics of a lifelong learner. The purpose of this Delphi study was to conceptualize lifelong learning from the perspective of nursing, and to identify characteristics and essential elements of lifelong learning. A Delphi Study technique in three phases was completed using an online survey tool. Data were analyzed for conceptual description, ratings of characteristics and attributes, and expert consensus in these three phases. An online survey tool was used in this study. Recognized experts in nursing education, administration and public policy participated in this study. Lifelong learning in nursing is defined as a dynamic process, which encompasses both personal and professional life. This learning process is also both formal and informal. Lifelong learning involves seeking and appreciating new worlds or ideas in order to gain a new perspective as well as questioning one's environment, knowledge, skills and interactions. The most essential characteristics of a lifelong learner are reflection, questioning, enjoying learning, understanding the dynamic nature of knowledge, and engaging in learning by actively seeking learning opportunities. Keeping the mind active is essential to both lifelong learning and being able to translate knowledge into the capacity to deliver high quality nursing care. It is hoped that a clearer understanding of lifelong learning in nursing will foster more discussion and research about intentional, active inclusion of lifelong learning behaviors in nursing curricula. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2018-05-01

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

  2. Delphi consensus on the diagnosis and management of dyslipidaemia in chronic kidney disease patients: A post hoc analysis of the DIANA study

    Directory of Open Access Journals (Sweden)

    Aleix Cases Amenós

    2016-11-01

    Conclusions: The consensus to analyse the lipid profile in CKD patients suggests acknowledgement of the high cardiovascular risk of this condition. However, the lack of consensus in considering renal function or albuminuria, both when selecting a statin and during follow-up, suggests a limited knowledge of the differences between statins in relation to CKD. Thus, it would be advisable to develop a guideline/consensus document on the use of statins in CKD.

  3. What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

    Science.gov (United States)

    Zhang, Yin; Salaba, Athena

    2009-01-01

    This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

  4. Exploration to Identify Professional Dispositions of School Librarians: A Delphi Study

    Science.gov (United States)

    Bush, Gail; Jones, Jami L.

    2010-01-01

    This article reports the findings of an exploratory study to identify professional dispositions of school librarians. The authors employed the Delphi method, a qualitative research method that emphasizes expert knowledge and consensus within a particular field. The Delphi panel consisted of members of the editorial boards of nationally recognized…

  5. A Delphi Study: Exploring Faculty Perceptions of the Best Practices Influencing Student Persistence in Blended Courses

    Science.gov (United States)

    Manning, Kim Elise

    2010-01-01

    This Delphi study explored the instructional practices of community college faculty who were teaching blended or Web-assisted courses and how these practices influenced student persistence. The Delphi method provided qualitative data in the form of expert advice through consensus building on the instructional practices most likely to influence…

  6. Procedural key steps in laparoscopic colorectal surgery, consensus through Delphi methodology.

    Science.gov (United States)

    Dijkstra, Frederieke A; Bosker, Robbert J I; Veeger, Nicolaas J G M; van Det, Marc J; Pierie, Jean Pierre E N

    2015-09-01

    While several procedural training curricula in laparoscopic colorectal surgery have been validated and published, none have focused on dividing surgical procedures into well-identified segments, which can be trained and assessed separately. This enables the surgeon and resident to focus on a specific segment, or combination of segments, of a procedure. Furthermore, it will provide a consistent and uniform method of training for residents rotating through different teaching hospitals. The goal of this study was to determine consensus on the key steps of laparoscopic right hemicolectomy and laparoscopic sigmoid colectomy among experts in our University Medical Center and affiliated hospitals. This will form the basis for the INVEST video-assisted side-by-side training curriculum. The Delphi method was used for determining consensus on key steps of both procedures. A list of 31 steps for laparoscopic right hemicolectomy and 37 steps for laparoscopic sigmoid colectomy was compiled from textbooks and national and international guidelines. In an online questionnaire, 22 experts in 12 hospitals within our teaching region were invited to rate all steps on a Likert scale on importance for the procedure. Consensus was reached in two rounds. Sixteen experts agreed to participate. Of these 16 experts, 14 (88%) completed the questionnaire for both procedures. Of the 14 who completed the first round, 13 (93%) completed the second round. Cronbach's alpha was 0.79 for the right hemicolectomy and 0.91 for the sigmoid colectomy, showing high internal consistency between the experts. For the right hemicolectomy, 25 key steps were established; for the sigmoid colectomy, 24 key steps were established. Expert consensus on the key steps for laparoscopic right hemicolectomy and laparoscopic sigmoid colectomy was reached. These key steps will form the basis for a video-assisted teaching curriculum.

  7. Experts' consensus on use of electronic cigarettes: a Delphi survey from Switzerland.

    Science.gov (United States)

    Blaser, Jeremie; Cornuz, Jacques

    2015-04-15

    In some countries, nicotine-containing electronic cigarettes (e-cigarettes) are considered a consumer product without specific regulations. In others (eg, Switzerland), the sale of e-cigarettes containing nicotine is forbidden, despite the eagerness of many smokers to obtain them. As scientific data about efficacy and long-term safety of these products are scarce, tobacco control experts are divided on how to regulate them. In order to gain consensus among experts to provide recommendations to health authorities, we performed a national consensus study. We used a Delphi method with electronic questionnaires to bring together the opinion of Swiss experts on e-cigarettes. 40 Swiss experts from across the country. We measured the degree of consensus between experts on recommendations regarding regulation, sale, use of and general opinion about e-cigarettes containing nicotine. New recommendations and statements were added following the experts' answers and comments. There was consensus that e-cigarettes containing nicotine should be made available, but only under specific conditions. Sale should be restricted to adults, using quality standards, a maximum level of nicotine and with an accompanying list of authorised ingredients. Advertisement should be restricted and use in public places should be forbidden. These recommendations encompass three principles: (1) the reality principle, as the product is already on the market; (2) the prevention principle, as e-cigarettes provide an alternative to tobacco for actual smokers, and (3) the precautionary principle, to protect minors and non-smokers, since long-term effects are not yet known. Swiss authorities should design specific regulations to sell nicotine-containing e-cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Acne severity grading: determining essential clinical components and features using a Delphi consensus.

    Science.gov (United States)

    Tan, Jerry; Wolfe, Barat; Weiss, Jonathan; Stein-Gold, Linda; Bikowski, Joseph; Del Rosso, James; Webster, Guy F; Lucky, Anne; Thiboutot, Diane; Wilkin, Jonathan; Leyden, James; Chren, Mary-Margaret

    2012-08-01

    There are multiple global scales for acne severity grading but no singular standard. Our objective was to determine the essential clinical components (content items) and features (property-related items) for an acne global grading scale for use in research and clinical practice using an iterative method, the Delphi process. Ten acne experts were invited to participate in a Web-based Delphi survey comprising 3 iterative rounds of questions. In round 1, the experts identified the following clinical components (primary acne lesions, number of lesions, extent, regional involvement, secondary lesions, and patient experiences) and features (clinimetric properties, ease of use, categorization of severity based on photographs or text, and acceptance by all stakeholders). In round 2, consensus for inclusion in the scale was established for primary lesions, number, sites, and extent; as well as clinimetric properties and ease of use. In round 3, consensus for inclusion was further established for categorization and acceptance. Patient experiences were excluded and no consensus was achieved for secondary lesions. The Delphi panel consisted solely of the United States (U.S.)-based acne experts. Using an established method for achieving consensus, experts in acne vulgaris concluded that an ideal acne global grading scale would comprise the essential clinical components of primary acne lesions, their quantity, extent, and facial and extrafacial sites of involvement; with features of clinimetric properties, categorization, efficiency, and acceptance. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  9. AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty.

    Science.gov (United States)

    Pijls, Bart G; Dekkers, Olaf M; Middeldorp, Saskia; Valstar, Edward R; van der Heide, Huub J L; Van der Linden-Van der Zwaag, Henrica M J; Nelissen, Rob G H H

    2011-07-22

    In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting quality, methodological quality and generalizability of case series and cohorts in total hip and total knee arthroplasty with a focus on aseptic loosening. A web-based Delphi was conducted consisting of two internal rounds and three external rounds in order to achieve expert consensus on items considered relevant for reporting quality, methodological quality and generalizability. The internal rounds were used to construct a master list. The first external round was completed by 44 experts, 35 of them completed the second external round and 33 of them completed the third external round. Consensus was reached on an 8-item reporting quality checklist, a 6-item methodological checklist and a 22-item generalizability checklist. Checklist for reporting quality, methodological quality and generalizability for case series and cohorts in total hip and total knee arthroplasty were successfully created through this Delphi. These checklists should improve the accuracy, completeness and quality of case series and cohorts regarding total hip and total knee arthroplasty.

  10. A Delphi consensus panel on nutritional therapy in chronic kidney disease.

    Science.gov (United States)

    Bellizzi, Vincenzo; Bianchi, Stefano; Bolasco, Piergiorgio; Brunori, Giuliano; Cupisti, Adamasco; Gambaro, Giovanni; Gesualdo, Loreto; Polito, Pasquale; Santoro, Domenico; Santoro, Antonio

    2016-10-01

    The conservative management of chronic kidney disease (CKD) includes nutritional therapy (NT) with the aim to reduce the intake of proteins, phosphorus, organic acids, sodium, and potassium, while ensuring adequate caloric intake. While there is evidence that NT may help to prevent and control metabolic alterations in CKD, the criteria for implementing a low-protein regimen in CKD are still debated. There is no final consensus on the composition of the diet, nor indications for specific patient settings or different stages of CKD. Also when and how to start dietary manipulation of different nutrients in CKD is not well defined. A group of Italian nephrologists participated, under the auspices of the Italian Society of Nephrology, in a Delphi exercise to explore the consensus on some open questions regarding the nutritional treatment in CKD in Italy, generating a consensus opinion for 23 statements on: (1) general principles of NT; (2) indications for and initiation of NT; (3) role of protein-free products; (4) NT safety; (5) integrated management of NT. This Delphi exercise shows that there is broad consensus regarding NT in CKD across a wide range of management areas. These clinician-led consensus statements provide a framework for appropriate guidance on NT in patients with CKD, and are intended as a guide in decision-making whenever possible.

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

    Science.gov (United States)

    Lis, Rebecca; Sakata, Vicki; Lien, Onora

    2017-08-01

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

  12. Development of a consensus taxonomy of sedentary behaviors (SIT: report of Delphi Round 1.

    Directory of Open Access Journals (Sweden)

    Sebastien Francois Martin Chastin

    Full Text Available BACKGROUND: Over the last decade, sedentary behaviors have emerged as a distinctive behavioral paradigm with deleterious effects on health independent of physical activity. The next phase of research is to establish dose response between sedentary behaviors and health outcomes and improve understanding of context and determinants of these behaviors. Establishing a common taxonomy of these behaviors is a necessary step in this process. AIM: The Sedentary behavior International Taxonomy project was developed to establish a classification of sedentary behaviors by use of a formal consensus process. METHODS: The study follows a Delphi process in three Rounds. A preparatory stage informed the development of terms of reference documents. In Round 1, experts were asked to make statements about the taxonomy; 1 its purpose and use ; 2 the domains, categories or facets that should be consider and include; 3 the structure/architecture to arrange and link these domains and facets. In Round 2 experts will be presented with a draft taxonomy emerging from Round 1 and invited to comment and propose alterations. The taxonomy will then be finalised at the outset of this stage. RESULTS: Results of Round 1 are reported here. There is a general consensus that a taxonomy will help advances in research by facilitating systematic and standardised: 1 investigation and analysis; 2 reporting and communication; 3 data pooling, comparison and meta-analysis; 4 development of measurement tools; 4 data descriptions, leading to higher quality in data querying and facilitate discoveries. There is also a consensus that such a taxonomy should be flexible to accommodate diverse purposes of use, and future advances in the field and yet provide a cross-disciplinary common language. A consensual taxonomy structure emerged with nine primary facets (Purpose, Environment, Posture, Social, Measurement, Associated behavior, Status, Time, Type and the draft structure presented here for

  13. Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts.

    Science.gov (United States)

    Mohile, Supriya Gupta; Velarde, Carla; Hurria, Arti; Magnuson, Allison; Lowenstein, Lisa; Pandya, Chintan; O'Donovan, Anita; Gorawara-Bhat, Rita; Dale, William

    2015-09-01

    Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes. Copyright © 2015 by the National Comprehensive Cancer Network.

  14. Development of a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan: a modified Delphi method.

    Science.gov (United States)

    Kizawa, Yoshiyuki; Tsuneto, Satoru; Tamba, Kaichiro; Takamiya, Yusuke; Morita, Tatsuya; Bito, Seiji; Otaki, Junji

    2012-07-01

    There is currently no consensus syllabus of palliative medicine for undergraduate medical education in Japan, although the Cancer Control Act proposed in 2007 covers the dissemination of palliative care. To develop a nationwide consensus syllabus of palliative medicine for undergraduate medical education in Japan using a modified Delphi method. We adopted the following three-step method: (1) a workshop to produce the draft syllabus; (2) a survey-based provisional syllabus; (3) Delphi rounds and a panel meeting (modified Delphi method) to produce the working syllabus. Educators in charge of palliative medicine from 63% of the medical schools in Japan collaborated to develop a survey-based provisional syllabus before the Delphi rounds. A panel of 32 people was then formed for the modified Delphi rounds comprising 28 educators and experts in palliative medicine, one cancer survivor, one bereaved family member, and two medical students. The final consensus syllabus consists of 115 learning objectives across seven sections as follows: basic principles; disease process and comprehensive assessment; symptom management; psychosocial care; cultural, religious, and spiritual issues; ethical issues; and legal frameworks. Learning objectives were categorized as essential or desirable (essential: 66; desirable: 49). A consensus syllabus of palliative medicine for undergraduate medical education was developed using a clear and innovative methodology. The final consensus syllabus will be made available for further dissemination of palliative care education throughout the country.

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

    Science.gov (United States)

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

    2013-04-01

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

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

    LENUS (Irish Health Repository)

    Wakai, Abel

    2012-02-29

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

  17. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

    2017-02-01

    Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice.

    Science.gov (United States)

    Cohn, David E; Havrilesky, Laura J; Osann, Kathryn; Lipscomb, Joseph; Hsieh, Susie; Walker, Joan L; Wright, Alexi A; Alvarez, Ronald D; Karlan, Beth Y; Bristow, Robert E; DiSilvestro, Paul A; Wakabayashi, Mark T; Morgan, Robert; Mukamel, Dana B; Wenzel, Lari

    2015-09-01

    To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Health care for immigrants in Europe: is there still consensus among country experts about principles of good practice? A Delphi study

    DEFF Research Database (Denmark)

    Devillé, Walter; Greacen, Tim; Bogic, Marija

    2011-01-01

    Background: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views...... to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider...... disagreement both within and between countries on specific issues that require further research and debate....

  20. DELPHI

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    The DELPHI detector for the LEP storage ring is described. It consists of time projection chamber within a superconducting magnet coil surrounded by a ring-image Cherenkov counter. Furthermore within the solenoid an electromagnetic calorimeter is located while outside the hadronic calorimeter is placed. Furthermore the data acquisition and filtering system is described. (HSI).

  1. Delphi

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    At CERN's new LEP electronpositron collider, the initial year of data-taking by the four big experiments - Aleph, Delphi, L3 and Opal, comes as the result of some ten years of careful preparation. This is the first in a series of four articles which looks at the history and aspirations of each of these mighty collaborations

  2. Assessment of critical thinking: a Delphi study.

    Science.gov (United States)

    Paul, Sheila A

    2014-11-01

    Nurse educators are responsible for preparing nurses who critically analyze patient information and provide meaningful interventions in today's complex health care system. By using the Delphi research method, this study, utilized the specialized and experiential knowledge of Certified Nurse Educators. This original Delphi research study asked Certified Nurse Educators how to assess the critical-thinking ability of nursing students in the clinical setting. The results showed that nurse educators need time, during the clinical experience, to accurately assess each individual nursing student. This study demonstrated the need for extended student clinical time, and a variety of clinical learning assessment tools. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Building consensus on key priorities for rural health care in South Africa using the Delphi technique

    Directory of Open Access Journals (Sweden)

    Marije Versteeg

    2013-01-01

    Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  4. Building consensus on key priorities for rural health care in South Africa using the Delphi technique.

    Science.gov (United States)

    Versteeg, Marije; du Toit, Lilo; Couper, Ian

    2013-01-24

    South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Response rates ranged from 83% in the first round (n=44) to 64% in the final round (n=34). The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH), governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  5. Association of Postoperative Readmissions With Surgical Quality Using a Delphi Consensus Process to Identify Relevant Diagnosis Codes.

    Science.gov (United States)

    Mull, Hillary J; Graham, Laura A; Morris, Melanie S; Rosen, Amy K; Richman, Joshua S; Whittle, Jeffery; Burns, Edith; Wagner, Todd H; Copeland, Laurel A; Wahl, Tyler; Jones, Caroline; Hollis, Robert H; Itani, Kamal M F; Hawn, Mary T

    2018-04-18

    Postoperative readmission data are used to measure hospital performance, yet the extent to which these readmissions reflect surgical quality is unknown. To establish expert consensus on whether reasons for postoperative readmission are associated with the quality of surgery in the index admission. In a modified Delphi process, a panel of 14 experts in medical and surgical readmissions comprising physicians and nonphysicians from Veterans Affairs (VA) and private-sector institutions reviewed 30-day postoperative readmissions from fiscal years 2008 through 2014 associated with inpatient surgical procedures performed at a VA medical center between October 1, 2007, and September 30, 2014. The consensus process was conducted from January through May 2017. Reasons for readmission were grouped into categories based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes. Panelists were given the proportion of readmissions coded by each reason and median (interquartile range) days to readmission. They answered the question, "Does the readmission reason reflect possible surgical quality of care problems in the index admission?" on a scale of 1 (never related) to 5 (directly related) in 3 rounds of consensus building. The consensus process was completed in May 2017 and data were analyzed in June 2017. Consensus on proportion of ICD-9-coded readmission reasons that reflected quality of surgical procedure. In 3 Delphi rounds, the 14 panelists achieved consensus on 50 reasons for readmission; 12 panelists also completed group telephone calls between rounds 1 and 2. Readmissions with diagnoses of infection, sepsis, pneumonia, hemorrhage/hematoma, anemia, ostomy complications, acute renal failure, fluid/electrolyte disorders, or venous thromboembolism were considered associated with surgical quality and accounted for 25 521 of 39 664 readmissions (64% of readmissions; 7.5% of 340 858 index surgical procedures). The proportion of readmissions

  6. Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology

    Directory of Open Access Journals (Sweden)

    Breda H. Eubank

    2016-05-01

    Full Text Available Abstract Background Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1 to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2 to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. Methods A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. Results In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. Conclusion This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

  7. Delphi consensus of an expert committee in oncogeriatrics regarding comprehensive geriatric assessment in seniors with cancer in Spain.

    Science.gov (United States)

    Molina-Garrido, Maria-Jose; Guillén-Ponce, Carmen; Blanco, Remei; Saldaña, Juana; Feliú, Jaime; Antonio, Maite; López-Mongil, Rosa; Ramos Cordero, Primitivo; Gironés, Regina

    2018-07-01

    The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66.7% coincidence in responses and by the stability of said coincidence (changes ≤15% between rounds). The study was conducted between July and December 2016. Of the 17 people invited to participate, 16 agreed. The panel concluded by consensus that the following domains should be included in the CGA:(and the scales to evaluate them): functional (Barthel Index, Lawton-Brody scale, gait speed), cognitive (Pfeiffer questionnaire), nutritional (Mini Nutritional Assessment - MNA), psychological/mood (Yesavage scale), social-familial (Gijon scale), comorbidity (Charlson index), medications, and geriatric syndromes (urinary and/or fecal incontinence, low auditory and/or visual acuity, presence of falls, pressure sores, insomnia, and abuse). Also by consensus, the CGA should be administered to older patients with cancer for whom there is a subsequent therapeutic intent and who scored positive on a previous frailty-screening questionnaire. After 3 rounds, consensus was reached regarding CGA domains to be used in older patients with cancer, the scales to be administered for each of these domains, as well as the timeline to be followed during consultation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

    Science.gov (United States)

    Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

    2016-05-20

    Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

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

    Science.gov (United States)

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

    2015-08-01

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

  10. What are the essential features of resilience for informal caregivers of people living with dementia? A Delphi consensus examination.

    Science.gov (United States)

    Joling, Karlijn J; Windle, Gill; Dröes, Rose-Marie; Huisman, Martijn; Hertogh, Cees M P M; Woods, Robert T

    2017-05-01

    Few studies have examined what might enable or prevent resilience in carers of people with dementia. Consequently, there are limited insights as to how it should be understood, defined and measured. This creates challenges for research, and also practice in terms of how it might best be promoted. This study aimed to address these limitations and add new insights, identifying the essential features of resilience in dementia caregiving. A Delphi consensus study was conducted, consulting a multi-disciplinary panel of informal caregivers and experts with relevant professional expertise. Panellists rated the relevance of various statements addressing essential components of resilience; 'adversity' and 'successful caregiving' on a 5-point Likert scale. Based on the median and Inter Quartile Range, the most relevant statements with moderate consensus were proposed in Round 2 in which panellists selected up to five statements in order of importance. Moderate consensus was reached for all statements after two rounds. Patients' behavioural problems and feeling competent as a caregiver were selected by both caregivers and professionals as essential resilience features. Caregivers also emphasized the importance of social support, the quality of the relationship with their relative and enjoying spending time together. Professionals considered coping skills, experiencing positive aspects of caregiving, and a good quality of life of caregivers most relevant. The essential elements of resilience selected from multiple stakeholder perspectives can be used to select appropriate outcomes for intervention studies and give guidance to policy to support caregivers more effectively and better tailored to their needs.

  11. Curricular priorities for business ethics in medical practice and research: recommendations from Delphi consensus panels.

    Science.gov (United States)

    DuBois, James M; Kraus, Elena M; Gursahani, Kamal; Mikulec, Anthony; Bakanas, Erin

    2014-11-15

    No published curricula in the area of medical business ethics exist. This is surprising given that physicians wrestle daily with business decisions and that professional associations, the Institute of Medicine, Health and Human Services, Congress, and industry have issued related guidelines over the past 5 years. To fill this gap, the authors aimed (1) to identify the full range of medical business ethics topics that experts consider important to teach, and (2) to establish curricular priorities through expert consensus. In spring 2012, the authors conducted an online Delphi survey with two heterogeneous panels of experts recruited in the United States. One panel focused on business ethics in medical practice (n = 14), and 1 focused on business ethics in medical research (n = 12). Panel 1 generated an initial list of 14 major topics related to business ethics in medical practice, and subsequently rated 6 topics as very important or essential to teach. Panel 2 generated an initial list of 10 major topics related to business ethics in medical research, and subsequently rated 5 as very important or essential. In both domains, the panel strongly recommended addressing problems that conflicts of interest can cause, legal guidelines, and the goals or ideals of the profession. The Bander Center for Medical Business Ethics at Saint Louis University will use the results of the Delphi panel to develop online curricular resources for each of the highest rated topics.

  12. Modified Delphi study to determine optimal data elements for inclusion in an emergency management database system

    Directory of Open Access Journals (Sweden)

    A. Jabar

    2012-03-01

    Conclusion: The use of a modified Expert Delphi study achieved consensus in aspects of hospital institutional capacity that can be translated into practical recommendations for implementation by the local emergency management database system. Additionally, areas of non-consensus have been identified where further work is required. This purpose of this study is to contribute to and aid in the development of this new system.

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

    Science.gov (United States)

    Strnad, Michael A., Sr.

    2013-01-01

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

  14. Critical Guidelines for U.S.-Based Counselor Educators When Working Transnationally: A Delphi Study

    Science.gov (United States)

    Smith, Paul H.; Benshoff, James M.; Gonzalez, Laura M.

    2018-01-01

    U.S.-based counselor education faculty increasingly are participating in transnational experiences, such as global research and study abroad. The purpose of this study was to develop guidelines for U.S.-based counselor educators when working transnationally. Using Delphi methodology, 69 consensus guidelines were developed from an expert panel.…

  15. Rehabilitation Counselor Competencies When Working With Hispanic/Latino Immigrant Injured Workers: A Delphi Study

    Science.gov (United States)

    Santos Román, Leslie M.; Estrada-Hernández, Noel

    2017-01-01

    Purpose: To explore and identify attitudes, knowledge, and skills rehabilitation practitioners in the private sector need when working with Hispanic/Latino immigrant injured workers. Methods: This study employed a 3-round Delphi study to obtain a consensus of 8 rehabilitation practitioners who had experience and expertise working with…

  16. Designing Graduate-Level Plant Breeding Curriculum: A Delphi Study of Private Sector Stakeholder Opinions

    Science.gov (United States)

    Miller, Jane K.; Repinski, Shelby L.; Hayes, Kathryn N.; Bliss, Frederick A.; Trexler, Cary J.

    2011-01-01

    A broad-based survey using the Delphi method was conducted to garner current information from private sector stakeholders and build consensus opinions supporting key ideas for enhancing plant breeder education and training. This study asked respondents to suggest and rate topics and content they deemed most important to plant breeding graduate…

  17. Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process.

    Science.gov (United States)

    Shaw, Joanne M; Price, Melanie A; Clayton, Josephine M; Grimison, Peter; Shaw, Tim; Rankin, Nicole; Butow, Phyllis N

    2016-01-01

    People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.

  18. Competencies of specialised wound care nurses: a European Delphi study.

    Science.gov (United States)

    Eskes, Anne M; Maaskant, Jolanda M; Holloway, Samantha; van Dijk, Nynke; Alves, Paulo; Legemate, Dink A; Ubbink, Dirk T; Vermeulen, Hester

    2014-12-01

    Health care professionals responsible for patients with complex wounds need a particular level of expertise and education to ensure optimum wound care. However, uniform education for those working as wound care nurses is lacking. We aimed to reach consensus among experts from six European countries as to the competencies for specialised wound care nurses that meet international professional expectations and educational systems. Wound care experts including doctors, wound care nurses, lecturers, managers and head nurses were invited to contribute to an e-Delphi study. They completed online questionnaires based on the Canadian Medical Education Directives for Specialists framework. Suggested competencies were rated on a 9-point Likert scale. Consensus was defined as an agreement of at least 75% for each competence. Response rates ranged from 62% (round 1) to 86% (rounds 2 and 3). The experts reached consensus on 77 (80%) competences. Most competencies chosen belonged to the domain 'scholar' (n = 19), whereas few addressed those associated with being a 'health advocate' (n = 7). Competencies related to professional knowledge and expertise, ethical integrity and patient commitment were considered most important. This consensus on core competencies for specialised wound care nurses may help achieve a more uniform definition and education for specialised wound care nurses. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Toronto, Coleen

    2017-06-22

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

  20. Defining a Bobath clinical framework - A modified e-Delphi study.

    Science.gov (United States)

    Vaughan-Graham, Julie; Cott, Cheryl

    2016-11-01

    To gain consensus within the expert International Bobath Instructors Training Association (IBITA) on a Bobath clinical framework on which future efficacy studies can be based. A three-round modified e-Delphi approach was used with 204 full members of the IBITA. Twenty-one initial statements were generated from the literature. Consensus was defined a priori as at least 80% of the respondents with a level of agreement on a Likert scale of 4 or 5. The Delphi questionnaire for each round was available online for two weeks. Summary reports and subsequent questionnaires were posted within four weeks. Ninety-four IBITA members responded, forming the Delphi panel, of which 68 and 66 responded to Rounds Two and Three, respectively. The 21 initial statements were revised to 17 statements and five new statements in Round Two in which eight statements were accepted and two statements were eliminated. Round Three presented 12 revised statements, all reaching consensus. The Delphi was successful in gaining consensus on a Bobath clinical framework in a geographically diverse expert association, identifying the unique components of Bobath clinical practice. Discussion throughout all three Rounds revolved primarily around the terminology of atypical and compensatory motor behavior and balance.

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

    Science.gov (United States)

    Blade, Joan; Calleja, Miguel Ángel; Lahuerta, Juan José; Poveda, José Luis; de Paz, Héctor David; Lizán, Luis

    2018-02-22

    To define a standard set of outcomes and the most appropriate instruments to measure them for managing newly diagnosed patients with multiple myeloma (MM). A literature review and five discussion groups facilitated the design of two-round Delphi questionnaire. Delphi panellists (haematologists, hospital pharmacists and patients) were identified by the scientific committee, the Spanish Program of Haematology Treatments Foundation, the Spanish Society of Hospital Pharmacies and the Spanish Community of Patients with MM. Panellist's perception about outcomes' suitability and feasibility of use was assessed on a seven-point Likert scale. Consensus was reached when at least 75% of the respondents reached agreement or disagreement. A scientific committee led the project. Fifty-one and 45 panellists participated in the first and second Delphi rounds, respectively. Consensus was reached to use overall survival, progression-free survival, minimal residual disease and treatment response to assess survival and disease control. Panellists agreed to measure health-related quality of life, pain, performance status, fatigue, psychosocial status, symptoms, self-perception on body image, sexuality and preferences/satisfaction. However, panellist did not reach consensus about the feasibility of assessing in routine practice psychosocial status, symptoms, self-perception on body image and sexuality. Consensus was reached to collect patient-reported outcomes through the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core questionnaire 30 (C30), three items from EORTC-QLQ-Multiple Myeloma (MY20) and EORTC-QLQ-Breast Cancer (BR23), pain Visual Analogue Scale, Morisky-Green and ad hoc questions about patients' preferences/satisfaction. A consensual standard set of outcomes for managing newly diagnosed patients with MM has been defined. The feasibility of its implementation in routine practice will be assessed in a future pilot

  2. Appropriateness of clinical and organizational criteria for intra-articular injection therapies in osteoarthritis: A Delphi method consensus initiative among experts in Italy

    Directory of Open Access Journals (Sweden)

    Marco Paoloni

    2015-06-01

    Full Text Available OBJECTIVE: The aim of the study was to identify the main aspects involved in patient selection, the choice of therapeutic agents and the safety profile, as well as the medico-legal and organizational aspects of intra-articular injection therapies for osteoarthritis. METHODS: A committee of 10 experts from Italian universities, public hospitals, territorial services, research institutes and patient associations was set up. Fifty-two clinicians from a large number of Italian medical centers specialized in intra-articular injection therapy took part in a Delphi process aimed at obtaining consensus statements among the participants. RESULTS: Large consensus was obtained for statements grouped under the following main themes: treatment indications; drug/medical device choice; treatment efficacy; and appropriate setting. CONCLUSIONS: The consensus statements developed by a large number of experts may be used as a practical reference tool to help physicians treat osteoarthritis patients by means of intra-articular injection therapies.

  3. Operationalising elaboration theory for simulation instruction design: a Delphi study.

    Science.gov (United States)

    Haji, Faizal A; Khan, Rabia; Regehr, Glenn; Ng, Gary; de Ribaupierre, Sandrine; Dubrowski, Adam

    2015-06-01

    The aim of this study was to assess the feasibility of incorporating the Delphi process within the simplifying conditions method (SCM) described in elaboration theory (ET) to identify conditions impacting the complexity of procedural skills for novice learners. We generated an initial list of conditions impacting the complexity of lumbar puncture (LP) from key informant interviews (n = 5) and a literature review. Eighteen clinician-educators from six different medical specialties were subsequently recruited as expert panellists. Over three Delphi rounds, these panellists rated: (i) their agreement with the inclusion of the simple version of the conditions in a representative ('epitome') training scenario, and (ii) how much the inverse (complex) version increases LP complexity for a novice. Cronbach's α-values were used to assess inter-rater agreement. All panellists completed Rounds 1 and 2 of the survey and 17 completed Round 3. In Round 1, Cronbach's α-values were 0.89 and 0.94 for conditions that simplify and increase LP complexity, respectively; both values increased to 0.98 in Rounds 2 and 3. With the exception of 'high CSF (cerebral spinal fluid) pressure', panellists agreed with the inclusion of all conditions in the simplest (epitome) training scenario. Panellists rated patient movement, spinal anatomy, patient cooperativeness, body habitus, and the presence or absence of an experienced assistant as having the greatest impact on the complexity of LP. This study demonstrated the feasibility of using expert consensus to establish conditions impacting the complexity of procedural skills, and the benefits of incorporating the Delphi method into the SCM. These data can be used to develop and sequence simulation scenarios in a progressively challenging manner. If the theorised learning gains associated with ET are realised, the methods described in this study may be applied to the design of simulation training for other procedural and non-procedural skills

  4. A Delphi Study of Additive Manufacturing Applicability for United States Air Force Civil Engineer Contingency Operations

    Science.gov (United States)

    2015-03-26

    be known as a Delphi study. Delphi Strengths. The Delphi approach was named after the Oracle at Delphi, a prominent figure in ancient Greek ... mythology who “was able to predict the future with infallible authority” (Clayton, 1997:374). The name is fitting as a Delphi study is often used to predict

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

    Science.gov (United States)

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

    2017-08-23

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

  6. Reference Materials in LIS Instruction: A Delphi Study

    Science.gov (United States)

    Rabina, Debbie

    2013-01-01

    This paper presents the results of a Delphi study conducted over a two-month period in 2011. The purpose of the study was to identify reference sources that should be covered in basic reference courses taught in LIS programs in the United States. The Delphi method was selected for its appropriateness in soliciting expert opinions and assessing the…

  7. Criteria required for an acceptable point-of-care test for UTI detection: Obtaining consensus using the Delphi technique.

    Science.gov (United States)

    Weir, Nichola-Jane M; Pattison, Sally H; Kearney, Paddy; Stafford, Bob; Gormley, Gerard J; Crockard, Martin A; Gilpin, Deirdre F; Tunney, Michael M; Hughes, Carmel M

    2018-01-01

    Urinary Tract Infections (UTIs) are common bacterial infections, second only to respiratory tract infections and particularly prevalent within primary care. Conventional detection of UTIs is culture, however, return of results can take between 24 and 72 hours. The introduction of a point of care (POC) test would allow for more timely identification of UTIs, facilitating improved, targeted treatment. This study aimed to obtain consensus on the criteria required for a POC UTI test, to meet patient need within primary care. Criteria for consideration were compiled by the research team. These criteria were validated through a two-round Delphi process, utilising an expert panel of healthcare professionals from across Europe and United States of America. Using web-based questionnaires, panellists recorded their level of agreement with each criterion based on a 5-point Likert Scale, with space for comments. Using median response, interquartile range and comments provided, criteria were accepted/rejected/revised depending on pre-agreed cut-off scores. The first round questionnaire presented thirty-three criteria to the panel, of which 22 were accepted. Consensus was not achieved for the remaining 11 criteria. Following response review, one criterion was removed, while after revision, the remaining 10 criteria entered the second round. Of these, four were subsequently accepted, resulting in 26 criteria considered appropriate for a POC test to detect urinary infections. This study generated an approved set of criteria for a POC test to detect urinary infections. Criteria acceptance and comments provided by the healthcare professionals also supports the development of a multiplex point of care UTI test.

  8. Delphi process yielded consensus on terminology and research agenda for therapeutic footwear for neuropathic foot.

    NARCIS (Netherlands)

    Dahmen, R.; van der Wilden, G.J.; Lankhorst, G.J.; Boers, M.

    2008-01-01

    Objective: To investigate areas of consensus and disagreement among Dutch physiatrists concerning prescription of therapeutic footwear for the neuropathic foot and to develop a research agenda. Study Design and Setting: Forty participants were physiatrists and experts in the field of orthopedic shoe

  9. Attribution of mental illness to work: a Delphi study.

    Science.gov (United States)

    Wong, M G P; Poole, C J M; Agius, R

    2015-07-01

    Clinicians may be asked whether mental ill-health has been caused by work but there is no guidance on how this judgement should be made. To seek a consensus on the factors that should be considered and how they should be sought when attributing mental ill-health to work. A three-round Delphi study involving expert academics, occupational physicians, psychiatrists and psychologists. We deemed consensus had been reached when 66% or more of the experts were in agreement. Of 54 invited experts, 35 (65%) took part in the first round, 30 of these 35 (86%) in the second and 29 of these 30 (97%) in the final round. Consensus was reached for 11 workplace stressors: high job strain; effort-reward imbalance; major trauma; interpersonal conflict; inadequate support; role ambiguity; person-job mismatch; organizational injustice; organizational culture; work scheduling and threats to job security. Seven personal factors were identified as being important: previous mental illness; personality traits of neuroticism; adverse life events or social circumstances; resilience; a family history of mental illness and secondary gain. The worker, manager and co-workers were thought to be the most useful sources of workplace information. Consensus was reached for a definition of occupational mental illness but not for a threshold of work-relatedness. The attribution of mental ill-health to work is complex and involves the consideration of both workplace stressors and personal factors of vulnerability. Clinical consultation with an occupational physician who is familiar with the workplace is central to the process. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Developing a Framework for Ankle Function: A Delphi Study

    Science.gov (United States)

    Snyder, Kelli R.; Evans, Todd A.; Neibert, Peter J.

    2014-01-01

    Context: Addressing clinical outcomes is paramount to providing effective health care, yet there is no consensus regarding the appropriate outcomes to address after ankle injuries. Compounding the problem is the repetitive nature of lateral ankle sprains, referred to as functional (FAI) or chronic (CAI) ankle instability. Although they are commonly used terms in practice and research, FAI and CAI are inconsistently defined and assessed. Objective: To establish definitions of a healthy/normal/noninjured ankle, FAI, and CAI, as well as their characteristics and assessment techniques. Design: Delphi study. Setting: Telephone interviews and electronic surveys. Patients or Other Participants: Sixteen experts representing the fields of ankle function and treatment, ankle research, and outcomes assessment and research were selected as panelists. Data Collection and Analysis: A telephone interview produced feedback regarding the definition of, functional characteristics of, and assessment techniques for a healthy/normal/noninjured ankle, an unhealthy/acutely injured ankle, and FAI/CAI. Those data were compiled, reduced, and returned through electronic surveys and were either included by reaching consensus (80% agreement) or excluded. Results: The definitions of a healthy/normal/noninjured ankle and FAI reached consensus. Experts did not agree on a definition of CAI. Eleven functional characteristics of a healthy/normal/noninjured ankle, 32 functional characteristics of an unhealthy/acutely injured ankle, and 13 characteristics of FAI were agreed upon. Conclusions: Although a consensus was reached regarding the definitions and functional characteristics of a healthy/normal/noninjured ankle and FAI, the experts could only agree on 1 characteristic to include in the FAI definition. Several experts did, however, provide additional comments that reinforced the differences in the interpretation of those concepts. Although the experts could not agree on the definition of CAI, its

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

    Science.gov (United States)

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

    2014-01-01

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

  12. A Multidisciplinary Delphi Consensus-Based Checklist to Define Clinical Documentation Tools for Both Routine and Research Purposes

    Directory of Open Access Journals (Sweden)

    Cecilia Veraar

    2018-01-01

    Full Text Available Background: To the best of our knowledge, a strategic approach to define the contents of structured clinical documentation tools for both clinical routine patient care and research purposes has not been reported so far, although electronic health record will become more and more structured and detailed in the future. Objective: To achieve an interdisciplinary consensus on a checklist to be considered for the preparation of disease- and situation-specific clinical documentation tools. Methods: A 2-round Delphi consensus-based process was conducted both with 19 physicians of different disciplines and 14 students from Austria, Switzerland, and Germany. Agreement was defined as 80% or more positive votes of the participants. Results: The participants agreed that a working group should be set up for the development of structured disease- or situation-specific documentation tools (97% agreement. The final checklist included 4 recommendations concerning the setup of the working group, 12 content-related recommendations, and 3 general and technical recommendations (mean agreement [standard deviation] = 97.4% [4.0%], ranging from 84.2% to 100.0%. Discussion and Conclusion: In the future, disease- and situation-specific structured documentation tools will provide an important bridge between registries and electronic health records. Clinical documentation tools defined according to this Delphi consensus-based checklist will provide data for registries while serving as high-quality data acquisition tools in routine clinical care.

  13. Recovery in psychosis: a Delphi study with experts by experience.

    Science.gov (United States)

    Law, Heather; Morrison, Anthony P

    2014-11-01

    This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  14. Prevention and control of bovine cysticercosis: a Delphi study

    Directory of Open Access Journals (Sweden)

    Elizandro Pruence Nickele

    2016-12-01

    Full Text Available Bovine cysticercosis is a zoonotic parasitic infection caused by the larval stage (Cysticercus bovis of Taenia saginata. This study aimed to identify prevention and control measures for bovine cysticercosis indicated by experts in the fields of public and animal health. The study was conducted through three rounds of the Delphi method and had the participation of 44 experts from 13 Brazilian states in 30 educational institutions, research institutions, and sanitary inspection services. The first round comprised an open question, the answers to which formed the basis for structuring the second and third questionnaire. To reach a consensus in the second and third rounds, experts were asked to express their agreement or disagreement of each proposition on the questionnaire using a five-point Likert scale. A descriptive statistical analysis was performed at the end of each round. Twenty-three specialists (52.27% participated in all three rounds. The first round resulted in 28 proposals categorized into six areas: health education, methods of diagnosis and treatment, sanitation measures, epidemiological studies, legislation and sanitary supervision, and intersectorality. In the second round, the experts reached a consensus on 16 propositions (57.14%. This percentage increased by 3.54% during the third round. At the end of the third round, the experts had reached a consensus on 17 of the 28 initial propositions (60.71%. The highest percentage of agreement (29.4% was observed in the category of health education. This study allowed us to identify 17 recommendations pertaining to the prevention and control of bovine cysticercosis. These measures are not mutually exclusive, and require an integrated approach to the establishment of intervention actions at various points in the life cycle of the parasite.

  15. A checklist to assess the quality of reports on spa therapy and balneotherapy trials was developed using the Delphi consensus method: the SPAC checklist.

    Science.gov (United States)

    Kamioka, Hiroharu; Kawamura, Yoichi; Tsutani, Kiichiro; Maeda, Masaharu; Hayasaka, Shinya; Okuizum, Hiroyasu; Okada, Shinpei; Honda, Takuya; Iijima, Yuichi

    2013-08-01

    The purpose of this study was to develop a checklist of items that describes and measures the quality of reports of interventional trials assessing spa therapy. The Delphi consensus method was used to select the number of items in the checklist. A total of eight individuals participated, including an epidemiologist, a clinical research methodologist, clinical researchers, a medical journalist, and a health fitness programmer. Participants ranked on a 9-point Likert scale whether an item should be included in the checklist. Three rounds of the Delphi method were conducted to achieve consensus. The final checklist contained 19 items, with items related to title, place of implementation (specificity of spa), care provider influence, and additional measures to minimize the potential bias from withdrawals, loss to follow-up, and low treatment adherence. This checklist is simple and quick to complete, and should help clinicians and researchers critically appraise the medical and healthcare literature, reviewers assess the quality of reports included in systematic reviews, and researchers plan interventional trials of spa therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach

    Directory of Open Access Journals (Sweden)

    Augestad KM

    2014-09-01

    Full Text Available Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 4Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs' EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £ to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670 and 37 (range 29–49 referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to

  17. Optimizing the pre-referral workup for gastroenterology and hepatology specialty care: consensus using the Delphi method.

    Science.gov (United States)

    Ho, Chanda K; Boscardin, Christy K; Gleason, Nathaniel; Collado, Don; Terdiman, Jonathan; Terrault, Norah A; Gonzales, Ralph

    2016-02-01

    Specialty care referrals have doubled in the last decade. Optimization of the pre-referral workup by a primary care doctor can lead to a more efficient first specialty visit with the patient. Guidance regarding pre-referral laboratory testing is a first step towards improving the specialty referral process. Our aim was to establish consensus regarding appropriate pre-referral workup for common gastrointestinal and liver conditions. The Delphi method was used to establish local consensus for recommending certain laboratory tests prior to specialty referral for 13 clinical conditions. Seven conditions from The University of Michigan outpatient referral guidelines were used as a baseline. An expert panel of three PCPs and nine gastroenterologists from three academic hospitals participated in three iterative rounds of electronic surveys. Each panellist ranked each test using a 5-point Likert scale (strongly disagree to strongly agree). Local panellists could recommend additional tests for the initial diagnoses, and also recommended additional diagnoses needing guidelines: iron deficiency anaemia, abdominal pain, irritable bowel syndrome, fatty liver disease, liver mass and cirrhosis. Consensus was defined as ≥70% of experts scoring ≥4 (agree or strongly agree). Applying Delphi methodology to extrapolate externally developed referral guidelines for local implementation resulted in considerable modifications. For some conditions, many tests from the external group were eliminated by the local group (abdominal bloating; iron deficiency anaemia; irritable bowel syndrome). In contrast, for chronic diarrhoea, abnormal liver enzymes and viral hepatitis, all/most original tests were retained with additional tests added. For liver mass, fatty liver disease and cirrhosis, there was high concordance among the panel with few tests added or eliminated. Consideration of externally developed referral guidelines using a consensus-building process leads to significant local

  18. Identification of the Competencies Needed to Apply Social Marketing to Extension Programming: Results of a Delphi Study

    Science.gov (United States)

    Warner, Laura A.; Stubbs, Eric; Murphrey, Theresa Pesl; Huynh, Phuong

    2016-01-01

    The purpose of this study was to identify the specific competencies needed to apply social marketing, a promising approach to behavior change, to Extension programming. A modified Delphi study was used to achieve group consensus among a panel of experts on the skills, characteristics, and knowledge needed to successfully apply this behavior change…

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

    Science.gov (United States)

    Craig, Catherine; Posner, Glenn D

    2017-09-01

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

  20. Neonatal palliative care: developing consensus among neonatologists using the Delphi technique in Portugal.

    Science.gov (United States)

    Mendes, Joana C C; Justo da Silva, Lincoln

    2013-12-01

    Pediatric palliative care in Portugal is improving, but there is still additional work to do concerning programs or guidelines for this subject. In Portugal, physicians are the stakeholders in the decision-making process with reference to the transition to palliative care in the neonatal intensive care unit, and it was considered very important to raise their awareness and motivation about neonatal palliative care. Our research was based on Catlin and Carter's protocol from 2002 and the main goal was to assess neonatologists' willingness to build a palliative care and end-of-life protocol that could be acceptable nationwide. The survey used the Delphi technique and was developed in 3 rounds. The expert panel was composed of 57 participants who represented 41% of the Portuguese neonatologists. The study was conducted via the Internet, based in a researcher-created private Web site, and e-mail was used for data collection and feedback. Neonatologists agreed on 7 areas: (1) planning (medical education, resources, and local), (2) prenatal palliative care, (3) neonatal palliative care criteria, (4) the parents (presenting neonatal palliative care to parents, including then in the daily care of newborns and in family-centered care), (5) physicians' needs, (6) pain and symptom management, and (7) end-of-life care (withholding/withdrawing ventilation and hydration/nutrition).

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

    Science.gov (United States)

    Eggers, Renee M.; Jones, Charles M.

    1998-01-01

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

  2. AQUILA: assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty

    NARCIS (Netherlands)

    Pijls, Bart G.; Dekkers, Olaf M.; Middeldorp, Saskia; Valstar, Edward R.; van der Heide, Huub J. L.; van der Linden-van der Zwaag, Henrica M. J.; Nelissen, Rob G. H. H.

    2011-01-01

    In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist for reporting

  3. AQUILA : Assessment of quality in lower limb arthroplasty. An expert Delphi consensus for total knee and total hip arthroplasty

    NARCIS (Netherlands)

    Pijls, B.G.; Dekkers, O.M.; Middeldorp, S.; Valstar, E.R.; Van der Heide, H.J.L.; Van der Linden-Van der Zwaag, H.M.J.; Nelissen, R.G.H.H.

    2011-01-01

    Background: In the light of both the importance and large numbers of case series and cohort studies (observational studies) in orthopaedic literature, it is remarkable that there is currently no validated measurement tool to appraise their quality. A Delphi approach was used to develop a checklist

  4. Selection processes in a Delphi study about key qualifications in Senior Secondary Vocational Education

    NARCIS (Netherlands)

    Zolingen, S.J. van; Klaassen, C.A.C.

    2003-01-01

    The focus of this study is the Delphi method. First, a short history of the Delphi method is given. Then, different types of the Delphi method are described, and the validity and reliability of the Delphi method are discussed. Finally, this study reports on the selection processes and assessments

  5. Defining contagion literacy: a Delphi study

    Science.gov (United States)

    Kilstadius, Margareta; Gericke, Niklas

    2017-11-01

    Against the background of climate change, which enables infectious diseases to move their frontiers and the increasing global mobility, which make people more exposed to contagion, we as citizens need to relate to this new scenario. A greater number of infectious diseases may also potentially lead to an increased need to use antibiotics and anti-parasitic substances. In view of this, the aim of this study was to identify the health literacy needed in the contemporary world and specify what should be taught in compulsory school. We present the findings of a Delphi study, performed in Sweden, regarding the opinions on contagion among experts in the field. We used Nutbeam's framework of health literacy and related it to Bloom's taxonomy of educational objectives in order to analyse and categorise the experts' responses, which were categorised into six main content themes: contagions, transmission routes, sexually transmitted diseases, hygiene, vaccinations and use of antibiotics and antibiotic resistance. These themes were then divided into the three levels of Nutbeam's framework: functional health literacy, which is about knowledge and understanding, interactive health literacy, which is about developing personal qualities and skills that promote health, and critical health literacy, which is about social and cognitive skills related to analysis and critical reflection. The implications for communication and education are then discussed and what should be taught in compulsory school is identified.

  6. Competencies required for nursing telehealth activities: A Delphi-study.

    Science.gov (United States)

    van Houwelingen, Cornelis T M; Moerman, Anna H; Ettema, Roelof G A; Kort, Helianthe S M; Ten Cate, Olle

    2016-04-01

    Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach full utilization. A better understanding of nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies can contribute to the development of nursing telehealth education. In a four-round Delphi-study, a panel of experts discussed which NT-EPAs are relevant for nurses and which competencies nurses need to possess to execute these activities effectively. The 51 experts, including nurses, nursing faculty, clients and technicians all familiar with telehealth, were asked to select items from a list of 52 competencies based on the literature and on a previous study. Additionally, the panelists could add competencies based on their experience in practice. The threshold used for consensus was set at 80%. Consensus was achieved on the importance of fourteen NT-EPAs, requiring one or more of the following core competencies; coaching skills, the ability to combine clinical experience with telehealth, communication skills, clinical knowledge, ethical awareness, and a supportive attitude. Each NT-EPA requires a specific set of competencies (at least ten). In total, 52 competencies were identified as essential in telehealth. Many competencies for telehealth, including clinical knowledge and communication skills, are not novel competencies. They are fundamental to nursing care as a whole and therefore are also indispensable for telehealth. Additionally, the fourteen NT-EPAs appeared to require additional subject specific competencies, such as the ability to put patients at ease when they feel insecure about using technology. The NT-EPAs and related competencies presented in this study can be used by nursing schools that are considering including or expanding

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

    Science.gov (United States)

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

    2017-02-01

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

  8. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

    Science.gov (United States)

    Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

    2016-06-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  9. A Delphi Study on Staff Bereavement Training in the Intellectual and Developmental Disabilities Field

    Science.gov (United States)

    Gray, Jennifer A.; Truesdale, Jesslyn

    2015-01-01

    The Delphi technique was used to obtain expert panel consensus to prioritize content areas and delivery methods for developing staff grief and bereavement curriculum training in the intellectual and developmental disabilities (IDD) field. The Delphi technique was conducted with a panel of 18 experts from formal and informal disability caregiving,…

  10. Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project

    NARCIS (Netherlands)

    Zondervan, P. J.; Wagstaff, P. G. K.; Desai, M. M.; de Bruin, D. M.; Fraga, A. F.; Hadaschik, B. A.; Köllermann, J.; Liehr, U. B.; Pahernik, S. A.; Schlemmer, H. P.; Wendler, J. J.; Algaba, F.; de la Rosette, J. J. M. C. H.; Laguna Pes, M. P.

    2016-01-01

    To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research. Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among

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

    Science.gov (United States)

    Bini, Stefano A; Mahajan, John

    2016-11-01

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

  12. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice: a modified Delphi study

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

    2010-01-01

    was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients......OBJECTIVE: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice. DESIGN: A modified 2-round Delphi study. SETTING: General practice. SUBJECTS: A panel of 27 experts (13 countries) comprising mainly general practitioners...

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

    Science.gov (United States)

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

    2017-07-01

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

  14. Determinants of innovation within health care organizations: literature review and Delphi study.

    Science.gov (United States)

    Fleuren, Margot; Wiefferink, Karin; Paulussen, Theo

    2004-04-01

    When introducing innovations to health care, it is important to gain insight into determinants that may facilitate or impede the introduction, in order to design an appropriate strategy for introducing the innovation. To obtain an overview of determinants of innovations in health care organizations, we carried out a literature review and a Delphi study. The Delphi study was intended to achieve consensus among a group of implementation experts on determinants identified from the literature review. We searched 11 databases for articles published between 1990 and 2000. The keywords varied according to the specific database. We also searched for free text. Forty-four implementation experts (implementation researchers, programme managers, and implementation consultants/advisors) participated in the Delphi study. The following studies were selected: (i) studies describing innovation processes, and determinants thereof, in health care organizations; (ii) studies where the aim of the innovations was to change the behaviour of health professionals; (iii) studies where the health care organizations provided direct patient care; and (iv) studies where only empirical studies were included. Two researchers independently selected the abstracts and analysed the articles. The determinants were divided into four categories: characteristics of the environment, characteristics of the organization, characteristics of the user (health professional), and characteristics of the innovation. When analysing the determinants, a distinction was made between systematically designed and non-systematically designed studies. In a systematic study, a determinant analysis was performed and the innovation strategy was adapted to these determinants. Furthermore, the determinants were associated with the degree of implementation, and both users and non-users of the innovation were asked about possible determinants. In the Delphi study, consensus was defined as agreement among 75% of the experts on

  15. Which Behavior Change Techniques May Help Waterpipe Smokers to Quit? An Expert Consensus Using a Modified Delphi Technique.

    Science.gov (United States)

    O'Neill, Nancy; Dogar, Omara; Jawad, Mohammed; Kellar, Ian; Kanaan, Mona; Siddiqi, Kamran

    2018-01-05

    Waterpipe smoking is addictive and harmful. The determinants of waterpipe smoking may differ from those of cigarette smoking; therefore, behavioral approaches to support quitting may also differ between these two tobacco products. While some evidence exists on effective behavioral change techniques (BCTs) to facilitate cigarette smoking cessation, there is little research on waterpipe smoking cessation. Twenty-four experts were selected from the author lists of peer-reviewed, randomized controlled trials on waterpipe smoking cessation. They were invited to two rounds of a consensus development exercise using modified Delphi technique. Experts ranked 55 BCTs categorized further into those that promote; "awareness of harms of waterpipe smoking and advantages of quitting" (14), "preparation and planning to quit" (29), and "relapse prevention and sustaining an ex-smoker identity" (12) on their potential effectiveness. Kendall's W statistics was used to assess agreement. Fifteen experts responded in round 1 and 14 completed both rounds. A strong consensus was achieved for BCTs that help in "relapse prevention and sustaining ex-smoker identity" (w = 0.7; p consequences of waterpipe smoking and its cessation, assessing readiness and ability to quit, and making people aware of the withdrawal symptoms, were the three highest-ranking BCTs. Based on expert consensus, an inventory of BCTs ordered for their potential effectiveness can be useful for health professionals offering cessation support to waterpipe smokers. Waterpipe smoking is addictive, harmful, and gaining global popularity, particularly among youth. An expert consensus on behavior change techniques, likely to be effective in supporting waterpipe smokers to quit, has practice and research implications. Smoking cessation advisors can use these techniques to counsel waterpipe smokers who wish to quit. Behavioral and public health scientists can also use these to develop and evaluate behavioral support interventions

  16. Towards consensus in operational definitions in functional capacity evaluation: A Delphi survey

    NARCIS (Netherlands)

    Soer, R.; Van Der Schans, C.; Groothoff, J.; Geertzen, J.; Reneman, M.

    2009-01-01

    Background: The problem of inconsistent terminology in Functional Capacity Evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. Objective: To gain consensus in

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Determining Possible Professionals and Respective Roles and Responsibilities for a Model Comprehensive Elder Abuse Intervention: A Delphi Consensus Survey.

    Directory of Open Access Journals (Sweden)

    Janice Du Mont

    Full Text Available We have undertaken a multi-phase, multi-method program of research to develop, implement, and evaluate a comprehensive hospital-based nurse examiner elder abuse intervention that addresses the complex functional, social, forensic, and medical needs of older women and men. In this study, we determined the importance of possible participating professionals and respective roles and responsibilities within the intervention.Using a modified Delphi methodology, recommended professionals and their associated roles and responsibilities were generated from a systematic scoping review of relevant scholarly and grey literatures. These items were reviewed, new items added for review, and rated/re-rated for their importance to the intervention on a 5-point Likert scale by an expert panel during a one day in-person meeting. Items that did not achieve consensus were subsequently re-rated in an online survey.Those items that achieved a mean Likert rating of 4+ (rated important to very important, and an interquartile range<1 in the first or second round, and/or for which 80% of ratings were 4+ in the second round were retained for the model elder abuse intervention.Twenty-two of 31 recommended professionals and 192 of 229 recommended roles and responsibilities rated were retained for our model elder abuse intervention. Retained professionals were: public guardian and trustee (mean rating = 4.88, geriatrician (4.87, police officer (4.87, GEM (geriatric emergency management nurse (4.80, GEM social worker (4.78, community health worker (4.76, social worker/counsellor (4.74, family physician in community (4.71, paramedic (4.65, financial worker (4.59, lawyer (4.59, pharmacist (4.59, emergency physician (4.57, geriatric psychiatrist (4.33, occupational therapist (4.29, family physician in hospital (4.28, Crown prosecutor (4.24, neuropsychologist (4.24, bioethicist (4.18, caregiver advocate (4.18, victim support worker (4.18, and respite care worker (4.12.A large and

  19. Determining Possible Professionals and Respective Roles and Responsibilities for a Model Comprehensive Elder Abuse Intervention: A Delphi Consensus Survey

    Science.gov (United States)

    Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark

    2015-01-01

    Objective We have undertaken a multi-phase, multi-method program of research to develop, implement, and evaluate a comprehensive hospital-based nurse examiner elder abuse intervention that addresses the complex functional, social, forensic, and medical needs of older women and men. In this study, we determined the importance of possible participating professionals and respective roles and responsibilities within the intervention. Methods Using a modified Delphi methodology, recommended professionals and their associated roles and responsibilities were generated from a systematic scoping review of relevant scholarly and grey literatures. These items were reviewed, new items added for review, and rated/re-rated for their importance to the intervention on a 5-point Likert scale by an expert panel during a one day in-person meeting. Items that did not achieve consensus were subsequently re-rated in an online survey. Analysis Those items that achieved a mean Likert rating of 4+ (rated important to very important), and an interquartile rangeelder abuse intervention. Results Twenty-two of 31 recommended professionals and 192 of 229 recommended roles and responsibilities rated were retained for our model elder abuse intervention. Retained professionals were: public guardian and trustee (mean rating = 4.88), geriatrician (4.87), police officer (4.87), GEM (geriatric emergency management) nurse (4.80), GEM social worker (4.78), community health worker (4.76), social worker/counsellor (4.74), family physician in community (4.71), paramedic (4.65), financial worker (4.59), lawyer (4.59), pharmacist (4.59), emergency physician (4.57), geriatric psychiatrist (4.33), occupational therapist (4.29), family physician in hospital (4.28), Crown prosecutor (4.24), neuropsychologist (4.24), bioethicist (4.18), caregiver advocate (4.18), victim support worker (4.18), and respite care worker (4.12). Conclusion A large and diverse group of multidisciplinary, intersectoral collaborators was

  20. Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process

    Science.gov (United States)

    2014-01-01

    Background Through the World Health Assembly Resolution, ‘Health of Migrants’, the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. Methods This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. Results A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created - the Migrant Friendly Maternity Care Questionnaire (MFMCQ) – in three languages (English, French and Spanish). It is

  1. Development of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process.

    Science.gov (United States)

    Gagnon, Anita J; DeBruyn, Rebecca; Essén, Birgitta; Gissler, Mika; Heaman, Maureen; Jeambey, Zeinab; Korfker, Dineke; McCourt, Christine; Roth, Carolyn; Zeitlin, Jennifer; Small, Rhonda

    2014-06-10

    Through the World Health Assembly Resolution, 'Health of Migrants', the international community has identified migrant health as a priority. Recommendations for general hospital care for international migrants in receiving-countries have been put forward by the Migrant Friendly Hospital Initiative; adaptations of these recommendations specific to maternity care have yet to be elucidated and validated. We aimed to develop a questionnaire measuring migrant-friendly maternity care (MFMC) which could be used in a range of maternity care settings and countries. This study was conducted in four stages. First, questions related to migrant friendly maternity care were identified from existing questionnaires including the Migrant Friendliness Quality Questionnaire, developed in Europe to capture recommended general hospital care for migrants, and the Mothers In a New Country (MINC) Questionnaire, developed in Australia and revised for use in Canada to capture the maternity care experiences of migrant women, and combined to create an initial MFMC questionnaire. Second, a Delphi consensus process in three rounds with a panel of 89 experts in perinatal health and migration from 17 countries was undertaken to identify priority themes and questions as well as to clarify wording and format. Third, the draft questionnaire was translated from English to French and Spanish and back-translated and subsequently culturally validated (assessed for cultural appropriateness) by migrant women. Fourth, the questionnaire was piloted with migrant women who had recently given birth in Montreal, Canada. A 112-item questionnaire on maternity care from pregnancy, through labour and birth, to postpartum care, and including items on maternal socio-demographic, migration and obstetrical characteristics, and perceptions of care, has been created--the Migrant Friendly Maternity Care Questionnaire (MFMCQ)--in three languages (English, French and Spanish). It is completed in 45 minutes via interview

  2. Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study.

    Science.gov (United States)

    Manzano-García, Guadalupe; Ayala, Juan-Carlos

    2017-01-01

    This study aimed to identify potentially important factors in explaining burnout in nursing that have been insufficiently studied or ignored. A three-round Delphi study via e-mail correspondence was conducted, with a group of 40 European experts. The e-Delphi questionnaire consisted of 52 factors identified from a literature review. Experts rated and scored the importance of factors in the occurrence of burnout and the degree of attention given by researchers to each of the variables listed, on a six-point Likert scale. We used the agreement percentage (>80%) to measure the level of consensus between experts. Furthermore, to confirm the level of consensus, we also calculated mean scores and modes. Regardless of the degree of consensus reached by the experts, we have calculated the mean of the stability of the answers for each expert (individual's qualitative stability) and the mean of the stability percentages of the experts (qualitative group stability). The response rate in the three rounds was 93.02% (n = 40). Eight new factors were suggested in the first round. After modified, the e-Delphi questionnaire in the second and third rounds had 60 factors. All the factors reached the third round with a consensus level above 80% in terms of the attention that researchers gave them in their studies. Moreover, the data show a total mean qualitative group stability of 96.21%. In the third round 9 factors were classified by experts as 'studied very little', 17 as 'studied little' and 34 as 'well studied'. Findings show that not all the factors that may influence nursing burnout have received the same attention from researchers. The panel of experts has identified factors that, although important in explaining burnout, have been poorly studied or even forgotten. Our results suggest that further study into factors such as a lack of recognition of part of the tasks that nurses perform, feminine stereotype or excessive bureaucracy is needed for a better understanding of this

  3. Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study.

    Directory of Open Access Journals (Sweden)

    Guadalupe Manzano-García

    Full Text Available This study aimed to identify potentially important factors in explaining burnout in nursing that have been insufficiently studied or ignored.A three-round Delphi study via e-mail correspondence was conducted, with a group of 40 European experts. The e-Delphi questionnaire consisted of 52 factors identified from a literature review. Experts rated and scored the importance of factors in the occurrence of burnout and the degree of attention given by researchers to each of the variables listed, on a six-point Likert scale. We used the agreement percentage (>80% to measure the level of consensus between experts. Furthermore, to confirm the level of consensus, we also calculated mean scores and modes. Regardless of the degree of consensus reached by the experts, we have calculated the mean of the stability of the answers for each expert (individual's qualitative stability and the mean of the stability percentages of the experts (qualitative group stability.The response rate in the three rounds was 93.02% (n = 40. Eight new factors were suggested in the first round. After modified, the e-Delphi questionnaire in the second and third rounds had 60 factors. All the factors reached the third round with a consensus level above 80% in terms of the attention that researchers gave them in their studies. Moreover, the data show a total mean qualitative group stability of 96.21%. In the third round 9 factors were classified by experts as 'studied very little', 17 as 'studied little' and 34 as 'well studied'.Findings show that not all the factors that may influence nursing burnout have received the same attention from researchers. The panel of experts has identified factors that, although important in explaining burnout, have been poorly studied or even forgotten. Our results suggest that further study into factors such as a lack of recognition of part of the tasks that nurses perform, feminine stereotype or excessive bureaucracy is needed for a better

  4. Insufficiently studied factors related to burnout in nursing: Results from an e-Delphi study

    Science.gov (United States)

    2017-01-01

    Objective This study aimed to identify potentially important factors in explaining burnout in nursing that have been insufficiently studied or ignored. Methods A three-round Delphi study via e-mail correspondence was conducted, with a group of 40 European experts. The e-Delphi questionnaire consisted of 52 factors identified from a literature review. Experts rated and scored the importance of factors in the occurrence of burnout and the degree of attention given by researchers to each of the variables listed, on a six-point Likert scale. We used the agreement percentage (>80%) to measure the level of consensus between experts. Furthermore, to confirm the level of consensus, we also calculated mean scores and modes. Regardless of the degree of consensus reached by the experts, we have calculated the mean of the stability of the answers for each expert (individual's qualitative stability) and the mean of the stability percentages of the experts (qualitative group stability). Results The response rate in the three rounds was 93.02% (n = 40). Eight new factors were suggested in the first round. After modified, the e-Delphi questionnaire in the second and third rounds had 60 factors. All the factors reached the third round with a consensus level above 80% in terms of the attention that researchers gave them in their studies. Moreover, the data show a total mean qualitative group stability of 96.21%. In the third round 9 factors were classified by experts as ‘studied very little’, 17 as ‘studied little’ and 34 as 'well studied' Conclusion Findings show that not all the factors that may influence nursing burnout have received the same attention from researchers. The panel of experts has identified factors that, although important in explaining burnout, have been poorly studied or even forgotten. Our results suggest that further study into factors such as a lack of recognition of part of the tasks that nurses perform, feminine stereotype or excessive bureaucracy is

  5. Priorities in public relations research: An international Delphi study

    OpenAIRE

    Watson, Tom

    2008-01-01

    A Delphi study on the priorities for public relations research, conducted in 2007 amongst\\ud academics, practitioners and senior executives of professional and industry bodies in five\\ud continents, has ranked the ten most important topics for research and proposed the associated\\ud research questions. This is the first completed Delphi study into public relations research since\\ud Synnott and McKie (1997) which was itself a development of earlier studies of this type by\\ud McElreath (1980, 1...

  6. Reporting outcomes of back pain trials: a modified Delphi study

    DEFF Research Database (Denmark)

    Froud, R.; Eldridge, S.; Kovacs, F.

    2011-01-01

    trials. METHODS: We presented experts with clinicians' views on different reporting methods and asked them to rate and comment on the suitability reporting methods for inclusion in a standardized set. Panellists developed a statement of recommendation over three online rounds. We used a modified Delphi......BACKGROUND: Low back pain is a common and expensive health complaint. Many low back pain trials have been conducted, but these are reported in a variety of ways and are often difficult to interpret. AIM: To facilitate consensus on a statement recommending reporting methods for future low back pain...... process and the RAND/UCLA appropriateness method as a formal framework for establishing appropriateness and quantifying panel disagreement. RESULTS: A group of 63 experts from 14 countries participated. Consensus was reached on a statement recommending that the continuous patient-reported outcomes...

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  9. A web-based delphi study for eliciting helpful criteria in the positive diagnosis of hemophagocytic syndrome in adult patients.

    Science.gov (United States)

    Hejblum, Gilles; Lambotte, Olivier; Galicier, Lionel; Coppo, Paul; Marzac, Christophe; Aumont, Cédric; Fardet, Laurence

    2014-01-01

    The diagnosis of the reactive form of hemophagocytic syndrome in adults remains particularly difficult since none of the clinical or laboratory manifestations are specific. We undertook a study in order to elicit which features constitute helpful criteria for a positive diagnosis. In this Delphi study, the features investigated in the questionnaire and the experts invited to participate in the survey were issued from a bibliographic search. The questionnaire was iteratively proposed to experts via a web-based application with a feedback of the results observed at the preceding Delphi round. Experts were asked to label each investigated criterion in one of the following categories: absolutely required, important, of minor interest, or not assessable in the routine practice environment. A positive consensus was a priori defined as at least 75% answers observed in the categories absolutely required and important. The questionnaire investigated 26 criteria and 24 experts originating from 13 countries participated in the second and final Delphi round. A positive consensus was reached for the nine following criteria: unilineage cytopenia, bicytopenia, pancytopenia, presence of hemophagocytosis pictures on a bone marrow aspirate or on a tissue biopsy, high ferritin level, fever, organomegaly, presence of a predisposing underlying disease, and high level of lactate dehydrogenase. A negative consensus was reached for 13 criteria, and an absence of consensus was observed for 4 criteria. The study constitutes the first initiative to date for defining international guidelines devoted to the positive diagnosis of the reactive form of hemophagocytic syndrome.

  10. Radiographer managers and service development: A Delphi study to determine an MRI service portfolio for year 2020

    International Nuclear Information System (INIS)

    Castillo, J.; Caruana, C.J.; Morgan, P.S.; Westbrook, C.

    2015-01-01

    Purpose: As high quality CPD courses become increasingly expensive and time off for radiographers progressively limited, it is important that CPD content be aligned to forecasted service portfolio development. When such a portfolio has not been developed locally the CPD planner should carry out an own forecasting exercise. The purpose of the study was to develop a 2020 MRI service portfolio using a Delphi study. Methods and materials: MRI stakeholder experts participated in a first Delphi round based on semi-structured interviews. The interviews were analysed thematically leading to a series of statements for a second Delphi round. Level of agreement was assessed as the median value on a 6 point Likert scale ranging from 1 (complete disagreement) to 6 (complete agreement), the level of consensus was assessed using the interquartile range (IQR). Consensus was defined as IQR ≤ 1. Results: Very strong agreement and consensus (median 6, IQR ≤ 1) was obtained for maintaining current service catalogue and introduction of breast biopsies, cardiac studies, ISO standards, referral guidelines, and departmental policies aligned to EU regulations. Strong agreement and consensus (median 5, IQR ≤ 1) was obtained for introduction of tumour assessment, tractography, elastography, enterography. The level of consensus was low (IQR ≥ 1) regarding research, 3T MRI, outsourcing, prostate screening and certification for MRI referral privileges. Conclusion: The multi stakeholder approach adopted ensured that the proposed service portfolio would be suitable for local healthcare needs. Although the methodology has been applied to MRI it could easily be adapted to any imaging modality. - Highlights: • A Delphi study was successfully used to forecast MRI service portfolio for year 2020. • The service portfolio determines the competences required by radiographers. • The service portfolio has helped in decision making to introduce waiting list initiatives. • Protocols

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

    Directory of Open Access Journals (Sweden)

    Aarts Marie-Jeanne

    2011-12-01

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

  12. Future Directions for Business Education: A Delphi Study

    Science.gov (United States)

    Kesten, Cyril A.; Lambrecht, Judith J.

    2010-01-01

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

  13. Updating the School Counseling Research Agenda: A Delphi Study

    Science.gov (United States)

    Villares, Elizabeth; Dimmitt, Carey

    2017-01-01

    The authors updated an earlier Delphi study identifying the research priorities for school counseling (Dimmitt et al., 2005). A 29-member expert panel selected research questions from the prior study, generated new questions, and rank ordered the combined set. The results provide guidance for prioritizing dissertation topics, targeting future…

  14. An international Delphi study examining health promotion and health education in nursing practice, education and policy.

    Science.gov (United States)

    Whitehead, Dean

    2008-04-01

    To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. A two-round Delphi technique via email correspondence. A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' This study provides a hitherto

  15. What is a good result after clubfoot treatment? A Delphi-based consensus on success by regional clubfoot trainers from across Africa.

    Directory of Open Access Journals (Sweden)

    Tracey Smythe

    Full Text Available Congenital talipes equino-varus (CTEV, also known as clubfoot, is one of the most common congenital musculoskeletal malformations. Despite this, considerable variation exists in the measurement of deformity correction and outcome evaluation. This study aims to determine the criteria for successful clubfoot correction using the Ponseti technique in low resource settings through Africa.Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an 'acceptable or good clubfoot correction' at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC. From the original 22 criteria, ten criteria with a mean score >7 and SD 9 and SD<1.5.The consensus definition of a successfully treated clubfoot includes: (1 a plantigrade foot, (2 the ability to wear a normal shoe, (3 no pain, and (4 the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97.The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.

  16. A delphi study on health in future India.

    Science.gov (United States)

    Rohatgi, K; Rohatgi, P K

    1980-07-01

    A delphi study was conducted to identify or envision health scenarios in India by the year 2000. Questionnaires consisting of 48 questions on 5 areas (diagnosis and therapy; family planning; pharmaceuticals and drugs; biochemical and biomedical research; health services) were mailed to 250 experts in India. 36 responded. Results were compiled and mailed back to the respondents for changes and comments. 17 people responded. Results of the delphi study shows that policy decisions with respect to compulsory family planning as well as health education at secondary school level will precede further breakthroughs in birth control technology. Non operation reversible sterilization procedures, immunological birth control, Ayurvedic medicines for contraception and abortion, and selection of baby's sex are all possible by 2000 thereafter. Complete eradication of infectious diseases, malnutrition and associated diseases is considered unlikely before 2000, as are advances in biomedical research. Changes in health services (e.g., significant increases in hospital beds and doctors, cheap bulk drugs), particularly in rural areas, are imminent, leading to prolonging of life expectancy to 70 years. Genetic engineering may provide significant breakthroughs in the prevention of malignancies and cardiac disorders. The India delphi study is patterned after a similar delphi study conducted in the U.S. by Smith, Kline and French (SKF) Laboratories in 1968. The SKF study was able to predict some breakthroughs with basic research which have been realized.

  17. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    Science.gov (United States)

    Townsend, Lori; Hofer, Amy R.; Hanick, Silvia Lin; Brunetti, Korey

    2016-01-01

    This study used the Delphi method to engage expert practitioners on the topic of threshold concepts--core ideas and processes in a discipline that students need to grasp in order to progress in their learning, but that are often unspoken or unrecognized by expert practitioners--for information literacy. A panel of experts considered two questions:…

  18. Helping Competencies of Student Affairs Professionals: A Delphi Study

    Science.gov (United States)

    Reynolds, Amy L.

    2011-01-01

    The purpose of this study was to gather student affairs professionals' perceptions of the knowledge and skills needed to effectively help students. Using the Delphi method, 159 entry-level and mid-level student affairs administrators from institutions across the United States were surveyed regarding their perceptions of the helping skills they use…

  19. The Delphi Method as a Useful Tool to Study Governance and Protected Areas?

    NARCIS (Netherlands)

    Mehnen, Nora; Mose, Ingo; Strijker, Dirk

    2013-01-01

    The Delphi method is a systematic, interactive, written method, which relies on a panel of experts. This paper seeks to discuss whether the Delphi method is an appropriate method for obtaining information about governance. In this study we used the Delphi method to assemble information from 10

  20. Analytical search of problems and prospects of power sector through Delphi study: case study of Kerala State, India

    International Nuclear Information System (INIS)

    Sharma, D.P.; Nair, P.S. Chandramohanan; Balasubramanian, R.

    2003-01-01

    This study attempts to review and analyse the critical issues that afflict the power sector of Kerala, a developing State in India. For this purpose a Delphi study, contacting experts in the field was conducted. The paper illustrates the process followed for the conduct of Delphi survey and evaluates the responses obtained. Consensus among experts could be arrived at on various issues related to Kerala power sector in two rounds of Delphi survey. The expert-opinion concluded on various issues is discussed in the context of the present energy shortage faced by the State. The experts participated in the Delphi survey unanimously stressed on the urgent need for an integrated approach in the power sector planning process of the State. They also emphasised on the imperativeness for exploiting the demand side management potential of the State to alleviate energy crisis in future. The study fetched informative and revealing results, which may aid to formulate and review future planning strategies for the expansion of power sector of the State

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

    Science.gov (United States)

    Mascherek, Anna C; Schwappach, David L B

    2016-08-05

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

  2. Determinants of Social Accountability in Iranian Nursing and Midwifery Schools: A Delphi Study

    Directory of Open Access Journals (Sweden)

    Amir Reza Salehmoghaddam

    2017-04-01

    Full Text Available Background: Revising the medical education programs to meet the needs of society has become both a necessity and an important priority due to the considerable increase of population, changing patterns of diseases, and new health priorities. While this necessity has been highlighted in Iran’s Fifth Development Plan as well as its National 2025 Vision Plan, the determinants of social accountability have not been explained yet. This study aimed to develop determinants of social accountability in the Iranian Nursing and Midwifery Schools. Methods: This classic Delphi study included thirty experts in Nursing and Midwifery Education, Research and Services selected based on purposive sampling and three rounds of Delphi technique and conducted in Nursing and Midwifery School of Mashhad University of Medical Sciences. The primary data were collected using an initial structured questionnaire prepared through extensive review of literature. SPSS 11.5 software was used to analyze the data. The interquartile deviation and percentage of agreement were also used to study the consensus of opinion by experts. Results: Finding obtained from the rounds of Delphi resulted in selecting 69 determinants out of the initial pool of 128 primary determinants of social accountability. The items were selected based on experts’ consensus and categorized under three main activities of Nursing and Midwifery School, namely education, research, and service. Conclusion: Social accountability determinants were explained by 69 items for Schools of Nursing and Midwifery in Iran. The proposed determinants can be used by managers and authorities of Nursing and Midwifery School, policy makers, and evaluating institutions associated with them to ensure realizing social accountability goals.

  3. Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends - a Delphi method study

    Directory of Open Access Journals (Sweden)

    Bisoffi Zeno

    2011-05-01

    Full Text Available Abstract Background Numbers of travellers visiting friends and relatives (VFRs from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. Methods European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. Results The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. Conclusions Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.

  4. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    Science.gov (United States)

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  5. Educational needs of reproductive health students: A Delphi study

    OpenAIRE

    N Yamani; M Shakour; S Ehsanpour

    2013-01-01

    Introduction: The importance of reproductive health led to establish the MSc in reproductive health program in developed country. In Iran, the program has not been offered yet. The aim of this study was to assess educational needs of MSc program in reproductive health. Methods: This research used Delphi method. Fifteen experts in reproductive health from Iran participated in this study. First, we provided a list of educational needs for every task, then experts confirmed or rejected education...

  6. Verification of a quality management theory: using a delphi study.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2013-11-01

    A model of quality management called Strategic Collaborative Quality Management (SCQM) model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. The proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement. The research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. A proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence.

  7. Verification of a Quality Management Theory: Using a Delphi Study

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2013-11-01

    Full Text Available BackgroundA model of quality management called Strategic Collaborative Quality Management (SCQM model was developed based on the quality management literature review, the findings of a survey on quality management assessment in healthcare organisations, semi-structured interviews with healthcare stakeholders, and a Delphi study on healthcare quality management experts. The purpose of this study was to verify the SCQM model. MethodsThe proposed model was further developed using feedback from thirty quality management experts using a Delphi method. Further, a guidebook for its implementation was prepared including a road map and performance measurement. ResultsThe research led to the development of a context-specific model of quality management for healthcare organisations and a series of guidelines for its implementation. ConclusionA proper model of quality management should be developed and implemented properly in healthcare organisations to achieve business excellence.

  8. [Study on commercial specification of atractylodes based on Delphi method].

    Science.gov (United States)

    Wang, Hao; Chen, Li-Xiao; Huang, Lu-Qi; Zhang, Tian-Tian; Li, Ying; Zheng, Yu-Guang

    2016-03-01

    This research adopts "Delphi method" to evaluate atractylodes traditional traits and rank correlation. By using methods of mathematical statistics the relationship of the traditional identification indicators and atractylodes goods rank correlation was analyzed, It is found that the main characteristics affectingatractylodes commodity specifications and grades of main characters wereoil points of transaction,color of transaction,color of surface,grain of transaction,texture of transaction andspoilage. The study points out that the original "seventy-six kinds of medicinal materials commodity specification standards of atractylodes differentiate commodity specification" is not in conformity with the actual market situation, we need to formulate corresponding atractylodes medicinal products specifications and grades.This study combined with experimental results "Delphi method" and the market actual situation, proposed the new draft atractylodes commodity specifications and grades, as the new atractylodes commodity specifications and grades standards. It provides a reference and theoretical basis. Copyright© by the Chinese Pharmaceutical Association.

  9. Integration of Social Media in Recruitment: A Delphi Study

    OpenAIRE

    Aurélie Girard; Bernard Fallery; Florence Rodhain

    2013-01-01

    International audience; Purpose -- The development of social media provides new opportunities for recruitment and raises various questions. This chapter aims to clarify areas of agreement and disagreement regarding the integration of social media in recruitment strategies. Methodology/approach -- A Delphi study was conducted among a panel of 34 French experts composed of 26 practitioners and 8 academics. Findings -- Three quantitative results and five qualitative results are presented. Social...

  10. Information systems outsourcing: a Delphi study from Spain

    OpenAIRE

    González Ramírez, María Reyes; Gascó Gascó, José Luis; Llopis Taverner, Juan

    2010-01-01

    Purpose – The widespread growth of information systems (IS) outsourcing on an international scale contrasts sharply with the somewhat limited development of this practice in Spain. The purpose of this paper is to deal with the situation of IS outsourcing in this country. Design/methodology/approach – For this purpose, the paper has used the opinions and comments of those in charge of IS departments at the largest Spanish firms through a normative Delphi study. Findings – Outsourcing makes it ...

  11. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    Directory of Open Access Journals (Sweden)

    Lori Townsend

    2016-06-01

    Full Text Available This study used the Delphi method to engage expert practitioners on the topic of threshold concepts for information literacy. A panel of experts considered two questions. First, is the threshold concept approach useful for information literacy instruction? The panel unanimously agreed that the threshold concept approach holds potential for information literacy instruction. Second, what are the threshold concepts for information literacy instruction? The panel proposed and discussed over fifty potential threshold concepts, finally settling on six information literacy threshold concepts.

  12. Identifying Threshold Concepts for Information Literacy: A Delphi Study

    OpenAIRE

    Lori Townsend; Amy R. Hofer; Silvia Lin Hanick; Korey Brunetti

    2016-01-01

    This study used the Delphi method to engage expert practitioners on the topic of threshold concepts for information literacy. A panel of experts considered two questions. First, is the threshold concept approach useful for information literacy instruction? The panel unanimously agreed that the threshold concept approach holds potential for information literacy instruction. Second, what are the threshold concepts for information literacy instruction? The panel proposed and discussed over fift...

  13. Study of ageing side effects in the DELPHI HPC calorimeter

    CERN Document Server

    Bonivento, W

    1997-01-01

    The readout proportional chambers of the HPC electromagnetic calorimeter in the DELPHI experiment are affected by large ageing. In order to study the long-term behaviour fo the calorimeter, one HPC module was extracted from DELPHI in 1992 and was brought to a test area where it was artificially aged during a period of two years; an ageing level exceeding the one expected for the HPC at the end of the LEP era was reached. During this period the performance of the module was periodically tested by means of dedicated beam tests whose results are discussed in this paper. These show that ageing has no significant effects on the response linearity and on the energy resolution for electromagnetic showers, once the analog response loss is compensated for by increasing the chamber gain through the anode voltage.

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

    Science.gov (United States)

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

    2015-10-01

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

  15. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs. © 2017 Michigan Association for Infant Mental Health.

  16. Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures.

    Science.gov (United States)

    Giangregorio, L M; McGill, S; Wark, J D; Laprade, J; Heinonen, A; Ashe, M C; MacIntyre, N J; Cheung, A M; Shipp, K; Keller, H; Jain, R; Papaioannou, A

    2015-03-01

    An international consensus process resulted in exercise and physical activity recommendations for individuals with osteoporosis. Emphasis was placed on strength, balance, and postural alignment. Rather than providing generic restrictions, activity should be encouraged while considering impairments, fracture risk, activity history, and preference, and guidance on spine sparing techniques should be provided. The objectives of this study were to establish expert consensus on key questions posed by patients or health care providers regarding recommended assessment domains to inform exercise prescription, therapeutic goals of exercise, and physical activity and exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. The Too Fit To Fracture expert panel identified researchers and clinicians with expertise in exercise and osteoporosis and stakeholder groups. We delivered a modified online Delphi survey (two rounds) to establish consensus on assessment, exercise, and physical activities for three cases with varying risk (osteoporosis based on bone mineral density; 1 spine fracture and osteoporosis; multiple spine fractures, osteoporosis, hyperkyphosis, and pain). Duplicate content analyses of free text responses were performed. Response rates were 52% (39/75) and 69% (48/70) for each round. Key consensus points are the following: (a) Current physical activity guidelines are appropriate for individuals with osteoporosis without spine fracture, but not for those with spine fracture; (b) after spine fracture, physical activity of moderate intensity is preferred to vigorous; (c) daily balance training and endurance training for spinal extensor muscles are recommended for all; (d) providing guidance on spine-sparing techniques (e.g., hip hinge) during activities of daily living or leisure, considering impairments, fracture risk, activity history, and preference, is recommended rather than providing generic restrictions (e.g., lifting <10

  17. Identifying research priorities for patient safety in mental health: an international expert Delphi study

    Science.gov (United States)

    Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

    2018-01-01

    Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096

  18. Curriculum Development Through Delphi

    Science.gov (United States)

    Reeves, Gary; Jauch, Lawrence R.

    1978-01-01

    The basic Delphi methodology is outlined along with possible goals and objectives in a Delphi study. The results of an actual case study in the use of the Delphi method for higher education curriculum development are reported, and attention is given to the problem of selecting participants for a Delphi exercise. (Author/LBH)

  19. Barriers to collaborative anesthetic care between anesthesiologists and nurses on the labour and delivery unit: a study using a modified Delphi technique.

    Science.gov (United States)

    Fung, Lillia Y; Downey, Kristi; Watts, Nancy; Carvalho, Jose C A

    2017-08-01

    The practice of obstetrical anesthesia relies on collaborative effort between anesthesiologists and nurses, but teamwork remains a challenge. We sought to identify a consensus on the perceived barriers to collaborative care between anesthesiologists and perinatal nurses in a Canadian tertiary labour and delivery (L&D) unit. A cross-sectional consensus-building study was conducted using a modified Delphi technique. We aimed to reach consensus on the barriers to collaborative care as well as to identify the reasons behind the issues and possible interventions. This technique involved conducting four parallel sequential rounds of questionnaires: Round 1 - posing open-ended questions to nurses and anesthesiologists; Round 2 - establishing an initial within-group consensus; Round 3 - conducting a cross-over round to determine the interprofessional consensus and the remaining anesthesia and nursing consensuses; Round 4 - ranking to identify the top three barriers identified by the three consensuses. Twenty-one anesthesiologists and 15 nurses were recruited. Themes of barriers to collaboration included issues on professionalism, availability, dissonance, team coordination, communication, organizational structure, educational gaps, and role clarity. The top two barriers from the interprofessional consensus were communication issues. Anesthesiologists and nurses at our tertiary L&D unit identified communication as a major barrier to collaborative care. This study also shows the feasibly of using the modified Delphi technique in L&D units seeking to improve collaborative care.

  20. Clarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior.

    Science.gov (United States)

    Gevers, D W M; Kremers, S P J; de Vries, N K; van Assema, P

    2014-08-01

    Inconsistencies in measurements of food parenting practices continue to exist. Fundamental to this problem is the lack of clarity about what is understood by different concepts of food parenting practices. The purpose of this study was to clarify food parenting practice concepts related to snacking. A three round Delphi study among an international group of experts (n = 63) was conducted. In the first round, an open-ended survey was used to collect food parenting practice descriptions and concept labels associated with those practices. In the second round, participants were asked to match up descriptions with the appropriate concept labels. The third and final round allowed participants to reconsider how descriptions and concept labels were matched, taking into account the opinions expressed in round two. Round one produced 408 descriptions of food parenting practices and 110 different concept names. Round two started with 116 descriptions of food parenting practices and 20 concept names. On 40 descriptions, consensus regarding the underlying concept name was reached in round two. Of the remaining 76 descriptions, consensus on 47 descriptions regarding the underlying concept name was reached in round three. The present study supports the essential process of consensus development with respect to food parenting practices concepts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Investigating Adaptive Grieving Styles: A Delphi Study

    Science.gov (United States)

    Doughty, Elizabeth A.

    2009-01-01

    There has been an evolution in the understanding of the nature of grief since S. Freud's initial work, Mourning and Melancholia (1917/1953). Mental health practitioners and researchers have established new models to aid in the conceptualization and treatment of grief issues. The purpose of this study was to examine the opinions of experts in the…

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

    Science.gov (United States)

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

    2017-07-01

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

  3. Core competencies for health professionals' training in pediatric behavioral sleep care: a Delphi study.

    Science.gov (United States)

    Boerner, Katelynn E; Coulombe, J Aimée; Corkum, Penny

    2015-01-01

    The need to train non-sleep-specialist health professionals in evidence-based pediatric behavioral sleep care is well established. The objective of the present study was to develop a list of core competencies for training health professionals in assisting families of 1- to 10-year old children with behavioral insomnia of childhood. A modified Delphi methodology was employed, involving iterative rounds of surveys that were administered to 46 experts to obtain consensus on a core competency list. The final list captured areas relevant to the identification and treatment of pediatric behavioral sleep problems. This work has the potential to contribute to the development of training materials to prepare non-sleep-specialist health professionals to identify and treat pediatric behavioral sleep problems, ideally within stepped-care frameworks.

  4. The influences on and experiences of becoming nurse entrepreneurs: a Delphi study.

    Science.gov (United States)

    Wilson, Anne; Averis, Andrea; Walsh, Ken

    2003-08-01

    There is little known about private practice nursing as an area of advanced practice. As more nurses take the option to develop private practice, the experiences of and influences on nurses currently in private practice might be a useful guide to the pitfalls and difficulties which might be encountered. In addition, an understanding of the experiences of and influences might assist nursing organizations and health services to provide support to nurses who play an integral part in health care delivery in the community. A research study was undertaken utilizing a two-round Delphi Technique to elicit and assess consensus on the reasons for nurses going into business and the experiences they encountered in becoming and being a nurse entrepreneur. The study instrument in round one comprised a questionnaire with statement headings inviting opinions on the influences and experiences of nurses in business. In the second round, levels of agreement were elicited from responders on collated opinions from round one, including statements formed from comments written in round one. The initial questionnaire also included closed questions to obtain a profile of nurses in private practice. Responders were 59 nurses in private practice in round one and 54 nurses in round two. The themes raised could be grouped under headings of influences, advantages/disadvantages, education/experience, skills/knowledge, characteristics and barriers. The level of agreement on the themes was reasonably high. Dissent occurred on issues of increased income, professional image and support structures. This Delphi study has identified key areas of consensus on the experiences of nurses in private practice who have extended their career into the business arena. It has also identified areas in which further work needs to be carried out to understand this work of nurse entrepreneurs.

  5. The impact of ERP on supply chain management: exploratory findings from a European Delphi study

    NARCIS (Netherlands)

    Akkermans, H.A.; Bogerd, P.; Yücesan, E.; Wassenhove, van L.N.

    2003-01-01

    This article presents results from a Delphi study on the future impact of enterprise resource planning (ERP) systems on supply chain management (SCM). The Delphi study was conducted with 23 Dutch supply chain executives of European multi-nationals. Findings from this exploratory study were

  6. IMPLEMENTATION OF THE DELPHI TECHNIQUE IN FINANCE

    Directory of Open Access Journals (Sweden)

    Marcin Kozak

    2015-05-01

    Full Text Available In the rapidly developing world, forecasting is very important for numerous aspects of our lives,the finance realm not being an exception. Various qualitative and quantitative methods are used to predict what is ahead. One of them is the Delphi method, an anonymous, structured discussion among experts on the forecasted topic. Developed over 60 years ago, it is one of the most effective qualitative forecasting and decision-making techniques. That said, literature review suggests Delphi’s advantages have not been sufficiently utilized in financial research. This paper is an introduction to Delphi with a focus on the method’s application possibilities in finance and related disciplines. For this purpose, we performed a literature review and presented a step-by-step guide for implementing the Delphi technique, describing a structure of the Delphi process, major principles of Delphi, experts’ selection, Delphi types, ways of establishing consensus, validity of the method among others. Finally, we focused on implementing Delphi in finance and offered example topics that could be studied with Delphi.

  7. European neonatal intensive care nursing research priorities: An e-delphi study

    NARCIS (Netherlands)

    J.M. Wielenga (Joke); L.N. Tume (Lyvonne); J.M. Latour (Jos); A. van den Hoogen (Agnes)

    2015-01-01

    textabstractObjective This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique.Design An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis

  8. European neonatal intensive care nursing research priorities : an e-Delphi study

    NARCIS (Netherlands)

    Wielenga, Joke M; Tume, Lyvonne N; Latour, Jos M; van den Hoogen, Agnes

    OBJECTIVE: This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. DESIGN: An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and

  9. European neonatal intensive care nursing research priorities: an e-Delphi study

    NARCIS (Netherlands)

    Wielenga, Joke M.; Tume, Lyvonne N.; Latour, Jos M.; van den Hoogen, Agnes

    2015-01-01

    This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and research statements

  10. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study

    NARCIS (Netherlands)

    Gijsbers, H. J. H.; Lauret, G. J.; van Hofwegen, A.; van Dockum, T. A.; Teijink, J. A. W.; Hendriks, H. J. M.

    2016-01-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a

  11. Setting Priorities for Gerontological Social Work Research: A National Delphi Study

    Science.gov (United States)

    Burnette, Denise; Morrow-Howell, Nancy; Chen, Li-Mei

    2003-01-01

    Purpose: An increasingly important task for all disciplines involved in aging research is to identify and prioritize areas for investigation. This article reports the results of a national Delphi study on setting research priorities for gerontological social work. Design and Methods: Delphi methodology, a structured process for eliciting and…

  12. Defining sustainable practice in community-based health promotion: a Delphi study of practitioner perspectives.

    Science.gov (United States)

    Harris, Neil; Sandor, Maria

    2013-04-01

    Sustainability of practice must be a central imperative in the practice of community-based health promotion to achieve population health and attract a greater share of public health spending. Although there has been some consideration of sustainability at the project or program levels, often understood as intervention longevity, very limited attention has been given to understanding sustainable practice. The present study develops a definition and features of sustainable practice in community-based health promotion through a Delphi method with health promotion practitioners in Queensland, Australia. The study presents a consensus definition and features of sustainable practice. The definition highlights the importance of collaboration, health determinants and aspirations, processes and outcomes. The four features of sustainable practice identified in the study are: (1) effective relationships and partnerships; (2) evidence-based decision making and practice; (3) emphasis on building community capacity; and (4) supportive context for practice. The definition and features are, to a large extent, consistent with the limited literature around sustainability at the project and program levels of health promotion. Together, they provide insight into a form of community-based health promotion that will be both viable and productive. So what? This consensus understanding of sustainable practice articulates the foundations of working effectively with local communities in achieving improved population health within global limits.

  13. Teacher Competencies in Health Education: Results of a Delphi Study.

    Science.gov (United States)

    Moynihan, Sharon; Paakkari, Leena; Välimaa, Raili; Jourdan, Didier; Mannix-McNamara, Patricia

    2015-01-01

    The aim of this research study was to identify the core competencies for health education teachers in supporting the development of health literacy among their students. A three round Delphi method was employed. Experts in health education were asked to identify core competencies for school health educators. Twenty six participants from the academic field were invited to participate in the study. Twenty participants completed the first round of the Delphi, while eighteen took part in round two and fifteen participated in the final round. Data were collected using an electronic questionnaire. The first round contained an open ended question in which participants were asked to name and define all the competencies they perceived were important. Thematic analysis was undertaken on these data. A list of 36 competencies was created from this round. This list was then returned to the same participants and they were asked to rate each competency on a 7 point semantic differential scale in terms of importance. The resulting data were then analysed. For the final round, participants were presented with a list of 33 competencies and were asked to rank them again, in order of importance. Twelve core competencies emerged from the analysis and these competencies comprised of a mixture of knowledge, attitude and skills. The authors suggest that how these competencies are achieved and operationalised in the school context can be quite complex and multi-faceted. While the authors do not seek to generalise from the study they suggest that these competencies are an important input for all stakeholders, in order to question national and international teacher guidelines. In addition the competencies identified may provide a useful starting point for others to undertake deeper analysis of what it means to be an effective health educator in schools.

  14. Teacher Competencies in Health Education: Results of a Delphi Study.

    Directory of Open Access Journals (Sweden)

    Sharon Moynihan

    Full Text Available The aim of this research study was to identify the core competencies for health education teachers in supporting the development of health literacy among their students.A three round Delphi method was employed. Experts in health education were asked to identify core competencies for school health educators. Twenty six participants from the academic field were invited to participate in the study. Twenty participants completed the first round of the Delphi, while eighteen took part in round two and fifteen participated in the final round. Data were collected using an electronic questionnaire. The first round contained an open ended question in which participants were asked to name and define all the competencies they perceived were important. Thematic analysis was undertaken on these data. A list of 36 competencies was created from this round. This list was then returned to the same participants and they were asked to rate each competency on a 7 point semantic differential scale in terms of importance. The resulting data were then analysed. For the final round, participants were presented with a list of 33 competencies and were asked to rank them again, in order of importance.Twelve core competencies emerged from the analysis and these competencies comprised of a mixture of knowledge, attitude and skills. The authors suggest that how these competencies are achieved and operationalised in the school context can be quite complex and multi-faceted. While the authors do not seek to generalise from the study they suggest that these competencies are an important input for all stakeholders, in order to question national and international teacher guidelines. In addition the competencies identified may provide a useful starting point for others to undertake deeper analysis of what it means to be an effective health educator in schools.

  15. Benchmarks for effective primary care-based nursing services for adults with depression: a Delphi study.

    Science.gov (United States)

    McIlrath, Carole; Keeney, Sinead; McKenna, Hugh; McLaughlin, Derek

    2010-02-01

    This paper is a report of a study conducted to identify and gain consensus on appropriate benchmarks for effective primary care-based nursing services for adults with depression. Worldwide evidence suggests that between 5% and 16% of the population have a diagnosis of depression. Most of their care and treatment takes place in primary care. In recent years, primary care nurses, including community mental health nurses, have become more involved in the identification and management of patients with depression; however, there are no appropriate benchmarks to guide, develop and support their practice. In 2006, a three-round electronic Delphi survey was completed by a United Kingdom multi-professional expert panel (n = 67). Round 1 generated 1216 statements relating to structures (such as training and protocols), processes (such as access and screening) and outcomes (such as patient satisfaction and treatments). Content analysis was used to collapse statements into 140 benchmarks. Seventy-three benchmarks achieved consensus during subsequent rounds. Of these, 45 (61%) were related to structures, 18 (25%) to processes and 10 (14%) to outcomes. Multi-professional primary care staff have similar views about the appropriate benchmarks for care of adults with depression. These benchmarks could serve as a foundation for depression improvement initiatives in primary care and ongoing research into depression management by nurses.

  16. Occupational health research priorities in Malaysia: a Delphi study.

    Science.gov (United States)

    Sadhra, S; Beach, J R; Aw, T C; Sheikh-Ahmed, K

    2001-07-01

    As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions.

  17. Complications to evaluate adult trauma care: An expert consensus study.

    Science.gov (United States)

    Moore, Lynne; Lauzier, François; Stelfox, Henry Thomas; Le Sage, Natalie; Bourgeois, Gilles; Clément, Julien; Shemilt, Michèle; Turgeon, Alexis F

    2014-08-01

    Complications affect up to 37% of patients hospitalized for injury and increase mortality, morbidity, and costs. One of the keys to controlling complications for injury admissions is to monitor in-hospital complication rates. However, there is no consensus on which complications should be used to evaluate the quality of trauma care. The objective of this study was to develop a consensus-based list of complications that can be used to assess the acute phase of adult trauma care. We used a three-round Web-based Delphi survey among experts in the field of trauma care quality with a broad range of clinical expertise and geographic diversity. The main outcome measure was median importance rating on a 5-point Likert scale (very low to very high); complications with a median of 4 or greater and no disagreement were retained. A secondary measure was the perceived quality of information on each complication available in patient files. Of 19 experts invited to participate, 17 completed the first (brainstorming) round and 16 (84%) completed all rounds. Of 73 complications generated in Round 1, a total of 25 were retained including adult respiratory distress syndrome, hospital-acquired pneumonia, sepsis, acute renal failure, deep vein thrombosis, pulmonary embolism, wound infection, decubitus ulcers, and delirium. Of these, 19 (76%) were perceived to have high-quality or very high-quality information in patient files by more than 50% of the panel members. This study proposes a consensus-based list of 25 complications that can be used to evaluate the quality of acute adult trauma care. These complications can be used to develop an informative and actionable quality indicator to evaluate trauma care with the goal of decreasing rates of hospital complications and thus improving patient outcomes and resource use. DRG International Classification of Diseases codes are provided.

  18. Delphi-RAND consensus of the Spanish Society of Internal Medicine on the controversies in anticoagulant therapy and prophylaxis in medical diseases. INTROMBIN Project (Uncertainty in thromboprophylaxis in internal medicine).

    Science.gov (United States)

    Ruiz-Ruiz, F; Medrano, F J; Navarro-Puerto, M A; Rodríguez-Torres, P; Romero-Alonso, A; Santos-Lozano, J M; Alonso-Ortiz Del Rio, C; Varela-Aguilar, J M; Calderón, E J; Marín-León, I

    2018-05-21

    The aim of this study was to determine the opinion of internists on the management of anticoagulation and thromboembolism prophylaxis in complex clinical scenarios in which the risk-benefit ratio of surgery is narrow and to develop a consensus document on the use of drugs anticoagulant therapy in this patient group. To this end, we identified by consensus the clinical areas of greatest uncertainty, a survey was created with 20 scenarios laid out in 40 clinical questions, and we reviewed the specific literature. The survey was distributed among the internists of the Spanish Society of Internal Medicine (SEMI) and was completed by 290 of its members. The consensus process was implemented by changing the Delphi-RAND appropriateness method in an anonymous, double-round process that enabled an expert panel to identify the areas of agreement and uncertainty. In our case, we also added the survey results to the panel, a methodological innovation that helps provide additional information on the standard clinical practice. The result of the process is a set of 19 recommendations formulated by SEMI experts, which helps establish guidelines for action on anticoagulant therapy in complex scenarios (high risk or active haemorrhage, short life expectancy, coexistence of antiplatelet therapy or comorbidities such as kidney disease and liver disease), which are not uncommon in standard clinical practice. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  19. Attitudes and values expected of public health nursing students at graduation: A delphi study.

    Science.gov (United States)

    Okura, Mika; Takizawa, Hiroko

    2018-06-01

    The skills and knowledge of the competencies expected of public health nursing (PHN) students at graduation have been clarified; however, the attitudes and values have not yet been studied in Japan. The objective of this study was to identify and reach a consensus among experts on the attitudes and values expected of PHN students at graduation. This survey was conducted as a two-stage Delphi study. We selected the following experts: 248 teachers in the faculty of public health nursing at a university as academic experts, and 250 public health nurses who were also experienced clinical instructors as clinical experts. The round 1 mailed survey was conducted using a questionnaire about the necessity and importance of attitudes and values, and 211 experts responded (42.4%, clinical; n = 124, academic; n = 87). In the Round 2 survey, the experts consisted of 60.2% of the round 1 participants (clinical; n = 73, academic; n = 54). Descriptive statistics were used for multiple imputation. We identified a total of 13 attitudes and values expected of PHN students, and reached ≥90% consensus for most items (except for one). Regarding the expected achievement level at graduation, there was no difference between clinical and academic experts except for one item. Consensus was clearly achieved for 13 attitudes and values expected of PHN students, as well as importance and expected achievement level at graduation. In the future, it is important to examine strategies that can effectively develop these attitudes and values through basic and continuous education. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study.

    Science.gov (United States)

    Van Grootven, Bastiaan; McNicoll, Lynn; Mendelson, Daniel A; Friedman, Susan M; Fagard, Katleen; Milisen, Koen; Flamaing, Johan; Deschodt, Mieke

    2018-03-16

    To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). Western Europe and the USA. Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate). Participants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method. In the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications. The indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All

  1. Development of the Korean framework for senior-friendly hospitals: a Delphi study.

    Science.gov (United States)

    Kim, Yoon-Sook; Han, Seol-Heui; Hwang, Jeong-Hae; Park, Jae-Min; Lee, Jongmin; Choi, Jaekyung; Moon, Yeonsil; Kim, Hee Joung; Shin, Grace Jung Eun; Lee, Ji-Sun; Choi, Ye Ji; Uhm, Kyeong Eun; Kim, In Ae; Nam, Ji-Won

    2017-08-04

    Aging is an inevitable part of life. One can maintain well-being and wellness even after discharge and/or transition if his or her functional decline is minimized, sudden decline is prevented, and functioning is promoted during hospitalization. Caring appropriately for elderly patients requires the systematic application of Senior-Friendly Hospital principles to all operating systems, including medical centres' organization and environment, as well as patient treatment processes. The Senior-Friendly Hospital framework is valid and important for patient safety and quality improvement. This study aimed to make recommendations regarding the development of the Korean Framework for Senior-Friendly Hospitals for older patients' care management, patient safety interventions, and health promotion, via a Delphi survey. Two rounds of Delphi surveying were conducted with 15 participants who had at least 3 years' experience in accreditation surveying and medical accreditation standards, survey methods, and accreditation investigator education. In each round, we calculated statistics describing each standard's validity and feasibility. The Korean Framework for Senior-Friendly Hospitals included 4 Chapters, 11 categories, and 67 standards through consensus of the Senior-Friendly Hospitals task force and experts' peer review. After the two rounds of Delphi surveying, validity evaluation led to no changes in standards of the Senior-Friendly Hospitals; however, the number of standards showing adequate validity decreased from 67 to 58. Regarding feasibility, no changes were necessary in the standards; however, the number of categories showing adequate feasibility decreased from 11 to 8 and from 67 to 30, respectively. The excluded categories were 3.2, 4.2, and 4.3 (service, transportation, and signage and identification). The highest feasibility values were given to standards 2.1.1, 4.1.4, and 4.1.6. The highest feasibility score was given to standard 2.4.2. The Korean Framework for

  2. Core principles of evolutionary medicine: A Delphi study.

    Science.gov (United States)

    Grunspan, Daniel Z; Nesse, Randolph M; Barnes, M Elizabeth; Brownell, Sara E

    2018-01-01

    Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education. The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle. Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine. This set of core principles will be helpful for researchers and instructors in evolutionary medicine. We recommend that evolutionary medicine instructors use the list of core principles to construct learning goals. Evolutionary medicine is a young field, so this list of core principles will likely change as the field develops further.

  3. Development of suicide postvention guidelines for secondary schools: a Delphi study

    Directory of Open Access Journals (Sweden)

    Georgina R. Cox

    2016-02-01

    Full Text Available Abstract Background Suicide of school-aged adolescents is a significant problem, with serious implications for students and staff alike. To date, there is a lack of evidence regarding the most effective way for a secondary school to respond to the suicide of a student, termed postvention [(Crisis 33:208-214, 2012, (Crisis 34:164-182, 2013]. The aim of this study was to employ the expert consensus (Delphi methodology to the development of a set of guidelines, to assist English-speaking secondary schools to develop a plan to respond to a student suicide, or to respond to a suicide in the absence of a predetermined plan. Methods The Delphi methodology was employed, which involved a two-stage process. Firstly, medical and research databases, existing postvention guidelines developed for schools, and lay literature were searched in order to identify potential actions that school staff could carry out following the suicide of a student. Based on this search, an online questionnaire was produced. Secondly, 40 experts in the area of suicide postvention from English-speaking countries were recruited and asked to rate each action contained within this questionnaire, in terms of how important they felt it was to be included in the postvention guidelines. A set of guidelines was developed based on these responses. In total, panel members considered 965 actions across three consensus rounds. Results Five hundred fourty-eight actions were endorsed for inclusion into the postvention guidelines based on an 80 % consensus agreement threshold. These actions were groups according to common themes, which are presented in the following sections: 1. Developing an Emergency Response Plan; 2. Forming an Emergency Response Team; 3. Activating the Emergency Response Team; 4. Managing a suspected suicide that occurs on school grounds; 5. Liaising with the deceased student’s family; 6. Informing staff of the suicide; 7. Informing students of the suicide; 8. Informing

  4. Barriers Inhibiting Albanian Tourism from Being Competitive: A Delphi Study

    Directory of Open Access Journals (Sweden)

    Mariett a Poshi

    2017-07-01

    Full Text Available Albanian tourism is a major income contributor to the country’s employment and economy. The industry is relatively new to the country and only recently has it been able to receive the attention it needs in regards to making it more appealing to tourists and everyone involved in it. The lack of inexperience as compared to countries in the region is very apparent especially by comparison of visitors per capita on Albania with the other destinations in the region. Research on various factors that might inhibit Albanian tourism have been conducted and while they display what the problems might be, they lack to suggest implementing strategies. A qualitative Delphi was used in this research study, which included a purposeful sample of SMEs in the field of Albanian tourism. The panel of experts were drawn from three groups: (a government officials, (b industry leaders, and (c academics. The data were collected and analyzed from three rounds of questionnaires. The study found 10 factors inhibiting Albanian tourism from being competitive in the region. SMEs suggested 6 short-term and 4 long-term actions needed to be taken by Albanian tourism in order to increase its competitiveness in the Mediterranean. Recommendations for academia, government, and industry included the need for more research in the field, regulation of industry taxes and fighting of corruption, investment of infrastructure, professional training and developed, and creation on independent professional organizations.

  5. Core Outcomes for Colorectal Cancer Surgery: A Consensus Study.

    Directory of Open Access Journals (Sweden)

    Angus G K McNair

    2016-08-01

    Full Text Available Colorectal cancer (CRC is a major cause of worldwide morbidity and mortality. Surgical treatment is common, and there is a great need to improve the delivery of such care. The gold standard for evaluating surgery is within well-designed randomized controlled trials (RCTs; however, the impact of RCTs is diminished by a lack of coordinated outcome measurement and reporting. A solution to these issues is to develop an agreed standard "core" set of outcomes to be measured in all trials to facilitate cross-study comparisons, meta-analysis, and minimize outcome reporting bias. This study defines a core outcome set for CRC surgery.The scope of this COS includes clinical effectiveness trials of surgical interventions for colorectal cancer. Excluded were nonsurgical oncological interventions. Potential outcomes of importance to patients and professionals were identified through systematic literature reviews and patient interviews. All outcomes were transcribed verbatim and categorized into domains by two independent researchers. This informed a questionnaire survey that asked stakeholders (patients and professionals from United Kingdom CRC centers to rate the importance of each domain. Respondents were resurveyed following group feedback (Delphi methods. Outcomes rated as less important were discarded after each survey round according to predefined criteria, and remaining outcomes were considered at three consensus meetings; two involving international professionals and a separate one with patients. A modified nominal group technique was used to gain the final consensus. Data sources identified 1,216 outcomes of CRC surgery that informed a 91 domain questionnaire. First round questionnaires were returned from 63 out of 81 (78% centers, including 90 professionals, and 97 out of 267 (35% patients. Second round response rates were high for all stakeholders (>80%. Analysis of responses lead to 45 and 23 outcome domains being retained after the first and

  6. A decision-making framework for total ownership cost management of complex systems: A Delphi study

    Science.gov (United States)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  7. Drivers for the effective management of HIV and AIDS in the South African construction industry--a Delphi study.

    Science.gov (United States)

    Harinarain, Nishani; Haupt, Theo Conrad

    2014-09-01

    Different industries manage the threats presented by HIV and AIDS in different ways. The construction industry is particularly vulnerable to the pandemic because of its large unskilled labour force, high labour turnover and the migratory nature of the workforce. The study reported on in this paper, the first of its kind in the South African construction industry, aimed to identify the important drivers needed for the effective management of HIV and AIDS and to understand their impact on the construction industry. The aim was achieved in two stages. The first stage involved an extensive literature review to determine the factors that drive corporate response in the management of HIV and AIDS in the South African construction sector. Six drivers, namely legal requirements, social pressures, business costs, voluntary regulation, visibility of the disease, and individuals within companies with a total of 87 items were identified. An iterative Delphi technique with a panel of experts was used to validate the factors identified in the literature review and formed the second stage of this research. The Delphi method was used as it provided a systematic approach to achieve consensus on the six drivers for effective management of HIV and AIDS management in the construction industry. An expert panel responded to three iterations of questionnaires to achieve consensus. The experts reached consensus on 56 items categorised under the 6 drivers. This study found that the legal driver was considered most important but only second in terms of impact. The second most important driver was the visibility of the disease and was regarded as the driver with the highest impact. Internal agents ranked third in terms of importance and impact. This study can be used for further research to assist the construction industry in helping fight HIV and AIDS.

  8. Environmental and occupational health research and training needs in Colombia: A Delphi study.

    Science.gov (United States)

    Rodríguez-Villamizar, Laura A; González, Beatriz Elena; Vera, Lina María; Patz, Jonathan; Bautista, Leonelo E

    2015-08-01

    Environmental factors contribute with 16% of the burden of disease in Colombia. A main obstacle in implementing national and regional environmental and occupational health policies is the limited knowledge on the local ability to study and control the impact of harmful exposures on health. To identify needs for research and training in environmental and occupational health in Colombia. We conducted a three-round hybrid Delphi study. A group of environmental and occupational health Colombian experts (n=16) from government agencies, universities, and research centers was recruited to participate in the study. Expert´s opinions on research and training needs were gathered through online questionnaires, followed by an in-person meeting. The percentage of agreement and the coefficient of variation were used to measure consensus. Air pollution and chemical products were considered the most important environmental and occupational exposures, due to their significant impact on chronic non-communicable diseases, such as respiratory diseases, cardiovascular diseases, and cancer. Research on the effects of outdoor air pollution on cardiovascular and respiratory diseases was considered of the greatest importance. Priority training areas included environmental and occupational health risk assessment, exposure modeling, advanced statistical methods, urban planning, occupational safety and hygiene, and epidemiology and toxicology. These findings provide a valuable input for the definition and implementation of national environmental and occupational health policies and for the development of a regional hub aimed at strengthening the capacity for research and training in Colombia.

  9. Research priorities for respiratory nursing: a UK-wide Delphi study

    Science.gov (United States)

    Pilkington, Melissa; Hodson, Matthew; Welch, Lindsay; Yorke, Janelle

    2018-01-01

    Respiratory nurses make a significant contribution to the delivery of respiratory healthcare, but there is a dearth of nurse-led, practice-focused, published research. Using a modified three-round Delphi, this study sought to identify research priorities for respiratory nursing to inform a national research strategy. Study information and the survey link were sent electronically to members of UK professional respiratory organisations. Round 1 had 78 items across 16 topics, informed by a systematic literature review. Respondents suggested additional items which were content analysed to inform Round 2. Respondents rated all items and ranked the topics in all rounds. To ensure rigour, rounds had an explicit focus with pre-determined criteria for consensus (70%). In total, 363 responses were received across Rounds 1, 2 and 3 (n=183, 95 and 85, respectively). The top five research priorities were: 1) “Patient understanding of asthma control”; 2) “The clinical and cost-effectiveness of respiratory nurse interventions”; 3) “The impact of nurse-led clinics on patient care”; 4) “Inhaler technique”; and 5) two topics jointly scored: “Prevention of exacerbations” and “Symptom management”. With potential international significance, this is the first UK study to identify research priorities for respiratory nursing, providing direction for those planning or undertaking research. PMID:29692999

  10. Environmental and occupational health research and training needs in Colombia: A Delphi study

    Science.gov (United States)

    Rodríguez-Villamizar, Laura A.; González, Beatriz Elena; Vera, Lina María; Patz, Jonathan; Bautista, Leonelo E.

    2015-01-01

    Introduction Environmental factors contribute with 16% of the burden of disease in Colombia. A main obstacle in implementing national and regional environmental and occupational health policies is the limited knowledge on the local ability to study and control the impact of harmful exposures on health. Objective To identify needs for research and training in environmental and occupational health in Colombia. Materials and methods We conducted a three-round hybrid Delphi study. A group of environmental and occupational health Colombian experts (n=16) from government agencies, universities, and research centers was recruited to participate in the study. Expert’s opinions on research and training needs were gathered through online questionnaires, followed by an in-person meeting. The percentage of agreement and the coefficient of variation were used to measure consensus. Results Air pollution and chemical products were considered the most important environmental and occupational exposures, due to their significant impact on chronic non-communicable diseases, such as respiratory diseases, cardiovascular diseases, and cancer. Research on the effects of outdoor air pollution on cardiovascular and respiratory diseases was considered of the greatest importance. Priority training areas included environmental and occupational health risk assessment, exposure modeling, advanced statistical methods, urban planning, occupational safety and hygiene, and epidemiology and toxicology. Conclusions These findings provide a valuable input for the definition and implementation of national environmental and occupational health policies and for the development of a regional hub aimed at strengthening the capacity for research and training in Colombia. PMID:26535742

  11. A Delphi Study and Initial Validation of Counselor Supervision Competencies

    Science.gov (United States)

    Neuer Colburn, Anita A.; Grothaus, Tim; Hays, Danica G.; Milliken, Tammi

    2016-01-01

    The authors addressed the lack of supervision training standards for doctoral counseling graduates by developing and validating an initial list of supervision competencies. They used content analysis, Delphi polling, and content validity methods to generate a list, vetted by 2 different panels of supervision experts, of 33 competencies grouped…

  12. Business intelligence and service-oriented architecture: a Delphi study

    NARCIS (Netherlands)

    Mueller, Roland; Linders, Stefan; Ferreira Pires, Luis

    Although service-oriented architecture (SOA) is becoming increasingly popular in enterprise application rchitectures, little is known about how SOA could support and influence the use and implementation of business intelligence (BI). We applied the Delphi method in order to identify opportunities

  13. A Delphi study to identify the core components of nurse to nurse handoff.

    Science.gov (United States)

    O'Rourke, Jennifer; Abraham, Joanna; Riesenberg, Lee Ann; Matson, Jeff; Lopez, Karen Dunn

    2018-03-08

    The aim of this study was to identify the core components of nurse-nurse handoffs. Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified. This lack of identification is a significant gap in moving towards a standardized approach for nurse-nurse handoff. Mixed methods design using the Delphi technique. From May 2016 - October 2016, using a series of iterative steps, a panel of handoff experts gave feedback on the nurse-nurse handoff core components and the content in each component to be passed from one nurse to the next during a typical unit-based shift handoff. Consensus was defined as 80% agreement or higher. After three rounds of participant review, 17 handoff experts with backgrounds in clinical nursing practice, academia and handoff research came to consensus on the core components of handoff: patient summary, action plan and nurse-nurse synthesis. This is the first study to identify the core components of nurse-nurse handoff. Subsequent testing of the core components will involve evaluating the handoff approach in a simulated and then actual patient care environment. Our long-term goal is to improve patient safety outcomes by validating an evidence-based handoff framework and handoff curriculum for pre-licensure nursing programmes that strengthen the quality of their handoff communication as they enter clinical practice. © 2018 John Wiley & Sons Ltd.

  14. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study.

    Science.gov (United States)

    Uribe Guajardo, Maria Gabriela; Slewa-Younan, Shameran; Santalucia, Yvonne; Jorm, Anthony Francis

    2016-01-01

    Refugees are one of the most vulnerable groups in Australian society, presenting high levels of exposure to traumatic events and consequently high levels of severe psychological distress. While there is a need for professional help, only a small percentage will receive appropriate care for their mental health concerns. This study aimed to determine cultural considerations required when providing mental health first aid to Iraqi refugees experiencing mental health problems or crises. Using a Delphi method, 16 experts were presented with statements about possible culturally-appropriate first aid actions via questionnaires and were encouraged to suggest additional actions not covered by the questionnaire content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥90 % of panellists as 'Essential' or 'Important'. From a total of 65 statements, 38 were endorsed (17 for cultural awareness, 12 for cross-cultural communication, 7 for stigma associated with mental health problems, and 2 for barriers to seeking professional help). Experts were able to reach consensus about how to provide culturally-appropriate first aid for mental health problems to Iraqi refugees, demonstrating the suitability of this methodology in developing cultural considerations guidelines. This specific refugee study provided potentially valuable cultural knowledge required to better equip members of the Australian public on how to respond to and assist Iraqi refugees experiencing mental health problems or crises.

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

    Science.gov (United States)

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

    2018-02-01

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

  16. [Prioritization and Consentation of Criteria for the Appraisal, Funding and Evaluation of Projects from the German Innovationsfonds: A multi-perspective Delphi study].

    Science.gov (United States)

    Schmitt, J; Petzold, T; Nellessen-Martens, G; Pfaff, H

    2015-09-01

    The German Innovationsfonds provides the chance for evidence-based developments of the German healthcare system. Prioritization of recommendations for an effective, efficient, fair, transparent, and sustainable granting of funds through a transparent, evidence-driven consensus-process involving all relevant stakeholder groups. Representatives from health and research policy, payers, patient representatives, healthcare providers, and scientists were invited to nominate participants for an electronic 3 round iterative Delphi-study to prioritize the thematic focus, requirements concerning study methods, the team of applicants, evaluation, utilization of study results, and for the selection of reviewers. Criteria considered as relevant by at least 60% of the panel (consensus definition) in the first 2 Delphi rounds were rated as facultative, preferable, or obligatory criteria for project funding. Data were analyzed descriptively. ( Datenbank Versorgungsforschung Deutschland VfD_15_003561). All invited stakeholder groups except payers participated. 34 (85%) of 40 nominated representatives participated in the Delphi-study. A total of 64 criteria were consented as relevant for project review and funding concerning the thematic focus (n=28), methodological requirements (n=13), requirements for applicants (n=4), for the evaluation (n=4), utilization (n=6), and selection of peer reviewers (n=9). It is the collective responsibility of all stakeholders to spend the designated funds as efficient and sustainable as possible. The consented recommendations shall serve decision makers as a resource for the granting of funds and the evaluation of the Innovationsfonds. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Physical activity and exercise priorities in community dwelling people with multiple sclerosis: a Delphi study.

    Science.gov (United States)

    Stennett, Andrea; De Souza, Lorraine; Norris, Meriel

    2018-07-01

    Exercise and physical activity have been found to be beneficial in managing disabilities caused by multiple sclerosis. Despite the known benefits, many people with multiple sclerosis are inactive. This study aimed to identify the prioritised exercise and physical activity practices of people with multiple sclerosis living in the community and the reasons why they are engaged in these activities. A four Round Delphi questionnaire scoped and determined consensus of priorities for the top 10 exercise and physical activities and the reasons why people with multiple sclerosis (n = 101) are engaged in these activities. Data were analysed using content analysis, descriptive statistics, and non-parametric tests. The top 10 exercise and physical activity practices and the top 10 reasons why people with multiple sclerosis (n = 70) engaged in these activities were identified and prioritised. Consensus was achieved for the exercise and physical activities (W = 0.744, p multiple sclerosis engaged in exercise and physical activity were diverse. These self-selected activities and reasons highlighted that people with multiple sclerosis might conceptualise exercise and physical activity in ways that may not be fully appreciated or understood by health professionals. Considerations of the views of people with multiple sclerosis may be essential if the goal of increasing physical activity in this population is to be achieved. Implications for Rehabilitation Health professionals should work collaboratively with people with multiple sclerosis to understand how they prioritise activities, the underlying reasons for their prioritisations and embed these into rehabilitation programmes. Health professionals should utilise activities prioritised by people with multiple sclerosis in the community as a way to support, promote, and sustain exercise and physical activity in this population. Rehabilitation interventions should include both the activities people with multiple

  18. Priorities for the professional development of registered nurses in nursing homes: a Delphi study.

    Science.gov (United States)

    Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara

    2017-01-08

    To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.

  19. Management of patients with type 2 diabetes and multiple chronic conditions: A Delphi consensus of the Spanish Society of Internal Medicine.

    Science.gov (United States)

    Ena, Javier; Gómez-Huelgas, Ricardo; Sánchez-Fuentes, Demetrio; Camafort-Babkowsk, Miguel; Formiga, Francesc; Michán-Doña, Alfredo; Casariego, Emilio

    2016-01-01

    To develop consensus-based recommendations for the management of chronic complex patients with type 2 diabetes mellitus using a two round Delphi technique. Experts from the Diabetes and Obesity Working Group (DOWG) of the Spanish Society of Internal Medicine (SEMI) reviewed MEDLINE, PubMed, SCOPUS and Cochrane Library databases up to September 2014 to gather information on organization and health care management, stratification of therapeutic targets and therapeutic approach for glucose control in chronic complex patients with type 2 diabetes mellitus. A list of 6 recommendations was created and rated by a panel of 75 experts from the DOWG by email (first round) and by open discussion (second round). A written document was produced and sent back to DOWG experts for clarification purposes. A high degree of consensus was achieved for all recommendations summarized as 1) there is a need to redesign and test new health care programs for chronic complex patients with type 2 diabetes mellitus; 2) therapeutic targets in patients with short life expectancy should be individualized in accordance to their personal, clinical and social characteristics; 3) patients with chronic complex conditions and type 2 diabetes mellitus should be stratified by hypoglycemia risk; 4) age and specific comorbidities should guide the objectives for glucose control; 5) the risk of hypoglycemia should be a key factor when choosing a treatment; and 6) basal insulin analogs compared to human insulin are cost-effective options. The assessment and recommendations provided herein represent our best professional judgment based on current data and clinical experience. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  20. Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

    Science.gov (United States)

    Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

    2017-07-01

    Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

  1. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments

    Directory of Open Access Journals (Sweden)

    Patrick DL

    2006-01-01

    Full Text Available Abstract Background Choosing an adequate measurement instrument depends on the proposed use of the instrument, the concept to be measured, the measurement properties (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability, the requirements, the burden for subjects, and costs of the available instruments. As far as measurement properties are concerned, there are no sufficiently specific standards for the evaluation of measurement properties of instruments to measure health status, and also no explicit criteria for what constitutes good measurement properties. In this paper we describe the protocol for the COSMIN study, the objective of which is to develop a checklist that contains COnsensus-based Standards for the selection of health Measurement INstruments, including explicit criteria for satisfying these standards. We will focus on evaluative health related patient-reported outcomes (HR-PROs, i.e. patient-reported health measurement instruments used in a longitudinal design as an outcome measure, excluding health care related PROs, such as satisfaction with care or adherence. The COSMIN standards will be made available in the form of an easily applicable checklist. Method An international Delphi study will be performed to reach consensus on which and how measurement properties should be assessed, and on criteria for good measurement properties. Two sources of input will be used for the Delphi study: (1 a systematic review of properties, standards and criteria of measurement properties found in systematic reviews of measurement instruments, and (2 an additional literature search of methodological articles presenting a comprehensive checklist of standards and criteria. The Delphi study will consist of four (written Delphi rounds, with approximately 30 expert panel members with different backgrounds in clinical medicine, biostatistics, psychology, and epidemiology. The final checklist will

  2. Contribution to environmental impact study of fuel cells of low and medium temperature using the Delphi methodology

    International Nuclear Information System (INIS)

    Ribeiro, Maria Alice Morato

    2009-01-01

    Assessing future energy systems is of major importance for providing information on potential environmental awareness of the some life cycle stage of innovative technologies, for determining competitive advantages compared to conventional technologies and for developing scenarios of future. The main objective of this work is to provide a contribution for the evaluation of the environmental impact of fuel cells of low and media temperature, including all life cycles, and hydrogen production step, using the Delphi methodology. This work introduces and characterizes several types of fuel cells, which are more researched in the last years and presents several life cycles analysis for the fuel cells, their manufacture, operation and waste after the lifetime. The Delphi research is presented, with the first and second round results, the questionnaire and the methods descriptions adopted in this study. The Delphi Methodology is detailed in this work detailing the entrance data, the philosophy to be used in this study of the future scenes, as well as, the statistical treatment to be used for evaluation of the final results. A questionnaire was constructed and a respondent's team participated in the research. Initially they received the questionnaire in the first round. In the next round they received again the questionnaire together with the responses obtained in the first stage. At the end, the study it was verified it there was an increase of consensus and an influence of the most qualified respondents on the other respondents. The results showed that the respondents believe in reducing the environmental impact of fuel cells. The most surprising in the research is that the respondents believe that the group's PGM catalysts can be replaced. (author)

  3. Choosing entrustable professional activities for neonatology: a Delphi study.

    Science.gov (United States)

    Parker, T A; Guiton, G; Jones, M D

    2017-12-01

    To assess candidate neonatology EPAs taken from separate but overlapping sets from two organizations. Using a Delphi process, we asked that neonatology fellowship directors (1) assess importance and scope of 19 candidate EPAs, and (2) propose additional EPAs if necessary. In round 2, we sought clarification of first round responses and evaluated proposed additional EPAs. Twenty program directors participated. In round 1, all EPAs were scored as important, but four were overly broad. In round 2, respondents rejected proposed subdivisions of one overly broad EPA, retaining it as originally proposed. Specification of entrustment criteria improved the scope of the three other broad EPAs. However, after specification, they were re-rated as insufficiently important and therefore rejected. Neither newly proposed EPA from round 1 was rated as sufficiently important. The Delphi process yielded 13 EPAs with which to assess capability to practice clinical neonatology.

  4. Occupational health research priorities in Malaysia: a Delphi study

    OpenAIRE

    Sadhra, S; Beach, J; Aw, T; Sheikh-Ahmed, K

    2001-01-01

    OBJECTIVES—As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia.
METHODS—Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked i...

  5. Quality Characteristics of a Graduate Teacher Education Program in Graphic Communications: Results from a Delphi Research Study.

    Science.gov (United States)

    Clark, Aaron C.; Scales, Alice Y.

    2000-01-01

    Investigates characteristics of a quality program in graphic communications teacher education with involvement of professionals in the field. Uses the Delphi technique to achieve consensus on the characteristics that they felt compromised a good educational program for future graphics teachers. (Contains 27 references.) (Author/YDS)

  6. Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach.

    Science.gov (United States)

    Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

    2017-04-10

    Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.

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

    Science.gov (United States)

    Haines, Sara; Baker, Tricia

    2013-01-01

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

  8. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study.

    Science.gov (United States)

    Mokkink, Lidwine B; Terwee, Caroline B; Patrick, Donald L; Alonso, Jordi; Stratford, Paul W; Knol, Dirk L; Bouter, Lex M; de Vet, Henrica C W

    2010-05-01

    Aim of the COSMIN study (COnsensus-based Standards for the selection of health status Measurement INstruments) was to develop a consensus-based checklist to evaluate the methodological quality of studies on measurement properties. We present the COSMIN checklist and the agreement of the panel on the items of the checklist. A four-round Delphi study was performed with international experts (psychologists, epidemiologists, statisticians and clinicians). Of the 91 invited experts, 57 agreed to participate (63%). Panel members were asked to rate their (dis)agreement with each proposal on a five-point scale. Consensus was considered to be reached when at least 67% of the panel members indicated 'agree' or 'strongly agree'. Consensus was reached on the inclusion of the following measurement properties: internal consistency, reliability, measurement error, content validity (including face validity), construct validity (including structural validity, hypotheses testing and cross-cultural validity), criterion validity, responsiveness, and interpretability. The latter was not considered a measurement property. The panel also reached consensus on how these properties should be assessed. The resulting COSMIN checklist could be useful when selecting a measurement instrument, peer-reviewing a manuscript, designing or reporting a study on measurement properties, or for educational purposes.

  9. Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study.

    Science.gov (United States)

    Tam, Vincent C; Ingledew, Paris-Ann; Berry, Scott; Verma, Sunil; Giuliani, Meredith E

    2016-01-01

    Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to

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

    Science.gov (United States)

    So, Hyo-Jeong; Bonk, Curtis J.

    2010-01-01

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

  11. A Classical Delphi Study to Identify the Barriers of Pursuing Green Information and Communication Technologies

    Science.gov (United States)

    Gotay, Jose Antonio

    2013-01-01

    This qualitative, classical Delphi study served to explore the apparent lack of corporate commitment to prioritized Green Information Communication Technologies (ICTs), which could delay the economic and social benefits for maximizing the use of natural energy resources in a weak economy. The purpose of this study was to examine the leadership…

  12. Concepts and contexts in engineering and technology education : An international and interdisciplinary Delphi study

    NARCIS (Netherlands)

    Rossouw, A.; Hacker, M.; De Vries, M.J.

    2010-01-01

    Inspired by a similar study by Osborne et al. we have conducted a Delphi study among experts to identify key concepts to be taught in engineering and technology education and relevant and meaningful contexts through which these concepts can be taught and learnt. By submitting the outcomes of the

  13. Research Priorities for YouTube and Video-Sharing Technologies: A Delphi Study

    Science.gov (United States)

    Snelson, Chareen; Rice, Kerry; Wyzard, Constance

    2012-01-01

    Online video-sharing services, particularly YouTube, have gained an audience of billions of users including educators and scholars. While the academic literature provides some evidence that YouTube has been studied and written about, little is known about priorities for YouTube research. The study employed the Delphi method to obtain a consensus…

  14. Understanding the Gap between Students Exiting High School and College Readiness: A Modified Delphi Study

    Science.gov (United States)

    Moore, Donna Rena

    2012-01-01

    The purpose of this Modified Delphi study was to discern the appropriate profile of an incoming freshman and the essential knowledge and skills freshmen need for academic success beyond high school. This study was conducted to examine the specific problem that the structure of public high school curriculum and the current college standards in the…

  15. A Delphi Study on Technology Enhanced Learning (TEL) Applied on Computer Science (CS) Skills

    Science.gov (United States)

    Porta, Marcela; Mas-Machuca, Marta; Martinez-Costa, Carme; Maillet, Katherine

    2012-01-01

    Technology Enhanced Learning (TEL) is a new pedagogical domain aiming to study the usage of information and communication technologies to support teaching and learning. The following study investigated how this domain is used to increase technical skills in Computer Science (CS). A Delphi method was applied, using three-rounds of online survey…

  16. Validation of a clinical leadership qualities framework for managers in aged care: a Delphi study.

    Science.gov (United States)

    Jeon, Yun-Hee; Conway, Jane; Chenoweth, Lynn; Weise, Janelle; Thomas, Tamsin Ht; Williams, Anna

    2015-04-01

    To establish validity of a clinical leadership framework for aged care middle managers (The Aged care Clinical Leadership Qualities Framework). Middle managers in aged care have responsibility not only for organisational governance also and operational management but also quality service delivery. There is a need to better define clinical leadership abilities in aged care middle managers, in order to optimise their positional authority to lead others to achieve quality outcomes. A Delphi method. Sixty-nine experts in aged care were recruited, representing rural, remote and metropolitan community and residential aged care settings. Panellists were asked to rate the proposed framework in terms of the relevance and importance of each leadership quality using four-point Likert scales, and to provide comments. Three rounds of consultation were conducted. The number and corresponding percentage of the relevance and importance rating for each quality was calculated for each consultation round, as well as mean scores. Consensus was determined to be reached when a percentage score reached 70% or greater. Twenty-three panellists completed all three rounds of consultation. Following the three rounds of consultation, the acceptability and face validity of the framework was confirmed. The study confirmed the framework as useful in identifying leadership requirements for middle managers in Australian aged care settings. The framework is the first validated framework of clinical leadership attributes for middle managers in aged care and offers an initial step forward in clarifying the aged care middle manager role. The framework provides clarity in the breadth of role expectations for the middle managers and can be used to inform an aged care specific leadership program development, individuals' and organisations' performance and development processes; and policy and guidelines about the types of activities required of middle managers in aged care. © 2014 John Wiley & Sons Ltd.

  17. Therapist competencies necessary for the delivery of compassion-focused therapy: A Delphi study.

    Science.gov (United States)

    Liddell, Alice E; Allan, Steven; Goss, Ken

    2017-06-01

    Compassion-focused therapy (CFT) has shown promising results for a range of clinical presentations. This study explored the therapeutic competencies required to deliver CFT and organized these into a coherent framework. The Delphi method was used to explore and refine competencies for delivering CFT in three rounds of data collection. The first round involved interviews with 12 experts in CFT. Data were analysed using template analysis to generate a draft competency framework. The main competencies were used to create a survey for rounds two and three involving CFT experts and practitioners. Data collected from the surveys were used to refine the competencies. The CFT competency framework (CFT-CF) that was produced comprised 25 main competencies within six key areas of competence. The areas were as follows: competencies in creating safeness, meta-skills, non-phase-specific skills, phase-specific skills, knowledge and understanding and use of supervision. The main competencies included several subcompetencies specifying knowledge, skills and attributes needed to demonstrate the main competence. Overall, there was consensus on 14 competencies and 20 competencies exceeded an 80% agreement level. Some of the CFT competencies overlapped with existing therapies, whilst others were specific to CFT. The CFT-CF provides useful guidance for clinicians, supervisors and training programmes. Further research could develop the CFT-CF into a therapist rating scale in order to measure the outcome of training and to assess treatment fidelity in clinical trials. The compassion-focused therapy competency framework (CFT-CF) identifies therapeutic competencies that overlap with existing treatments as well as those specific to compassion-focused therapy (CFT). The CFT-CF builds guidance for the competencies required to deliver CFT in a range of clinical settings. The CFT-CF provides guidance for those training CFT therapists. The CFT-CF could be used as a basis to develop a therapist

  18. The future of organization development: A delphi study among Dutch experts

    NARCIS (Netherlands)

    Korten, F.; de Caluwe, L.I.A.; Geurts, J.

    2010-01-01

    From this Delphi study among Dutch experts, the future of organization development (OD) emerges as a loosely coupled community of practice, linking very diverse members, professionals as well as scholars. One finds different priorities and values in this community, some of them even dilemmatic. The

  19. Towards an Understanding of Instructional Design Heuristics: An Exploratory Delphi Study

    Science.gov (United States)

    York, Cindy S.; Ertmer, Peggy A.

    2011-01-01

    Evidence suggests that experienced instructional designers often use heuristics and adapted models when engaged in the instructional design problem-solving process. This study used the Delphi technique to identify a core set of heuristics designers reported as being important to the success of the design process. The overarching purpose of the…

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

    Science.gov (United States)

    Jordan, Edgar A.

    2010-01-01

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

  1. Factors influencing continuing professional development : A Delphi study among nursing experts

    NARCIS (Netherlands)

    Brekelmans, G.B.; Poell, R.F.; van Wijk, K.

    2013-01-01

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

  2. Inquiry-based Science Education Competence of Primary School Teachers: A Delphi Study

    NARCIS (Netherlands)

    Alake-Tuenter, E.; Biemans, H.J.A.; Tobi, H.; Mulder, M.

    2013-01-01

    Earlier, extracted inquiry-based science teaching competency elements and domains from the international literature were compared to the United States' National Science Teaching Standards. The present Delphi study aimed to validate the findings for the Netherlands, where such standards are lacking.

  3. Delphi in Criminal Justice Policy: A Case Study on Judgmental Forecasting

    NARCIS (Netherlands)

    Loyens, Kim; Maesschalck, Jeroen; Bouckaert, Geert

    2011-01-01

    This article provides an in-depth case study analysis of a pilot project organized by the section “Strategic Analysis” of the Belgian Federal Police. Using the Delphi method, which is a judgmental forecasting technique, a panel of experts was questioned about future developments of crime, based on

  4. Delphi in Criminal Justice Policy: A Case Study on Judgmental Forecasting

    Science.gov (United States)

    Loyens, Kim; Maesschalck, Jeroen; Bouckaert, Geert

    2011-01-01

    This article provides an in-depth case study analysis of a pilot project organized by the section "Strategic Analysis" of the Belgian Federal Police. Using the Delphi method, which is a judgmental forecasting technique, a panel of experts was questioned about future developments of crime, based on their expertise in criminal or social…

  5. Experimental study of the single electron response of the DELPHI Barrel RICH MWPC's

    International Nuclear Information System (INIS)

    Dracos, M.

    1989-01-01

    We present herewith the results of an experimental study of the multiwire proportionnal chambers (MWPC's) used in the Barrel RICH particle identifier of the LEP-DELPHI experiment. Emphasis is given to the problem of detection efficiency and to the measurements of the charge induced by a single photoelectron

  6. The Future of Information Literacy in Academic Libraries: A Delphi Study

    Science.gov (United States)

    Saunders, Laura

    2009-01-01

    Information literacy is a central tenet of academic librarianship. However, technological advancements coupled with drastic changes in users' information needs and expectations are having a great impact on this service, leading practitioners to wonder how programs may evolve. Based on a Delphi study, this article surveyed 13 information literacy…

  7. Achieving Next Generation Science Standards through Agricultural Contexts: A Delphi Study of Outdoor Education Experts

    Science.gov (United States)

    Meals, Anthony; Washburn, Shannon

    2015-01-01

    A Delphi survey was conducted with 30 outdoor education experts in Kansas. Participant responses helped frame a Kansas definition of outdoor education and identified essential educational goals and outcomes, critical components for effective outdoor education programming, and barriers facing outdoor education in Kansas. The study highlights…

  8. Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

    Science.gov (United States)

    Herlihy, Barbara; Dufrene, Roxane L.

    2011-01-01

    A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

  9. Qualitative Delphi Study of Factors Influencing Data Center Investment in Eco-Innovations

    Science.gov (United States)

    Stewart, M. Bennett

    2016-01-01

    This qualitative investigation explored the diffusion of eco-innovations within the U.S. data center industry from 2007 to 2015 whose adoption was intended to decouple digital economy growth from environmental impact. Using diffusion of innovation theory to inform the study, and synthesizing subject matter expert input from a Delphi panel…

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

    Science.gov (United States)

    Elbarbary, Rafik Said

    2015-01-01

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

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

    Science.gov (United States)

    Fuller, Matthew; Henderson, Susan; Bustamante, Rebecca

    2015-01-01

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

  12. Trends that FCS Education Should Address: A Delphi Study Reveals Top 16

    Science.gov (United States)

    Alexander, Karen L.; Davis, Kimberlee

    2011-01-01

    This study used the Delphi method to identify trends of importance to family and consumer sciences (FCS) education. A panel of 21 FCS education experts identified 16 trends and evaluated them by importance, desirability, feasibility, and confidence in validity of the trend. Nutrition appeared as a top priority, followed by consumer economics. The…

  13. Building a Privacy, Ethics, and Data Access Framework for Real World Computerised Medical Record System Data: A Delphi Study. Contribution of the Primary Health Care Informatics Working Group.

    Science.gov (United States)

    Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S

    2016-11-10

    Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.

  14. Competencies of specialised wound care nurses : a European Delphi study

    NARCIS (Netherlands)

    Eskes, Anne M; Maaskant, Jolanda M; Holloway, Samantha; van Dijk, Nynke; Alves, Paulo; Legemate, Dink A; Ubbink, Dirk T; Vermeulen, Hester

    2014-01-01

    Health care professionals responsible for patients with complex wounds need a particular level of expertise and education to ensure optimum wound care. However, uniform education for those working as wound care nurses is lacking. We aimed to reach consensus among experts from six European countries

  15. Competencies of specialised wound care nurses: a European Delphi study

    NARCIS (Netherlands)

    Eskes, Anne M.; Maaskant, Jolanda M.; Holloway, Samantha; van Dijk, Nynke; Alves, Paulo; Legemate, Dink A.; Ubbink, Dirk T.; Vermeulen, Hester

    2014-01-01

    Health care professionals responsible for patients with complex wounds need a particular level of expertise and education to ensure optimum wound care. However, uniform education for those working as wound care nurses is lacking. We aimed to reach consensus among experts from six European countries

  16. The capabilities and scope-of-practice requirements of advanced life support practitioners undertaking critical care transfers: A Delphi study

    Directory of Open Access Journals (Sweden)

    Monique Venter

    2016-11-01

    Full Text Available Background. Critical care transfers (CCT refer to the high level of care given during transport (via ambulance, helicopter or fixed-wing aircraft of patients who are of high acuity. In South Africa (SA, advanced life support (ALS paramedics undertake CCTs. The scope of ALS in SA has no extended protocol regarding procedures or medications in terms of dealing with these CCTs. Aim. The aim of this study was to obtain the opinions of several experts in fields pertaining to critical care and transport and to gain consensus on the skills and scope-of-practice requirements of paramedics undertaking CCTs in the SA setting. Methods. A modified Delphi study consisting of three rounds was undertaken using an online survey platform. A heterogeneous sample (n=7, consisting of specialists in the fields of anaesthesiology, emergency medicine, internal medicine, critical care, critical care transport and paediatrics, was asked to indicate whether, in their opinion, selected procedures and medications were needed within the scope of practice of paramedics undertaking CCTs. Results. After three rounds, consensus was obtained in 70% (57/81 of procedures and medications. Many of these items are not currently within the scope of paramedics’ training. The panel felt that paramedics undertaking these transfers should have additional postgraduate training that is specific to critical care. Conclusion. Major discrepancies exist between the current scope of paramedic practice and the suggested required scope of practice for CCTs. An extended scope of practice and additional training should be considered for these practitioners.

  17. The Consensus of Strategic Consensus: A Study of the State of the Art about the Theme

    Directory of Open Access Journals (Sweden)

    Marcelo Curth

    2018-04-01

    Full Text Available This paper aims to present the state of the art regarding the strategic consensus, emphasizing the approaches and the nature of the research methods used, the results obtained and the future agenda for this theme studies. Analyzing beyond the last four decades of publications, it was understood that relating the strategic consensus only with the performance and strategic levels can be seen as something limited, suggesting the need to bring to the researching field new aspects and backgrounds as innovation, the methods for generating new ideas, the occurrence beyond the Top Management Team level (TMT, among others. Moreover, concludes that the predominant approach the strategic consensus is a process and the methodology used is based on quantitative techniques. As a suggestion for future studies, this study indicates the investigation of situations in which the strategic consensus is not positive.

  18. Delphi project in bronchial asthma. Two stages.

    Science.gov (United States)

    Fernández-Benítez, M; Ibero Iborra, M; Sanz Ortega, J; Garde Garde, J

    2010-01-01

    From the paediatric point of view, we have undertaken two Delphi studies into bronchial asthma. The first is related to the consensus known as the consensus document of the five associations. The second is more recent and has been undertaken with GEMA (the Spanish Guidelines on the Management of Asthma). The aim of this paper is to carry out a descriptive study comparing the 2 Delphi processes and to objectively assess if in some way behaviour over the past two years has changed as far as expert opinion is concerned. In the consensus document those points giving rise to most controversy were the treatment of children under three years of age and treatment with immunotherapy in allergic asthma. It is also necessary to highlight how important it was at that particular point in time to define the phenotypes of wheezing and the predictive index of asthma in children of less than 3 years of age. Of the 52 questions in the questionnaire, in 13.6% the panel of experts reached no consensus in their positions. Following GEMA the Delphi methodology, 56 questions were asked in the first round of the questionnaire, and consensus was reached in 87.5%. As regards the paediatric part relating to diagnosis and treatment in children, agreement was reached on all the questions in the first round. Agreement was reached in 8.92% questions in the second round. Clinical guidelines and consensus documents can modify behaviour towards an illness, both in the diagnosis and treatment. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  19. Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure

    NARCIS (Netherlands)

    Khalil, Asma; Beune, Irene; Hecher, Kurt; Wynia, Klaske; Ganzevoort, Wessel; Reed, Keith; Lewi, Liesbeth; Oepkes, Dick; Gratacos, Eduardo; Thilaganathan, Basky; Gordijn, Sanne J.

    2018-01-01

    Twin pregnancies complicated by selective fetal growth restriction (sFGR) are associated with increased perinatal mortality and morbidity. Inconsistences in the diagnostic criteria for sFGR employed in existing studies hinder the ability to compare or combine their findings. It is therefore

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

    Science.gov (United States)

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

    2017-09-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  2. Charting the New Territory of Adaptive Co-management: A Delphi Study

    Directory of Open Access Journals (Sweden)

    Ryan Plummer

    2007-12-01

    Full Text Available Complex systems understanding implies a world characterized by dynamic, nonlinear interactions, discontinuities, and surprises. Such conditions are not amenable to conventional resource management approaches that stress command-and-control, and therefore, novel governance approaches more suited to complexity and uncertainty are required. Adaptive co-management has emerged as an interdisciplinary response to this need, and blends the adaptive management and collaborative management narratives. However, concepts associated with adaptive co-management are relatively new and quickly expanding from multiple perspectives. The objective of this paper is to take stock of this relatively recent concept and synthesize current thinking in terms of: (1 the core components of adaptive co-management, (2 emerging research directions, (3 the barriers to implementation of adaptive co-management, and (4 criteria for success. To explore these four areas, a three-round, classical Delphi process was administered with an expert panel of 30 individuals. All members of the expert panel initially responded to open-ended questions, and the qualitative results were analyzed using QSR NVIVO. The subsequent two rounds of the Delphi required quantitative responses in which the expert panel was asked to indicate the level of importance using a seven point likert scale associated with specific items. Results of the Delphi survey reveal a high degree of consensus on several core areas within this emerging interdisciplinary governance approach. Results of this research should foster precision with respect to employment of the term, foster scholarly discourse, and indicate areas of practical importance to adaptive co-management.

  3. Defining palliative care in cystic fibrosis: A Delphi study.

    Science.gov (United States)

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

    2018-05-01

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

  4. Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study.

    Science.gov (United States)

    Bernardo, Miquel; de Dios, Consuelo; Pérez, Víctor; Ignacio, Emilio; Serrano, Manuel; Vieta, Eduard; Mira, José Joaquín; Guilabert, Mercedes; Roca, Miquel

    To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. From equity to power: Critical Success Factors for Twinning between midwives, a Delphi study.

    Science.gov (United States)

    Cadée, Franka; Nieuwenhuijze, Marianne J; Lagro-Janssen, Antoine L M; de Vries, Raymond

    2018-02-28

    To gain consensus for Critical Success Factors associated with Twinning in Midwifery. International publications identify midwifery as important for improving maternity care worldwide. Midwifery is a team effort where midwives play a key role. Yet their power to take on this role is often lacking. Twinning has garnered potential to develop power in professionals, however, its success varies because implementation is not always optimal. Critical Success Factors have demonstrated positive results in the managerial context and can be helpful to build effective Twinning relationships. We approached 56 midwife Twinning experts from 19 countries to participate in three Delphi rounds between 2016 - 2017. In round 1, experts gave input through an open ended questionnaire and this was analysed to formulate Critical Success Factors statements that were scored on a 1-7 Likert scale aiming to gain consensus in rounds 2 and 3. These statements were operationalized for practical use such as a check list in planning, monitoring and evaluation in the field. Thirty-three experts from 14 countries took part in all three Delphi rounds, producing 58 initial statements. This resulted in 25 Critical Success Factors covering issues of management, communication, commitment and values, most focus on equity. The Critical Success Factors formulated represent the necessary ingredients for successful Twinning by providing a practical implementation framework and promote further research into the effect of Twinning. Findings show that making equity explicit in Twinning may contribute towards the power of midwives to take on their identified key role. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  6. The assessment and treatment of unhealthy exercise in adolescents with anorexia nervosa: A Delphi study to synthesize clinical knowledge.

    Science.gov (United States)

    Noetel, Melissa; Dawson, Lisa; Hay, Phillipa; Touyz, Stephen

    2017-04-01

    This study aimed to explore and synthesize expert clinical knowledge on defining and managing unhealthy exercise in adolescents with AN. The Delphi methodology was used. Clinicians (n = 25) considered experts in the treatment of AN in adolescents were recruited internationally to form the panel. The first round of the questionnaires was comprised of five open-ended questions regarding defining, assessing, and treating unhealthy exercise in adolescents with AN. Statements were derived from this data using content analysis, and included as Likert-based items in two subsequent rounds, in which panellists were required to rate their level of agreement for each item. All 25 respondents completed the three rounds of questionnaires. Consensus was achieved for 59.0% of the items included in the second and third round of questionnaires. Although consensus was not achieved, compulsive exercise was the preferred term for the panel when referring to unhealthy exercise in adolescents with AN. The panel clearly delineated features of unhealthy and healthy exercise, and endorsed a number of items considered important to assess for when evaluating exercise in this clinical population. A variety of treatment approaches and strategies reached consensus. Notably, for those who are medically stable and progressing toward recovery, the panel recommended initial exercise restriction practices and reintroducing healthy exercise behaviors, rather than exercise cessation practices. The current findings can serve as preliminary treatment guidelines. A unified approach to labeling and defining unhealthy exercise in the eating disorder literature and clinical settings is required to achieve further progress. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2016-10-01

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

  8. Factors influencing the adoption, implementation, and continuation of physical activity interventions in primary health care: A Delphi study

    NARCIS (Netherlands)

    Huijg, J.M.; Crone, M.R.; Verheijden, M.W.; Zouwe, N. van der; Middelkoop, B.J.; Gebhardt, W.A.

    2013-01-01

    Background: The introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies. This Delphi study aimed to identify factors most relevant for the

  9. Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study.

    Science.gov (United States)

    Jenkins, Louis; Mash, Bob; Derese, Anselme

    2012-03-03

    Within the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA) require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa. A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence. Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the portfolio. The panel recommended

  10. Studies of the stability and sistematics of operation of the DELPHI plastic streamer tubes

    International Nuclear Information System (INIS)

    Alekseev, G.D.; Bilenky, M.S.; Bonyushkin, Yu.Ye.; Korrytov, A.V.

    1989-01-01

    The influeNce of gas pressure and temperature, slight changes in a gas mixture, self-sustaining discharge, aging, different deviations in the detector geometry on the operation of the DELPHI plastic streamer tubes is studied. The contribution of these factors to the DELPHI hadron calorimeter energy resolution is estimated. The major influence is found to be due to atmospheric pressure fluctuations (∼ ±1% streamer charge change per ±1 Torr). The question of the choice of a gas mixture is studied as well. Maximal streamer charge is shown to be independent of component concentrations in the Ar:CO 2 :i-C 4 H 10 ) or C 5 H 12 ) gas mixtures. 23 refs.; 21 figs.; 1 tab

  11. The Delphi Technique in Educational Research

    Directory of Open Access Journals (Sweden)

    Ravonne A. Green

    2014-04-01

    Full Text Available The Delphi Technique has been useful in educational settings in forming guidelines, standards, and in predicting trends. Judd lists these major uses of the Delphi Technique in higher education: (a cost-effectiveness, (b cost–benefit analysis, (c curriculum and campus planning, and (d university-wide educational goals and objectives. The thorough Delphi researcher seeks to reconcile the Delphi consensus with current literature, institutional research, and the campus environment. This triangle forms a sound base for responsible research practice. This book gives an overview of the Delphi Technique and the primary uses of this technique in research. This article on the Delphi Technique will give the researcher an invaluable resource for learning about the Delphi Technique and for applying this method in educational research projects.

  12. A Delphi Technology Foresight Study: Mapping Social Construction of Scientific Evidence on Metagenomics Tests for Water Safety.

    Directory of Open Access Journals (Sweden)

    Stanislav Birko

    Full Text Available Access to clean water is a grand challenge in the 21st century. Water safety testing for pathogens currently depends on surrogate measures such as fecal indicator bacteria (e.g., E. coli. Metagenomics concerns high-throughput, culture-independent, unbiased shotgun sequencing of DNA from environmental samples that might transform water safety by detecting waterborne pathogens directly instead of their surrogates. Yet emerging innovations such as metagenomics are often fiercely contested. Innovations are subject to shaping/construction not only by technology but also social systems/values in which they are embedded, such as experts' attitudes towards new scientific evidence. We conducted a classic three-round Delphi survey, comprised of 107 questions. A multidisciplinary expert panel (n = 24 representing the continuum of discovery scientists and policymakers evaluated the emergence of metagenomics tests. To the best of our knowledge, we report here the first Delphi foresight study of experts' attitudes on (1 the top 10 priority evidentiary criteria for adoption of metagenomics tests for water safety, (2 the specific issues critical to governance of metagenomics innovation trajectory where there is consensus or dissensus among experts, (3 the anticipated time lapse from discovery to practice of metagenomics tests, and (4 the role and timing of public engagement in development of metagenomics tests. The ability of a test to distinguish between harmful and benign waterborne organisms, analytical/clinical sensitivity, and reproducibility were the top three evidentiary criteria for adoption of metagenomics. Experts agree that metagenomic testing will provide novel information but there is dissensus on whether metagenomics will replace the current water safety testing methods or impact the public health end points (e.g., reduction in boil water advisories. Interestingly, experts view the publics relevant in a "downstream capacity" for adoption of

  13. Assisting an Australian Aboriginal and Torres Strait Islander person with gambling problems: a Delphi study.

    Science.gov (United States)

    Bond, Kathy S; Dart, Katrina M; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Reavley, Nicola J

    2017-08-02

    Gambling problems appear to be more prevalent in the Australian Aboriginal and Torres Strait Islander population than in the non-Indigenous population. Although gambling harms can be significant, treatment-seeking rates are low. The Delphi expert consensus method was used to develop a set of guidelines on how a family or community member can assist an Aboriginal or Torres Strait Islander person with gambling problems. Building on a previous systematic review of websites, books and journal articles a questionnaire was developed that contained items about the knowledge, skills and actions needed for supporting an Aboriginal or Torres Strait Islander person with gambling problems. These items were rated over three rounds by an expert panel comprising professionals who provide treatment to or conduct research with Aboriginal and Torres Strait Islander people with gambling problems. A total of 22 experts rated 407 helping statements according to whether they thought the statements should be included in these guidelines. There were 225 helping statements that were endorsed by at least 90% of participants. These endorsed statements were used to develop the guidelines. Experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support an Aboriginal or Torres Strait Islander person to change.

  14. Delphi Study to Determine Rehabilitation Research Priorities for Older Adults With Cancer.

    Science.gov (United States)

    Lyons, Kathleen Doyle; Radomski, Mary Vining; Alfano, Catherine M; Finkelstein, Marsha; Sleight, Alix G; Marshall, Timothy F; McKenna, Raymond; Fu, Jack B

    2017-05-01

    To solicit expert opinions and develop consensus around the research that is needed to improve cancer rehabilitation for older adults. Delphi methods provided a structured process to elicit and prioritize research questions from national experts. National, Web-based survey. Members (N=32) of the American Congress of Rehabilitation Medicine completed at least 1 of 3 investigator-developed surveys. Not applicable. In the first survey, participants identified up to 5 research questions that needed to be answered to improve cancer rehabilitation for older adults. In 2 subsequent surveys, participants viewed the compilation of questions, rated the importance of each question, and identified the 5 most important questions. This generated priority scores for each question. Consensus scores were created to describe the degree of agreement around the priority of each question. Highest priority research concerns the epidemiology and measurement of function and disability in older adult cancer survivors; the effects of cancer rehabilitation interventions on falls, disability, participation, survival, costs, quality of care, and health care utilization; and testing models of care that facilitate referrals from oncology to rehabilitation providers as part of coordinated, multicomponent care. A multipronged approach is needed to fill these gaps, including targeted funding opportunities developed with an advisory panel of cancer rehabilitation experts, development of a research network to facilitate novel collaborations and grant proposals, and coordinated efforts of clinical groups to advocate for funding, practice change, and policy change. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Terminating Sequential Delphi Survey Data Collection

    Science.gov (United States)

    Kalaian, Sema A.; Kasim, Rafa M.

    2012-01-01

    The Delphi survey technique is an iterative mail or electronic (e-mail or web-based) survey method used to obtain agreement or consensus among a group of experts in a specific field on a particular issue through a well-designed and systematic multiple sequential rounds of survey administrations. Each of the multiple rounds of the Delphi survey…

  16. Specialty Training's Organizational Readiness for curriculum Change (STORC): development of a questionnaire in a Delphi study.

    Science.gov (United States)

    Bank, Lindsay; Jippes, Mariëlle; van Luijk, Scheltus; den Rooyen, Corry; Scherpbier, Albert; Scheele, Fedde

    2015-08-05

    In postgraduate medical education (PGME), programs have been restructured according to competency-based frameworks. The scale and implications of these adjustments justify a comprehensive implementation plan. Organizational Readiness for Change (ORC) is seen as a critical precursor for a successful implementation of change initiatives. Though, ORC in health care settings is mostly assessed in small scale settings and in relation to new policies and practices rather than educational change. Therefore our aim with this work was to develop an instrument to asses Specialty Training's Organizational Readiness for curriculum Change (STORC). A Delphi procedure was conducted to examine the applicability of a preliminary questionnaire in PGME, which was based on existing instruments designed for business and health care organizations. The 41 panellists (19 trainees and 22 supervisors from 6 specialties) from four different countries who were confronted with an apparent curriculum change, or would be in the near future, were asked to rate the relevance of a 89-item web-based questionnaire with regard to changes in specialty training on a 5-point Likert scale. Furthermore, they were invited to make qualitative comments on the items. In two rounds the 89-item preliminary questionnaire was reduced to 44 items. Items were either removed, kept, adapted or added based on individual item scores and qualitative comments. In the absence of a gold standard, this Delphi procedure was considered complete when the overall questionnaire rating exceeded 4.0 (scale 0-5). The overall item score reached 4.1 in the second round, meeting our criteria for completion of this Delphi procedure. This Delphi study describes the initial validating step in the development of an instrument to asses Specialty Training's Organisational Readiness for curriculum Change (STORC). Since ORC is measured on various subscales and presented as such, its strength lies in analysing these subscales. The latter makes

  17. Validation of consensus panel diagnosis in dementia.

    Science.gov (United States)

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

    2010-12-01

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

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

    Science.gov (United States)

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

    2016-09-14

    To develop an active behavioural physiotherapy intervention (ABPI) for managing acute whiplash-associated disorder (WAD) II using a modified Delphi method to develop consensus for the basic features of the ABPI. Modified Delphi study. Our systematic review and meta-analysis evaluating conservative management for acute WADII found that a combined ABPI may be a useful intervention to prevent patients progressing to chronicity. No previous research has considered a combined behavioural approach and active physiotherapy in the management of acute WADII patients. The ABPI was therefore developed using a rigorous consensus method using international research and local clinical whiplash experts. Descriptive statistics were used to assess consensus in each round. Online international survey. A purposive sample of 97 potential participants (aiming to recruit n=30) consisting of international research whiplash experts, UK private physiotherapists and UK postgraduate musculoskeletal physiotherapy students were invited to participate via electronic mail with an attached participant information sheet and consent form. 36 individuals signed and returned the consent form. In round 1, 32/36 participants (response rate=89%, mean age±SD=36.03±13.22 years) across 8 countries (Australia, Finland, Greece, India, Netherlands, Norway, Sweden and UK) contributed to round 1 questionnaire. Response rates were 78% and 75% for rounds 2 and 3, respectively. Following round 3, 12 underlying principles (eg, return to normal function as soon as possible, pain management, encouragement of self-management, reduce fear avoidance and anxiety) achieved consensus. The treatment components reaching consensus included behavioural (eg, education, reassurance, self-management) and physiotherapy components (eg, exercises for stability and mobility). No passive intervention achieved consensus. Experts suggested and agreed the underlying principles and treatment components of the ABPI for the management

  19. Validation of the tool assessment of clinical education (AssCE): A study using Delphi method and clinical experts.

    Science.gov (United States)

    Löfmark, Anna; Mårtensson, Gunilla

    2017-03-01

    The aim of the present study was to establish the validity of the tool Assessment of Clinical Education (AssCE). The tool is widely used in Sweden and some Nordic countries for assessing nursing students' performance in clinical education. It is important that the tools in use be subjected to regular audit and critical reviews. The validation process, performed in two stages, was concluded with a high level of congruence. In the first stage, Delphi technique was used to elaborate the AssCE tool using a group of 35 clinical nurse lecturers. After three rounds, we reached consensus. In the second stage, a group of 46 clinical nurse lecturers representing 12 universities in Sweden and Norway audited the revised version of the AssCE in relation to learning outcomes from the last clinical course at their respective institutions. Validation of the revised AssCE was established with high congruence between the factors in the AssCE and examined learning outcomes. The revised AssCE tool seems to meet its objective to be a validated assessment tool for use in clinical nursing education. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Institutional Oversight of Faculty-Industry Consulting Relationships in U.S. Medical Schools: A Delphi Study.

    Science.gov (United States)

    Morain, Stephanie R; Joffe, Steven; Campbell, Eric G; Mello, Michelle M

    2015-01-01

    The conflicts of interest that may arise in relationships between academic researchers and industry continue to prompt controversy. The bulk of attention has focused on financial aspects of these relationships, but conflicts may also arise in the legal obligations that faculty acquire through consulting contracts. However, oversight of faculty members' consulting agreements is far less vigorous than for financial conflicts, creating the potential for faculty to knowingly or unwittingly contract away important rights and freedoms. Increased regulation could prevent this, but it is unclear what forms of oversight universities view as feasible and effective. In this article, we report on a Delphi study to evaluate several approaches for oversight of consulting agreements by medical schools. The panel was comprised of 11 senior administrators with responsibility for oversight of faculty consulting relationships. We found broad agreement among panelists regarding the importance of institutional oversight to protect universities' interests. There was strong support for two specific approaches: providing educational resources to faculty and submitting consulting agreements for institutional review. Notwithstanding the complexities of asserting authority to regulate private consulting agreements between faculty members and companies, medical school administrators reached consensus that several approaches to improving institutional oversight are feasible and useful. © 2015 American Society of Law, Medicine & Ethics, Inc.

  1. Current opinion and consensus statement regarding the diagnosis, prognosis, and treatment of patients with essential thrombocythemia: a survey of the Spanish Group of Ph-negative Myeloproliferative Neoplasms (GEMFIN) using the Delphi method.

    Science.gov (United States)

    Besses, C; Hernández-Boluda, J C; Pérez Encinas, M; Raya, J M; Hernández-Rivas, J M; Jiménez Velasco, A; Martínez Lopez, J; Vicente, V; Burgaleta, C

    2016-04-01

    The current consensus on the diagnosis, prognosis, and treatment of essential thrombocythemia (ET) is based on experts' recommendations. However, several aspects of the diagnosis of, prognosis of, and therapy for ET are still controversial. The Delphi method was employed with an expert panel of members of the Spanish Group of Ph-negative Myeloproliferative Neoplasms in order to identify the degree of agreement on the diagnosis, prognosis, and treatment of ET. Nine leading experts selected a total of 41 clinical hematologists with well-known expertise in ET. An electronic questionnaire was used to collect the questions rated in a four-step scale. The questions were grouped into four blocks: diagnosis, risk stratification, goals of therapy, and treatment strategy. After the first round consisting of 80 questions, a second round including 14 additional questions focused on the recommendations advocated by experts of the European LeukemiaNet in 2011 was analyzed. The median and mean values for the first and second rounds were calculated. A summary of the conclusions considered as the most representative of each block of questions is presented. The Delphi method is a powerful instrument to address the current approaches and controversies surrounding ET.

  2. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    Directory of Open Access Journals (Sweden)

    Kulnaree Hanpatchaiyakul

    2016-08-01

    Full Text Available Background: Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective: The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design: Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results: Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions: Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers.

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

    Science.gov (United States)

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

    2016-06-01

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

  4. Medicine authentication technology as a counterfeit medicine-detection tool: a Delphi method study to establish expert opinion on manual medicine authentication technology in secondary care.

    Science.gov (United States)

    Naughton, Bernard; Roberts, Lindsey; Dopson, Sue; Brindley, David; Chapman, Stephen

    2017-05-06

    This study aims to establish expert opinion and potential improvements for the Falsified Medicines Directive mandated medicines authentication technology. A two-round Delphi method study using an online questionnaire. Large National Health Service (NHS) foundation trust teaching hospital. Secondary care pharmacists and accredited checking technicians. Seven-point rating scale answers which reached a consensus of 70-80% with a standard deviation (SD) of <1.0. Likert scale questions which reached a consensus of 70-80%, a SD of <1.0 and classified as important according to study criteria. Consensus expert opinion has described database cross-checking technology as quick and user friendly and suggested the inclusion of an audio signal to further support the detection of counterfeit medicines in secondary care (70% consensus, 0.9 SD); other important consensus with a SD of <1.0 included reviewing the colour and information in warning pop up screens to ensure they were not mistaken for the 'already dispensed here' pop up, encouraging the dispenser/checker to act on the warnings and making it mandatory to complete an 'action taken' documentation process to improve the quarantine of potentially counterfeit, expired or recalled medicines. This paper informs key opinion leaders and decision makers as to the positives and negatives of medicines authentication technology from an operator's perspective and suggests the adjustments which may be required to improve operator compliance and the detection of counterfeit medicines in the secondary care sector. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Developing Soft Skills in Millennial Students: A Delphi Study

    Science.gov (United States)

    McCullough-Billups, Mary Y.

    2017-01-01

    This study addressed the deficiency in soft skills of millennial workers in the United States. The weakness or absence of soft skills of millennial workers is problematic because Millennials are rapidly increasing in the workplace as large numbers of baby boomers are retiring. The purpose of this study was to obtain the expert opinions of a sample…

  6. New CKM-related studies on b decays in the DELPHI experiment at LEP

    CERN Document Server

    Mitaroff, Winfried A

    2003-01-01

    The e-e+ collider LEP, running at sqrt{s} = m(Z0), has been a copious source of b-hadrons produced in decays Z0 -> b \\b. We present recent studies using up to 4*10^6 hadronic Z0 decays acquired by the DELPHI detector between 1992 and 2000. They rely on efficient particle identification, precise track and vertex reconstruction and sophisticated data analysis algorithms. Presented are: a new measurement of the CKM matrix element |V_cb| in the semileptonic exclusive decays B0_d -> D*+ l- \

  7. Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

    Science.gov (United States)

    Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

    2015-10-01

    Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

  8. Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study.

    Science.gov (United States)

    Sampaio, Francisco Miguel Correia; Sequeira, Carlos; Lluch Canut, Teresa

    2017-04-01

    To estimate the content validity of a psychotherapeutic intervention model in nursing. Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. Modified e-Delphi. Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Rethinking clinical governance : Healthcare professionals' views: a Delphi study

    NARCIS (Netherlands)

    Veenstra, Gepke L.; Ahaus, Kees; Welker, Gera A.; Heineman, Erik; van der Laan, Maarten J.; Muntinghe, Friso L. H.

    OBJECTIVE: Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to

  10. Exploring research priorities in landscape architecture: An international Delphi study

    NARCIS (Netherlands)

    Meijering, J.V.; Tobi, H.; Brink, van den A.; Morris, F.A.; Bruns, D.

    2015-01-01

    Many of the world's major challenges require responses that are embedded in landscape planning, design, and management. To date, however, it is unclear which research domains should form the core of a future landscape architecture research agenda. This study explored which domains landscape

  11. Standards for midwife practitioners of external cephalic version: A Delphi study.

    Science.gov (United States)

    Walker, Shawn; Perilakalathil, Prasanth; Moore, Jenny; Gibbs, Claire L; Reavell, Karen; Crozier, Kenda

    2015-05-01

    expansion of advanced and specialist midwifery practitioner roles across professional boundaries requires an evidence-based framework to evaluate achievement and maintenance of competency. In order to develop the role of Breech Specialist Midwife to include the autonomous performance of external cephalic version within one hospital, guidance was required on standards of training and skill development, particularly in the use of ultrasound. a three-round Delphi survey was used to determine consensus among an expert panel, including highly experienced obstetric and midwife practitioners, as well as sonographers. The first round used mostly open-ended questions to gather data, from which statements were formed and returned to the panel for evaluation in subsequent rounds. standards for achieving and maintaining competence to perform ECV, and in the use of basic third trimester ultrasound as part of this practice, should be the same for midwives and doctors. The maintenance of proficiency requires regular practice. midwives can appropriately expand their sphere of practice to include ECV and basic third trimester ultrasound, according to internal guidelines, following the completion of a competency-based training programme roughly equivalent to those used to guide obstetric training. Ideally, ECV services should be offered in organised clinics where individual practitioners in either profession are able to perform approximately 30 or more ECVs per year in order to maintain an appropriate level of skill. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Competency model for dentists in China: Results of a Delphi study.

    Science.gov (United States)

    Geng, Yunxia; Zhao, Liying; Wang, Yu; Jiang, Yiyuan; Meng, Kai; Zheng, Dongxiang

    2018-01-01

    With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.

  13. Psychosocial care for persons affected by emergencies and major incidents: a Delphi study to determine the needs of professional first responders for education, training and support.

    Science.gov (United States)

    Drury, John; Kemp, Verity; Newman, Jonathan; Novelli, David; Doyle, Christopher; Walter, Darren; Williams, Richard

    2013-10-01

    The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised in recent Department of Health guidance. The study described in this paper identified NHS professional first responders' needs for education about survivors' psychosocial responses, training in psychosocial skills, and continuing support. Ambulance staff participated in an online Delphi questionnaire, comprising 74 items (Round 1) on 7-point Likert scales. Second-round and third-round participants each received feedback based on the previous round, and responded to modified versions of the original items and to new items for clarification. One hundred and two participants took part in Round 1; 47 statements (64%) achieved consensus. In Round 2, 72 people from Round 1 participated; 15 out of 39 statements (38%) achieved consensus. In Round 3, 49 people from Round 2 participated; 15 out of 27 statements (59%) achieved consensus. Overall, there was consensus in the following areas: 'psychosocial needs of patients' (consensus in 34/37 items); 'possible sources of stress in your work' (8/9); 'impacts of distress in your work' (7/10); 'meeting your own emotional needs' (4/5); 'support within your organisation' (2/5); 'needs for training in psychosocial skills for patients' (15/15); 'my needs for psychosocial training and support' (5/6). Ambulance clinicians recognise their own education needs and the importance of their being offered psychosocial training and support. The authors recommend that, in order to meet patients' psychosocial needs effectively, ambulance clinicians are provided with education and training in a number of skills and their own psychosocial support should be enhanced.

  14. [Competency requirements for executives in healthcare and social services organizations: Results of a Delphi study].

    Science.gov (United States)

    Pielach, Martin; Schubert, Hans-Joachim

    2018-02-07

    Leadership in social services and healthcare organizations is marked by high levels of complexity and contradiction, which cannot be fully explained by politically, economically, and socially induced changes. Rather, it is the particularities of service provision in healthcare and social services that confront executives with specific demands. This study aimed to capture and prioritize required leadership competencies in healthcare and social services organizations. A three-step Delphi study was conducted with executives and managerial staff, who are job holders and thus experts on their occupation. For the first step, an explorative qualitative approach was chosen to record general opinion without prior assumptions. The following two steps weighted and selected the competency requirements in step one using rating- and ranking procedures. Results of the Delphi inquiry imply high relevance of social and personal competencies. Approximately 66 % of the competencies assessed in round three were social and personal competencies. 12 out of the 15 highest rated competencies in Delphi step three can be assigned to these two competency categories. In contrast, the importance of professional as well as methodical competencies was rated as less important. Only two methodical competencies and one professional competency were rated as very important by the panel. Nevertheless, the importance of executive professional and methodical competencies in healthcare and social services organizations is emphasized by high ratings of the competencies "Sector-specific expertise" and "Analytical skills". The methodical competency "Analytical skills" was identified by the Delphi respondents as the most important competency requirement. Social and personal requirements are of primary importance for leadership in healthcare and social services organizations. These results mostly correspond to leadership requirements posited in the literature on leadership skills. Emphasis should be on the

  15. Engaging stakeholders and target groups in prioritising a public health intervention: the Creating Active School Environments (CASE) online Delphi study.

    Science.gov (United States)

    Morton, Katie L; Atkin, Andrew J; Corder, Kirsten; Suhrcke, Marc; Turner, David; van Sluijs, Esther M F

    2017-01-13

    Stakeholder engagement and public involvement are considered as integral to developing effective public health interventions and is encouraged across all phases of the research cycle. However, limited guidelines and appropriate tools exist to facilitate stakeholder engagement-especially during the intervention prioritisation phase. We present the findings of an online 'Delphi' study that engaged stakeholders (including young people) in the process of prioritising secondary school environment-focused interventions that aim to increase physical activity. Web-based data collection using an online Delphi tool enabling participation of geographically diverse stakeholders. 37 stakeholders participated, including young people (age 13-16 years), parents, teachers, public health practitioners, academics and commissioners; 33 participants completed both rounds. Participants were asked to prioritise a (short-listed) selection of school environment-focused interventions (eg, standing desks, outdoor design changes) based on the criteria of 'reach', 'equality', 'acceptability', 'feasibility', 'effectiveness' and 'cost'. Participants were also asked to rank the criteria and the effectiveness outcomes (eg, physical activity, academic achievement, school enjoyment) from most to least important. Following feedback along with any new information provided, participants completed round 2 4 weeks later. The intervention prioritisation process was feasible to conduct and comments from participants indicated satisfaction with the process. Consensus regarding intervention strategies was achieved among the varied groups of stakeholders, with 'active lessons' being the favoured approach. Participants ranked 'mental health and well-being' as the most important outcome followed by 'enjoyment of school'. The most important criteria was 'effectiveness', followed by 'feasibility'. This novel approach to engaging a wide variety of stakeholders in the research process was feasible to conduct

  16. Application of Delphi expert panel in joint venture projects

    Science.gov (United States)

    Adnan, H.; Rosman, M. R.; Rashid, Z. Z. Ahmad; Mohamad Yusuwan, N.; Bakhary, N. A.

    2018-02-01

    This study was conducted with the aim to identify the application of the Delphi Technique in validating findings obtained from questionnaire surveys and interviews done in- depth on the subject of joint venture projects in Malaysia. The Delphi technique aims to achieve a consensus of opinion amongst expert panellist that were selected on the primary factors in JV projects. To achieve research objectives, a progressive series of questions was designed where a selected panel of expert to confirm and validate the final findings. The rationale, benefits, limitations and recommendations for the use of Delphi were given in this study. From the literature review done, twenty-one factors were identified as critical factors to the making any joint venture project successful. Detail information from contractors were obtained by using the questionnaire survey method and forty-three in-depth interviews were carried out. Trust between partners, mutual understanding, partner selection criteria, agreement of contract, objective compatibility, conflict, and commitment were confirmed by the Delphi panel to be the critical success factors besides another fourteen factors which were found to be the Failure Reduction Criteria. Delphi techniques has proven to successfully assist in recognising the main factors and would be beneficial in supplementing the success of joint venture arrangements application for construction projects in Malaysia.

  17. A Delphi study to establish national cost-effectiveness research priorities for positron emission tomography

    International Nuclear Information System (INIS)

    Robert, Glenn; Milne, Ruairidh

    1999-01-01

    Objective: This study aimed to determine the key cost-effectiveness research questions relating to positron emission tomography (PET) in the UK. Methods: A systematic literature review was conducted to establish the existing knowledge base relating to the cost-effectiveness of PET in the various conditions for which it has been proposed. A three-round postal Delphi study of relevant individuals was used to determine the key cost-effectiveness research questions relating to PET in the UK. The content and structure of the Delphi study was informed by the results of the literature review. Results: The most important cost-effectiveness research priorities for the National Health Service (NHS) relating to PET were in the clinical areas of lung cancer, breast cancer and the assessment of myocardial viability. Gamma camera PET using coincidence imaging was highlighted as a modality whose clinical role needed to be determined urgently. Conclusion: Underlying the cost-effectiveness research priorities which were established is the need for evidence that the use of the various PET modalities as a diagnostic technique will alter patient management as compared to existing diagnostic strategies. The findings of the project provide a contemporary overview of the potential role for PET in the NHS and will be relevant to other countries

  18. Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study

    NARCIS (Netherlands)

    Turner, Sandra; Seel, Matthew; Trotter, Theresa; Giuliani, Meredith; Benstead, Kim; Eriksen, Jesper G.; Poortmans, Philip; Verfaillie, Christine; Westerveld, Henrike; Cross, Shamira; Chan, Ming-Ka; Shaw, Timothy

    2017-01-01

    The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al.,

  19. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

    Directory of Open Access Journals (Sweden)

    Elisabeta Ioana Hiriscau

    2016-05-01

    Full Text Available Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

  20. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study.

    Science.gov (United States)

    Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

    2016-05-11

    Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

  1. Competition in the European electricity markets – outcomes of a Delphi study

    International Nuclear Information System (INIS)

    Makkonen, Mari; Pätäri, Satu; Jantunen, Ari; Viljainen, Satu

    2012-01-01

    Internal European electricity markets are a target set by the European Union (EU) and under development at present. This article presents the findings of a Delphi study focusing on the prospects of European electricity markets. The main aim is to report the obstacles that participants in the survey felt were the most critical ones affecting competition in the European electricity markets of the future. The respondents were European electricity market specialists, and the themes of the survey ranged from transmission networks and electricity trade to demand flexibility. One of the key findings was shared concern over the adequacy of transmission network capacity in Europe. It was considered that technical issues, such as existing transmission network bottlenecks, are most likely to form obstacles to creating common European electricity markets if new capacity is not built quickly enough. It was seen by the panellists that electricity trading arrangements, whilst important, are unlikely to form a barrier to the development of an internal electricity market. It was noted that electricity trading issues have recently been the subject of development work in the EU. - Highlights: ► The internal electricity market is a priority of the European Union. ► The Delphi method was used to study competition in the European electricity markets. ► The congested grid hampers the development of internal electricity markets in Europe. ► The significance of a transmission network will be emphasised in the future. ► Electricity trading arrangements are likely to be solved.

  2. Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

    Science.gov (United States)

    Hiriscau, Elisabeta Ioana; Stingelin-Giles, Nicola; Wasserman, Danuta; Reiter-Theil, Stella

    2016-01-01

    Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors. PMID:27187425

  3. Scenarios for future agriculture in Finland: a Delphi study among agri-food sector stakeholders

    Directory of Open Access Journals (Sweden)

    P. RIKKONEN

    2008-12-01

    Full Text Available This article presents alternative scenarios for future agriculture in Finland up to 2025. These scenarios are the results of a large Delphi study carried out among Finnish agri-food sector stakeholders. The Delphi panel members gave their future view on desirable and probable futures. From these two dimensions, three scenarios were elaborated through the future images – the subjective future path and the importance analysis. The scenarios represent a technology optimistic “day-dream agriculture”, a probable future as “industrialised agriculture” and an undesirable future path as “drifting agriculture”. Two mini-scenarios are also presented. They are based on a discontinuity event as an unexpected impact of climate change and an analogy event as an ecological breakdown due to the expansive animal disease epidemics. In both mini-scenarios, the directions of storylines are dramatically changed. The scenarios support strategic planning introducing not only one forecast but alternative outcomes as a basis for future strategy and decisions. In this study the scenarios were constructed to address the opportunities as a desired vision and also the threats as to an undesirable future in the agricultural sector. These results bring to the table a Finnish agri-food expert community view of the future directions of relevant key issues in the agricultural policy agenda.;

  4. Identifying management competencies for health care executives: review of a series of Delphi studies.

    Science.gov (United States)

    Hudak, R P; Brooke, P P; Finstuen, K

    2000-01-01

    This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.

  5. In search for a public health leadership competency framework to support leadership curriculum-a consensus study.

    Science.gov (United States)

    Czabanowska, Katarzyna; Smith, Tony; Könings, Karen D; Sumskas, Linas; Otok, Robert; Bjegovic-Mikanovic, Vesna; Brand, Helmut

    2014-10-01

    Competency-based education is increasingly popular, especially in the area of continuing professional development. Many competency frameworks have been developed; however, few address leadership competencies for European public health professionals. The aim of this study was to develop a public health leadership competency framework to inform a leadership curriculum for public health professionals. The framework was developed as part of the Leaders for European Public Health project-supported by the EU Lifelong Learning Programme. The study was carried out in three phases: a literature review, consensus development panel and Delphi survey. The public health leadership competency framework was initially developed from a literature review. A preliminary list of competencies was submitted to a panel of experts. Two consensus development panels were held to evaluate and make changes to the initial draft competency framework. Then two rounds of a Delphi survey were carried out in an effort to reach consensus. Both surveys were presented through Survey Monkey to members of the Association of the Schools of Public Health in the European Region Working Group on Innovation in Public Health Teaching and Education. The framework was developed consisting of 52 competencies organized into eight domains: Systems Thinking; Political Leadership; Collaborative Leadership: Building and Leading Interdisciplinary Teams; Leadership and Communication; Leading Change; Emotional Intelligence and Leadership in Team-based Organizations; Leadership, Organizational Learning and Development and Ethics and Professionalism. The framework can serve as a useful tool in identifying gaps in knowledge and skills, and shaping competency-based continuing professional development leadership curricula for public health professionals in Europe. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  6. Development of an English-language version of a Japanese iPad application to facilitate collaborative goal setting in rehabilitation: a Delphi study and field test.

    Science.gov (United States)

    Levack, William; Tomori, Kounosuke; Takahashi, Kayoko; Sherrington, Aidan J

    2018-03-01

    This study aimed to investigate the content of an English-language version of a Japanese iPad application designed to facilitate shared decision-making around goal setting in rehabilitation: Aid for Decision-making in Occupational Choice-English (ADOC-E). Phase 1: Delphi methods to reach consensus with an international group of expert occupational therapists on the text and images in ADOC-E. Phase 2: Testing correct recognition (unprompted and prompted) of images in ADOC-E by health service users in inpatient rehabilitation and residential care. Phase 1: International, online. Phase 2: Three healthcare services in New Zealand-(1) a residential rehabilitation service for traumatic brain injury, (2) a nursing home for frail older adults and (3) an inpatient rehabilitation ward in a public hospital. Phase 1: Fourteen experienced occupational therapists from New Zealand (4), Australia (4), UK (2) and USA (4). Phase 2: Twenty-four rehabilitation and residential care service users (10 men, 14 women; 20-95 years; Mini-Mental State Exam scores 13-30). Four Delphi rounds were required to reach consensus with the experienced occupational therapists on the content of ADOC-E, ending with 100 items covering daily activities that people do and social roles they participate in. Ninety-five per cent (95/100) of ADOC-E items could each be correctly identified by over 80% of service user participants with either unprompted or prompted recognition. While a few of the more abstract concepts in ADOC-E (related to complex social roles) were less likely to be correctly recognised by all participants, the text and images ADOC-E were deemed to be fit for purpose overall and ready for future clinical testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. A Research Study Using the Delphi Method to Define Essential Competencies for a High School Game Art and Design Course Framework at the National Level

    Science.gov (United States)

    Mack, Nayo Corenus-Geneva

    2011-01-01

    This research study reports the findings of a Delphi study conducted to determine the essential competencies and objectives for a high school Game Art and Design course framework at the national level. The Delphi panel consisted of gaming, industry and educational experts from all over the world who were members of the International Game…

  8. Delphi cookbook

    CERN Document Server

    Teti, Daniele

    2014-01-01

    Intended to refresh the basics of Delphi as well as advance your knowledge to the next level, it is assumed you will know RAD studio and the Object Pascal language. However, if you are not an experienced RAD studio programmer this accessible guide will still develop those initial crucial skills.

  9. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    Science.gov (United States)

    Cowman, Seamus; Gethin, Georgina; Clarke, Eric; Moore, Zena; Craig, Gerardine; Jordan-O'Brien, Julie; McLain, Niamh; Strapp, Helen

    2012-02-01

    To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. The study used a survey method. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. conclusion: Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The determination of research and education priorities is therefore an absolute requirement

  10. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    LENUS (Irish Health Repository)

    2012-02-01

    Aim. To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. Design. The study used a survey method. Methods. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Results. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. Conclusion. Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. Relevance to clinical practice. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The

  11. Consulting the oracle: ten lessons from using the Delphi technique in nursing research.

    Science.gov (United States)

    Keeney, Sinead; Hasson, Felicity; McKenna, Hugh

    2006-01-01

    The aim of this paper was to provide insight into the Delphi technique by outlining our personal experiences during its use over a 10-year period in a variety of applications. As a means of achieving consensus on an issue, the Delphi research method has become widely used in healthcare research generally and nursing research in particular. The literature on this technique is expanding, mainly addressing what it is and how it should be used. However, there is still much confusion and uncertainty surrounding it, particularly about issues such as modifications, consensus, anonymity, definition of experts, how 'experts' are selected and how non-respondents are pursued. This issues that arise when planning and carrying out a Delphi study include the definition of consensus; the issue of anonymity vs. quasi-anonymity for participants; how to estimate the time needed to collect the data, analyse each 'round', feed back results to participants, and gain their responses to this feedback; how to define and select the 'experts' who will be asked to participate; how to enhance response rates; and how many 'rounds' to conduct. Many challenges and questions are raised when using the Delphi technique, but there is no doubt that it is an important method for achieving consensus on issues where none previously existed. Researchers need to adapt the method to suit their particular study.

  12. Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study

    International Nuclear Information System (INIS)

    Adleman, Jenna; Gillan, Caitlin; Caissie, Amanda; Davis, Carol-Anne; Liszewski, Brian; McNiven, Andrea; Giuliani, Meredith

    2017-01-01

    Purpose: To develop an entry-to-practice quality and safety competency profile for radiation oncology residency. Methods and Materials: A comprehensive list of potential quality and safety competency items was generated from public and professional resources and interprofessional focus groups. Redundant or out-of-scope items were eliminated through investigator consensus. Remaining items were subjected to an international 2-round modified Delphi process involving experts in radiation oncology, radiation therapy, and medical physics. During Round 1, each item was scored independently on a 9-point Likert scale indicating appropriateness for inclusion in the competency profile. Items indistinctly ranked for inclusion or exclusion were re-evaluated through web conference discussion and reranked in Round 2. Results: An initial 1211 items were compiled from 32 international sources and distilled to 105 unique potential quality and safety competency items. Fifteen of the 50 invited experts participated in round 1: 10 radiation oncologists, 4 radiation therapists, and 1 medical physicist from 13 centers in 5 countries. Round 1 rankings resulted in 80 items included, 1 item excluded, and 24 items indeterminate. Two areas emerged more prominently within the latter group: change management and human factors. Web conference with 5 participants resulted in 9 of these 24 items edited for content or clarity. In Round 2, 12 participants rescored all indeterminate items resulting in 10 items ranked for inclusion. The final 90 enabling competency items were organized into thematic groups consisting of 18 key competencies under headings adapted from Deming's System of Profound Knowledge. Conclusions: This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.

  13. Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study

    Energy Technology Data Exchange (ETDEWEB)

    Adleman, Jenna [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Gillan, Caitlin [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Caissie, Amanda [Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada); Saint John Regional Hospital, Saint John, New Brunswick (Canada); Davis, Carol-Anne [Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada); Nova Scotia Cancer Centre, Halifax, Nova Scotia (Canada); Liszewski, Brian [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); McNiven, Andrea [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Giuliani, Meredith, E-mail: Meredith.Giuliani@rmp.uhn.ca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)

    2017-06-01

    Purpose: To develop an entry-to-practice quality and safety competency profile for radiation oncology residency. Methods and Materials: A comprehensive list of potential quality and safety competency items was generated from public and professional resources and interprofessional focus groups. Redundant or out-of-scope items were eliminated through investigator consensus. Remaining items were subjected to an international 2-round modified Delphi process involving experts in radiation oncology, radiation therapy, and medical physics. During Round 1, each item was scored independently on a 9-point Likert scale indicating appropriateness for inclusion in the competency profile. Items indistinctly ranked for inclusion or exclusion were re-evaluated through web conference discussion and reranked in Round 2. Results: An initial 1211 items were compiled from 32 international sources and distilled to 105 unique potential quality and safety competency items. Fifteen of the 50 invited experts participated in round 1: 10 radiation oncologists, 4 radiation therapists, and 1 medical physicist from 13 centers in 5 countries. Round 1 rankings resulted in 80 items included, 1 item excluded, and 24 items indeterminate. Two areas emerged more prominently within the latter group: change management and human factors. Web conference with 5 participants resulted in 9 of these 24 items edited for content or clarity. In Round 2, 12 participants rescored all indeterminate items resulting in 10 items ranked for inclusion. The final 90 enabling competency items were organized into thematic groups consisting of 18 key competencies under headings adapted from Deming's System of Profound Knowledge. Conclusions: This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.

  14. Development of mental health first aid guidelines for panic attacks: a Delphi study

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2009-08-01

    Full Text Available Abstract Background Panic attacks are common, and while they are not life-threatening events, they can lead to the development of panic disorder and agoraphobia. Appropriate help at the time that a panic attack occurs may decrease the fear associated with the attack and reduce the risk of developing an anxiety disorder. However, few people have the knowledge and skills required to assist. Simple first aid guidelines may help members of the public to offer help to people who experience panic attacks. Methods The Delphi method was used to reach consensus in a panel of experts. Experts included 50 professionals and 6 people who had experience of panic attacks and were active in mental health advocacy. Statements about how to assist someone who is having a panic attack were sourced through a systematic search of both professional and lay literature. These statements were rated for importance as first aid guidelines by the expert and consumer panels and guidelines were written using the items most consistently endorsed. Results Of 144 statements presented to the panels, 27 were accepted. These statements were used to develop the guidelines appended to this paper. Conclusion There are a number of actions which are considered to be useful for members of the public to do if they encounter someone who is having a panic attack. These guidelines will be useful in revision of curricula of mental health first aid programs. They can also be used by members of the public who want immediate information about how to assist someone who is experiencing panic attacks.

  15. Development of mental health first aid guidelines for suicidal ideation and behaviour: A Delphi study

    Directory of Open Access Journals (Sweden)

    Kitchener Betty A

    2008-03-01

    Full Text Available Abstract Background Suicide is a statistically rare event, but devastating to those left behind and one of the worst possible outcomes associated with mental illness. Although a friend, family member or co-worker may be the first person to notice that a person is highly distressed, few have the knowledge and skills required to assist. Simple guidelines may help such a person to encourage a suicidal individual to seek professional help or decide against suicide. Methods This research was conducted using the Delphi methodology, a method of reaching consensus in a panel of experts. Experts recruited to the panels included 22 professionals, 10 people who had been suicidal in the past and 6 carers of people who had been suicidal in the past. Statements about how to assist someone who is thinking about suicide were sourced through a systematic search of both professional and lay literature. The guidelines were written using the items most consistently endorsed by all three panels. Results Of 114 statements presented to the panels, 30 were accepted. These statements were used to develop the guidelines appended to this paper. Conclusion There are a number of actions which are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. These guidelines will be useful in revision of curricula of mental health first aid and suicide intervention training programs. They can also be used by members of the public who want immediate information about how to assist a suicidal person.

  16. Standardised method for reporting exercise programmes: protocol for a modified Delphi study.

    Science.gov (United States)

    Slade, Susan C; Dionne, Clermont E; Underwood, Martin; Buchbinder, Rachelle

    2014-12-30

    Exercise is integral to health across the lifespan and important for people with chronic health conditions. A systematic review of exercise trials for chronic conditions reported suboptimal descriptions of the evaluated interventions and concluded that this hinders interpretation and replication. The aim of this project is to develop a standardised method for reporting essential exercise programme details being evaluated in clinical trials. A modified Delphi technique will be used to gain consensus among international exercise experts. We will use three sequential rounds of anonymous online questionnaires to refine a standardised checklist. A draft checklist of potentially relevant items was developed based on the results of a systematic review of exercise systematic reviews. An international panel of experts was identified by exercise systematic review authorship, established international profile in exercise research and practice and by peer referral. In round 1, the international panel of experts will be asked to rate the importance of each draft item and provide additional suggestions for revisions or new items. Consensus will be considered reached if at least 70% of the panel strongly agree/disagree that an item should be included or excluded. Where agreement is not reached or there are suggestions for altered or new items, these will be taken to round 2 together with an aggregated summary of round 1 responses. Following the second round, a ranking of item importance will be made to rationalise the number of items. The final template will be distributed to panel members for approval. Ethics approval was received from The Cabrini Institute Ethics Committee, Melbourne, Australia (HREC 02-07-04-14). We plan to use a stepwise process to develop and refine a standardised and internationally agreed template for explicit reporting of exercise programmes. The template will be generalisable across all types of exercise interventions. The findings will be disseminated

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

    Science.gov (United States)

    Franklin, Edward A.

    2011-01-01

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

  18. Defining Malaysian Knowledge Society: Results from the Delphi Technique

    Science.gov (United States)

    Hamid, Norsiah Abdul; Zaman, Halimah Badioze

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

  19. Building consensus on clinical procedural skills for South African ...

    African Journals Online (AJOL)

    Background: The development of registrar training as part of the newly created speciality of family medicine in South Africa requires the development of a national consensus on the clinical procedural skills outcomes that should be expected of training programmes. Methods: This study utilized a Delphi technique to ...

  20. Barriers and facilitators to providing undergraduate physiotherapy clinical education in the primary care setting: a three-round Delphi study.

    Science.gov (United States)

    McMahon, S; Cusack, T; O'Donoghue, G

    2014-03-01

    With the global shift in health care from secondary to primary care, employment opportunities for newly qualified physiotherapists are likely to be in the primary care setting. However, to date, undergraduate physiotherapy clinical education has been centred around secondary care, focusing on acute services in large teaching hospitals. For contemporary physiotherapists to become effective first-contact primary care providers, they need to be exposed to the primary care environment during their undergraduate education. To explore the concept and identify perceived barriers and facilitators to providing physiotherapy undergraduate clinical placements in the primary healthcare setting A three-round Delphi survey was used. Participants were asked to answer open-ended questions with regard to: (i) student preparation for and (ii) provision of primary care placements (Round 1). Content analysis was employed to identify key themes. These themes generated statements for Round 2. In Round 2, participants were asked to rate their level of agreement/disagreement with the generated statements. In Round 3, a final rating process was conducted. Level of consensus was established as ≥70% agreement, with an interquartile range of ≤1. One hundred and ninety-eight primary care physiotherapy staff. Barriers identified included shortage of resources (e.g. staff) and a lack of tradition; in other words, students are not traditionally educated in the primary care setting. Response rates were 60% (120/198), 70% (84/120) and 76% (64/84) for Rounds 1, 2 and 3, respectively. All seven key facilitators identified reached consensus. They included additional support for staff taking students and motivated students. This study revealed that there is support for the provision of physiotherapy clinical education in the primary care setting. Through careful consideration with clear planning and collaboration with all stakeholders, it may be possible to convert the main barriers identified into

  1. Is There a Consensus on Consensus Methodology? Descriptions and Recommendations for Future Consensus Research.

    Science.gov (United States)

    Waggoner, Jane; Carline, Jan D; Durning, Steven J

    2016-05-01

    The authors of this article reviewed the methodology of three common consensus methods: nominal group process, consensus development panels, and the Delphi technique. The authors set out to determine how a majority of researchers are conducting these studies, how they are analyzing results, and subsequently the manner in which they are reporting their findings. The authors conclude with a set of guidelines and suggestions designed to aid researchers who choose to use the consensus methodology in their work.Overall, researchers need to describe their inclusion criteria. In addition to this, on the basis of the current literature the authors found that a panel size of 5 to 11 members was most beneficial across all consensus methods described. Lastly, the authors agreed that the statistical analyses done in consensus method studies should be as rigorous as possible and that the predetermined definition of consensus must be included in the ultimate manuscript. More specific recommendations are given for each of the three consensus methods described in the article.

  2. Attributions, false consensus and valence: two field studies

    NARCIS (Netherlands)

    van der Pligt, J.

    1984-01-01

    Two studies, with 1,056 Ss, investigated attitudes, knowledge, and behavior with regard to several environmental issues. Findings demonstrate that observers tend to perceive a false consensus with respect to the relative commonness of their own behavioral choices. This phenomenon was replicated

  3. European neonatal intensive care nursing research priorities: an e-Delphi study.

    Science.gov (United States)

    Wielenga, Joke M; Tume, Lyvonne N; Latour, Jos M; van den Hoogen, Agnes

    2015-01-01

    This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and research statements were generated to be ranged on importance on a scale of 1-6 (not important to most important). Neonatal intensive care units (NICUs) in 17 European countries. NICU clinical nurses, managers, educators and researchers (n=75). None. A list of 43 research statements in eight domains. The six highest ranking statements (≥5.0 mean score) were related to prevention and reduction of pain (mean 5.49; SD 1.07), medication errors (mean 5.20; SD 1.13), end-of-life care (mean 5.05; SD 1.18), needs of parents and family (mean 5.04; SD 1.23), implementing evidence into nursing practice (mean 5.02; SD 1.03), and pain assessment (mean 5.02; SD 1.11). The research domains were prioritised and ranked: (1) pain and stress; (2) family centred care; (3) clinical nursing care practices; (4) quality and safety; (5) ethics; (6) respiratory and ventilation; (7) infection and inflammation; and (8) professional issues in neonatal intensive care nursing. The results of this study might support developing a nursing research strategy for the nursing section of the European Society of Paediatric and Neonatal Intensive Care. In addition, this may promote more European researcher collaboratives for neonatal nursing research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. International, Expert-Based, Consensus Statement Regarding the Management of Acute Diverticulitis.

    Science.gov (United States)

    O'Leary, D Peter; Lynch, Noel; Clancy, Cillian; Winter, Desmond C; Myers, Eddie

    2015-09-01

    This Delphi study provides consensus related to many aspects of acute diverticulitis and identifies other areas in need of research. To generate an international, expert-based, consensus statement to address controversies in the management of acute diverticulitis. This study was conducted using the Delphi technique from April 3 through October 21, 2014. A survey website was used and a panel of acute diverticulitis experts was formed via the snowball method. The top 5 acute diverticulitis experts in 5 international geographic regions were identified based on their number of publications related to acute diverticulitis. The Delphi study used 3 rounds of questions, after which the consensus statement was collated. A consensus statement related to the management of acute diverticulitis. Twenty items were selected for inclusion in the consensus statement following 3 rounds of questioning. A clear definition of uncomplicated and complicated diverticulitis is provided. In uncomplicated diverticulitis, consensus was reached regarding appropriate laboratory and radiological evaluation of patients as well as nonsurgical, surgical, and follow-up strategies. A number of important topics, including antibiotic treatment, failed to reach consensus. In addition, consensus was reached regarding many nonsurgical and surgical treatment strategies in complicated diverticulitis. Controversy continues internationally regarding the management of acute diverticulitis. This study demonstrates that there is more nonconsensus among experts than consensus regarding most issues, even in the same region. It also provides insight into the status quo regarding the treatment of acute diverticulitis and provides important direction for future research.

  5. DELPHI Exhibition

    CERN Multimedia

    2000-01-01

    DELPHI (Detector for Lepton, Photon and Hadron Identification) is a detector for e+e- physics, with special emphasis on powerful particle identification, three-dimensional information, high granularity and precise vertex determination. It is installed at LEP (Large Electron and Positron collider) at CERN where it has operated since 1989. The present collaboration consists of about 550 physicists from 56 participating universities and institutes in 22 countries.

  6. Determinants of Financial Sustainability for Farm Credit Applications—A Delphi Study

    Directory of Open Access Journals (Sweden)

    Johannes I. F. Henning

    2016-01-01

    Full Text Available Farmers use credit from commercial credit providers to finance production activities. Commercial credit providers have to predict the financial sustainability of the enterprise to ensure that the borrower will have the ability to repay the loan. A Delphi study was conducted to explore what factors are used as indicators of loan-repayment ability of farmers. The objective was not only to identify factors that are currently considered, but also to identify other personal attributes that may improve the accuracy in predicting the repayment ability of potential borrowers. The Delphi was applied to a panel consisting of nine credit analysts and credit managers from a commercial credit provider in South Africa. The results indicate that the current and past financial performance, account standing, collateral, and credit record of the farm are very important in the assessment of applications in terms of financial performance. Experience and the success factors compared to competitors were found to be important, while age and education/qualification are regarded as less important in predicting repayment ability. The results also show that, although not currently objectively included in credit evaluations, credit analysis regards leadership and human relations; commitment and confidence; internal locus of control; self-efficacy; calculated risk taking; need for achievement; and opportunity seeking as important indicators of the ability of potential borrows to repay their loans. Thus, credit analysts and managers also regard management abilities and entrepreneurial characteristics of potential borrowers to be good indicators of repayment ability. Results from this research provide new indicator factors that can be used to extend existing credit evaluation instruments in order to more accurately predict repayment ability.

  7. A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress).

    Science.gov (United States)

    Evans, Bruce J W; Allen, Peter M; Wilkins, Arnold J

    Visual stress (VS) is characterised by symptoms of visual perceptual distortions and eyestrain when viewing text, symptoms that are alleviated by individually prescribed coloured filters. A recent review supports the existence of VS and its treatment, but noted that controversy remains, in part due to inconsistencies in the diagnosis of the condition. The present paper reviews the diagnostic criteria for VS in the literature and reports a Delphi analysis of the criteria currently used in clinical practice. Twenty-six eyecare practitioners were invited to participate in a Delphi study. They were selected because they were frequent prescribers of precision tinted lenses. In the first round they were sent a list of the indicators for which there is literature to suggest a relevance in the diagnosis of VS. The practitioners were invited to rank the indicators and add any additional criteria they use in diagnosis. In the second round a revised list was circulated, including items added from the responses in the first round. The respondents included optometrists, orthoptists and opticians. In the first round the response rate was 85%. Ninety-one percent of those who participated in the first round also responded in the second round. Strong indicators in the second round included the symptom of words moving when reading, voluntary use of an overlay for a prolonged period, improved performance of ≥15% with an overlay on the Wilkins Rate of Reading test, and an abnormally high score on the Pattern Glare Test. The strongest diagnostic criteria are combined in a diagnostic tool. This is proposed as a guide for clinical practice and further research. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  8. International Consensus for ultrasound lesions in gout

    DEFF Research Database (Denmark)

    Gutierrez, Marwin; Schmidt, Wolfgang A; Thiele, Ralf G

    2015-01-01

    OBJECTIVE: To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. METHODS: The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert...... lesions in gout, demonstrated good reliability overall. It constitutes an essential step in developing a core outcome measurement that permits a higher degree of homogeneity and comparability between multicentre studies....

  9. A Delphi Study to Detect Deficiencies and Propose Actions in Real Life Treatment of Neovascular Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Alfredo García-Layana

    2014-01-01

    Full Text Available Purpose. Spanish retina specialists were surveyed in order to propose actions to decrease deficiencies in real-life neovascular age macular degeneration treatment (nv-AMD. Methods. One hundred experts, members of the Spanish Vitreoretinal Society (SERV, were invited to complete an online survey of 52 statements about nv-AMD management with a modified Delphi methodology. Four rounds were performed using a 5-point Linkert scale. Recommendations were developed after analyzing the differences between the results and the SERV guidelines recommendations. Results. Eighty-seven specialists completed all the Delphi rounds. Once major potential deficiencies in real-life nv-AMD treatment were identified, 15 recommendations were developed with a high level of agreement. Consensus statements to reduce the burden of the disease included the use of treat and extend regimen and to reduce the amount of diagnostic tests during the loading phase and training technical staff to perform these tests and reduce the time between relapse detection and reinjection, as well as establishing patient referral protocols to outside general ophthalmology clinics. Conclusion. The level of agreement with the final recommendations for nv-AMD treatment among Spanish retinal specialist was high indicating that some actions could be applied in order to reduce the deficiencies in real-life nv-AMD treatment.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rym Boulkedid

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

  14. A case study of consensus modelling for tracking oil spills

    International Nuclear Information System (INIS)

    King, Brian; Brushett, Ben; Lemckert, Charles

    2010-01-01

    Metocean forecast datasets are essential for the timely response to marine incidents and pollutant spill mitigation at sea. To effectively model the likely drift pattern and the area of impact for a marine spill, both wind and ocean current forecast datasets are required. There are two ocean current forecast models and two wind forecast models currently used operationally in the Australia and Asia Pacific region. The availability of several different forecast models provides a unique opportunity to compare the outcome of a particular modelling exercise with the outcome of another using a different model and determining whether there is consensus in the results. Two recent modelling exercises, the oil spill resulting from the damaged Pacific Adventurer (in Queensland) and the oil spill from the Montara well blowout (in Western Australia) are presented as case studies to examine consensus modelling.

  15. Adaptation of the WHO maternal near miss tool for use in sub-Saharan Africa: an International Delphi study.

    Science.gov (United States)

    Tura, Abera K; Stekelenburg, Jelle; Scherjon, Sicco A; Zwart, Joost; van den Akker, Thomas; van Roosmalen, Jos; Gordijn, Sanne J

    2017-12-29

    Assessments of maternal near miss (MNM) are increasingly used in addition to those of maternal mortality measures. The World Health Organization (WHO) has introduced an MNM tool in 2009, but this tool was previously found to be of limited applicability in several low-resource settings. The aim of this study was to identify adaptations to enhance applicability of the WHO MNM tool in sub-Saharan Africa. Using a Delphi consensus methodology, existing MNM tools were rated for applicability in sub-Saharan Africa over a series of three rounds. Maternal health experts from sub-Saharan Africa or with considerable knowledge of the context first rated importance of WHO MNM parameters using Likert scales, and were asked to suggest additional parameters. This was followed by two confirmation rounds. Parameters accepted by at least 70% of the panel members were accepted for use in the region. Of 58 experts who participated from study onset, 47 (81%) completed all three rounds. Out of the 25 WHO MNM parameters, all 11 clinical, four out of eight laboratory, and four out of six management-based parameters were accepted, while six parameters (PaO2/FiO2 100 μmol/l or >6.0 mg/dl, pH 5 μmol/l, dialysis for acute renal failure and use of continuous vasoactive drugs) were deemed to not be applicable. An additional eight parameters (uterine rupture, sepsis/severe systemic infection, eclampsia, laparotomy other than caesarean section, pulmonary edema, severe malaria, severe complications of abortions and severe pre-eclampsia with ICU admission) were suggested for inclusion into an adapted sub-Saharan African MNM tool. All WHO clinical criteria were accepted for use in the region. Only few of the laboratory- and management based were rated applicable. This study brought forward important suggestions for adaptations in the WHO MNM criteria to enhance its applicability in sub-Saharan Africa and possibly other low-resource settings.

  16. Clinical and Para Clinical Information Needs of Infertility Electronic Health Records in Iran: A Delphi Study.

    Science.gov (United States)

    Farzandipour, Mehrdad; Jeddi, Fateme Rangraz; Gilasi, Hamid Reza; Shirzadi, Diana

    2017-09-01

    infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method. Designing the questionnaire was done based on library studies and Gathering experts' views was done based on Delphi technique. 261 items from clinical and Para clinical information of infertile patients' electronic health records were subjected to an opinion poll by experts. During this process 223 items were accepted and 38 items have been rejected after two sessions of surveys by infertility experts. Para clinical information section consisted of 57 items that all of them have been accepted by the experts. Also, clinical information section consisted of 242 items from which 204 items were accepted and 38 items were rejected by the experts. existence of a structured electronic record system of infertile patients' information leads to the integration of patients' information, improvement of health care services and a decrease in treatment costs: all working to increase information safety. Furthermore, only essential and relevant information would be provided for the specialists and it will facilitate and direct the future infertility related studies due to the coherence, unity and relevance of the information.

  17. Study of multi-muon bundles in cosmic ray showers detected with the DELPHI detector at LEP

    International Nuclear Information System (INIS)

    Abdallah, J.; Abreu, P.; Adam, W.; Besancon, M.; Besson, N.; Boonekamp, M.; Jarry, P.; Lutz, P.; Nicolaidou, R.; Ouraou, A.; Pierre, F.; Ruhlmann-Kleider, V.; Turluer, M.L.; Vilanova, D.

    2007-01-01

    The DELPHI detector at LEP has been used to measure multi-muon bundles originating from cosmic ray interactions with air. The cosmic events were recorded in 'parasitic mode' between individual e + e - interactions and the total live time of this data taking is equivalent to 1.6 * 10 6 s. The DELPHI apparatus is located about 100 m underground and the 84 metres rock overburden imposes a cutoff of about 52 GeV/c on muon momenta. The data from the large volume Hadron Calorimeter allowed the muon multiplicity of 54,201 events to be reconstructed. The resulting muon multiplicity distribution is compared with the prediction of the Monte Carlo simulation based on CORSIKA/QGSJETOI. The model fails to describe the abundance of high multiplicity events. The impact of QGSJET internal parameters on the results is also studied. (authors)

  18. Contribution to the study of the environmental impact from fuel cells and hydrogen, using the Delphi methodology

    International Nuclear Information System (INIS)

    Ribeiro, Maria Alice M.; Oliveira, Wagner dos Santos; Hamada, Margarida Mizue

    2007-01-01

    The evaluation of the future systems of energy supply is of greatest importance to obtain information on the potential risk of environmental impact of some new processes. This work has as main objective to make a forecast of the environmental impact of low and average temperature fuel cells, in the long run, analyzing all the stages of their useful life and final disposal of the materials that constitute them, using the Delphi methodology. Data-collecting of Life Cycle Analysis are presented for the fuel cells type PEMFC related to the evaluation of the environmental impact that the new materials and processes will cause during the manufacture, operation and final disposal, after complete their useful life. This work also presents the hydrogen production nuclear methods. The entrance data and the philosophy to be used in this study of the future scenario are presented, as well as the results obtained from the first round of the questionnaire applied in the Delphi Method. (author)

  19. Study of rare b decays with the DELPHI detector at LEP

    CERN Document Server

    Adam, W; Agasi, E; Ajinenko, I; Aleksan, Roy; Alekseev, G D; Alemany, R; Allport, P P; Almehed, S; Amaldi, Ugo; Amato, S; Andreazza, A; Andrieux, M L; Antilogus, P; Apel, W D; Arnoud, Y; Åsman, B; Augustin, J E; Augustinus, A; Baillon, Paul; Bambade, P; Barão, F; Barate, R; Barbi, M S; Bardin, Dimitri Yuri; Baroncelli, A; Bärring, O; Barrio, J A; Bartl, Walter; Bates, M J; Battaglia, Marco; Baubillier, M; Baudot, J; Becks, K H; Begalli, M; Beillière, P; Belokopytov, Yu A; Benvenuti, Alberto C; Berggren, M; Bertini, D; Bertrand, D; Bianchi, F; Bigi, M; Bilenky, S M; Billoir, P; Bloch, D; Blume, M; Bolognese, T; Bonesini, M; Bonivento, W; Booth, P S L; Borisov, G; Bosio, C; Botner, O; Boudinov, E; Bouquet, B; Bourdarios, C; Bowcock, T J V; Bozzo, M; Branchini, P; Brand, K D; Brenke, T; Brenner, R A; Bricman, C; Brown, R C A; Brückman, P; Brunet, J M; Bugge, L; Buran, T; Burgsmüller, T; Buschmann, P; Buys, A; Cabrera, S; Caccia, M; Calvi, M; Camacho-Rozas, A J; Camporesi, T; Canale, V; Canepa, M; Cankocak, K; Cao, F; Carena, F; Carroll, L; Caso, Carlo; Castillo-Gimenez, M V; Cattai, A; Cavallo, F R; Chabaud, V; Charpentier, P; Chaussard, L; Chauveau, J; Checchia, P; Chelkov, G A; Chen, M; Chierici, R; Chliapnikov, P V; Chochula, P; Chorowicz, V; Chudoba, J; Cindro, V; Collins, P; Contreras, J L; Contri, R; Cortina, E; Cosme, G; Cossutti, F; Crawley, H B; Crennell, D J; Crosetti, G; Cuevas-Maestro, J; Czellar, S; Dahl-Jensen, Erik; Dahm, J; D'Almagne, B; Dam, M; Damgaard, G; Dauncey, P D; Davenport, Martyn; Da Silva, W; Defoix, C; Deghorain, A; Della Ricca, G; Delpierre, P A; Demaria, N; De Angelis, A; de Boer, Wim; De Brabandere, S; De Clercq, C; La Vaissière, C de; De Lotto, B; De Min, A; De Paula, L S; De Saint-Jean, C; Dijkstra, H; Di Ciaccio, Lucia; Djama, F; Dolbeau, J; Dönszelmann, M; Doroba, K; Dracos, M; Drees, J; Drees, K A; Dris, M; Durand, J D; Edsall, D M; Ehret, R; Eigen, G; Ekelöf, T J C; Ekspong, Gösta; Elsing, M; Engel, J P; Erzen, B; Espirito-Santo, M C; Falk, E; Fassouliotis, D; Feindt, Michael; Fenyuk, A; Ferrer, A; Fichet, S; Filippas-Tassos, A; Firestone, A; Fischer, P A; Föth, H; Fokitis, E; Fontanelli, F; Formenti, F; Franek, B J; Frenkiel, P; Fries, D E C; Frodesen, A G; Frühwirth, R; Fulda-Quenzer, F; Fuster, J A; Galloni, A; Gamba, D; Gandelman, M; García, C; García, J; Gaspar, C; Gasparini, U; Gavillet, P; Gazis, E N; Gelé, D; Gerber, J P; Gibbs, M; Gokieli, R; Golob, B; Gopal, Gian P; Gorn, L; Górski, M; Guz, Yu; Gracco, Valerio; Graziani, E; Grosdidier, G; Grzelak, K; Gumenyuk, S A; Gunnarsson, P; Günther, M; Guy, J; Hahn, F; Hahn, S; Hajduk, Z; Hallgren, A; Hamacher, K; Hao, W; Harris, F J; Hedberg, V; Henriques, R P; Hernández, J J; Herquet, P; Herr, H; Hessing, T L; Higón, E; Hilke, Hans Jürgen; Hill, T S; Holmgren, S O; Holt, P J; Holthuizen, D J; Hoorelbeke, S; Houlden, M A; Hrubec, Josef; Huet, K; Hultqvist, K; Jackson, J N; Jacobsson, R; Jalocha, P; Janik, R; Jarlskog, C; Jarlskog, G; Jarry, P; Jean-Marie, B; Johansson, E K; Jönsson, L B; Jönsson, P E; Joram, Christian; Juillot, P; Kaiser, M; Kapusta, F; Karafasoulis, K; Karlsson, M; Karvelas, E; Katsanevas, S; Katsoufis, E C; Keränen, R; Khokhlov, Yu A; Khomenko, B A; Khovanskii, N N; King, B J; Kjaer, N J; Klein, H; Klovning, A; Kluit, P M; Köne, B; Kokkinias, P; Koratzinos, M; Korcyl, K; Kostyukhin, V; Kourkoumelis, C; Kuznetsov, O; Kramer, P H; Krammer, Manfred; Kreuter, C; Kronkvist, I J; Krumshtein, Z; Krupinski, W; Kubinec, P; Kucewicz, W; Kurvinen, K L; Lacasta, C; Laktineh, I; Lamblot, S; Lamsa, J; Lanceri, L; Lane, D W; Langefeld, P; Last, I; Laugier, J P; Lauhakangas, R; Leser, G; Ledroit, F; Lefébure, V; Legan, C K; Leitner, R; Lemoigne, Y; Lemonne, J; Lenzen, Georg; Lepeltier, V; Lesiak, T; Libby, J; Liko, D; Lindner, R; Lipniacka, A; Lippi, I; Lörstad, B; Loken, J G; López, J M; Loukas, D; Lutz, P; Lyons, L; MacNaughton, J N; Maehlum, G; Maio, A; Malychev, V; Marco, J; Marco, R P; Maréchal, B; Margoni, M; Marin, J C; Mariotti, C; Markou, A; Maron, T; Martínez-Rivero, C; Martínez-Vidal, F; Martí i García, S; Masik, J; Matorras, F; Matteuzzi, C; Matthiae, Giorgio; Mazzucato, M; McCubbin, M L; McKay, R; McNulty, R; Medbo, J; Merk, M; Meroni, C; Meyer, S; Meyer, W T; Myagkov, A; Michelotto, M; Migliore, E; Mirabito, L; Mitaroff, Winfried A; Mjörnmark, U; Moa, T; Møller, R; Mönig, K; Monge, M R; Morettini, P; Müller, H; Mundim, L M; Murray, W J; Muryn, B; Myatt, Gerald; Naraghi, F; Navarria, Francesco Luigi; Navas, S; Nawrocki, K; Negri, P; Neumann, W; Neumeister, N; Nicolaidou, R; Nielsen, B S; Nieuwenhuizen, M; Nikolaenko, V; Niss, P; Nomerotski, A; Normand, Ainsley; Novák, M; Oberschulte-Beckmann, W; Obraztsov, V F; Olshevskii, A G; Onofre, A; Orava, Risto; Österberg, K; Ouraou, A; Paganini, P; Paganoni, M; Pagès, P; Palka, H; Papadopoulou, T D; Papageorgiou, K; Pape, L; Parkes, C; Parodi, F; Passeri, A; Pegoraro, M; Peralta, L; Pernegger, H; Pernicka, Manfred; Perrotta, A; Petridou, C; Petrolini, A; Petrovykh, M; Phillips, H T; Piana, G; Pierre, F; Pimenta, M; Pindo, M; Plaszczynski, S; Podobrin, O; Pol, M E; Polok, G; Poropat, P; Pozdnyakov, V; Prest, M; Privitera, P; Pukhaeva, N; Pullia, Antonio; Radojicic, D; Ragazzi, S; Rahmani, H; Rames, J; Ratoff, P N; Read, A L; Reale, M; Rebecchi, P; Redaelli, N G; Regler, Meinhard; Reid, D; Renton, P B; Resvanis, L K; Richard, F; Richardson, J; Rídky, J; Rinaudo, G; Ripp, I; Romero, A; Roncagliolo, I; Ronchese, P; Roos, L; Rosenberg, E I; Rosso, E; Roudeau, Patrick; Rovelli, T; Rückstuhl, W; Ruhlmann-Kleider, V; Ruiz, A; Rybicki, K; Saarikko, H; Sacquin, Yu; Sadovskii, A; Sahr, O; Sajot, G; Salt, J; Sánchez, J; Sannino, M; Schimmelpfennig, M; Schneider, H; Schwickerath, U; Schyns, M A E; Sciolla, G; Scuri, F; Seager, P; Sedykh, Yu; Segar, A M; Seitz, A; Sekulin, R L; Shellard, R C; Siccama, I; Siegrist, P; Simonetti, S; Simonetto, F; Sissakian, A N; Sitár, B; Skaali, T B; Smadja, G; Smirnov, N; Smirnova, O G; Smith, G R; Sokolov, A; Solovyanov, O; Sosnowski, R; Souza-Santos, D; Spassoff, Tz; Spiriti, E; Sponholz, P; Squarcia, S; Stanescu, C; Stapnes, Steinar; Stavitski, I; Stevenson, K; Stichelbaut, F; Stocchi, A; Strauss, J; Strub, R; Stugu, B; Szczekowski, M; Szeptycka, M; Tabarelli de Fatis, T; Tavernet, J P; Chikilev, O G; Thomas, J; Tilquin, A; Timmermans, J; Tkatchev, L G; Todorov, T; Todorova, S; Toet, D Z; Tomaradze, A G; Tomé, B; Tonazzo, A; Tortora, L; Tranströmer, G; Treille, D; Trischuk, W; Tristram, G; Trombini, A; Troncon, C; Tsirou, A L; Turluer, M L; Tyapkin, I A; Tyndel, M; Tzamarias, S; Überschär, B; Ullaland, O; Uvarov, V; Valenti, G; Vallazza, E; Van der Velde, C; van Apeldoorn, G W; van Dam, P; Van Doninck, W K; Van Eldik, J; Vassilopoulos, N; Vegni, G; Ventura, L; Venus, W A; Verbeure, F; Verlato, M; Vertogradov, L S; Vilanova, D; Vincent, P; Vitale, L; Vlasov, E; Vodopyanov, A S; Vrba, V; Wahlen, H; Walck, C; Waldner, F; Weierstall, M; Weilhammer, Peter; Weiser, C; Wetherell, Alan M; Wicke, D; Wickens, J H; Wielers, M; Wilkinson, G R; Williams, W S C; Winter, M; Witek, M; Woschnagg, K; Yip, K; Yushchenko, O P; Zach, F; Zaitsev, A; Zalewska-Bak, A; Zalewski, Piotr; Zavrtanik, D; Zevgolatakos, E; Zimin, N I; Zito, M; Zontar, D; Zucchelli, G C; Zumerle, G

    1996-01-01

    Rare decays of beauty particles were studied in several charmless modes using the data collected with the DELPHI detector at LEP from 1991 to 1994. These decays are mediated by both tree level $b \\rightarrow u$ and one-loop penguin $b \\rightarrow s$, $d$ transitions. Evidence for charmless $B$ decays was obtained in two body hadronic modes. The branching ratios of $B^{0}_{d,s}$ to $\\pi^+ \\pi^-$ or $K^+ \\pi^-$ and $B^{-}_{u}$ to $\\rho^0 \\pi^-$ or $K^{*0} \\pi^-$ were found to be $(2.8 ^{+1.5}_{-1.0} \\pm 0.2) \\times 10^{-5}$ and $(1.7 ^{+1.2}_{-0.8} \\pm 0.2) \\times 10^{-4}$ respectively. The fraction of these decays with a charged kaon in the final state that is not from the spectator $s$ quark, was measured to be $0.58 \\pm 0.18$. Upper limits were set at 90\\% confidence level on the branching ratios %for other two body modes including the $\\Lambda_b^0\\to pK^-$ decay and for three and four body charmless hadronic decays in the range of \\mbox{$(1 - 3)\\times10^{-4}$}, for inclusive radiative $b \\rightarrow s \\gamm...

  20. Barriers to using consumer science information in food technology innovations: An exploratory study using Delphi methodology

    Directory of Open Access Journals (Sweden)

    Marian E. Raley

    2016-04-01

    Full Text Available Food technology innovation has the potential to deliver many benefits to society, although some technologies have been problematic in terms of public acceptance. In promoting the commercial success of innovative technological processes and resultant products it will be important to incorporate information relating to consumer preferences and concerns during their development. The barriers to the utilisation of consumer information during technological development was explored using a two round Delphi study involving 75 experts with an interest in new food technology (food technologists and consumer scientists. There was overall agreement that consumer information should be used in technology implementation and product design, and that good communication between key actors at pivotal stages during the development of new food technologies and products was important. However disciplinary differences were perceived to be a barrier to communication, as were difficulties associated with producing consumer information usable by food technologists. A strategy to improve inter-disciplinary communication is proposed, involving the creation of multi-disciplinary teams working together throughout the development project’s duration, including those with interdisciplinary experience. Deficiencies in the specification of the information required from consumer scientists need to be overcome. Consumer science results need to be concrete and presented as salient to and usable by food technologists.

  1. Expert opinion on detecting and treating depression in palliative care: A Delphi study

    Directory of Open Access Journals (Sweden)

    Hotopf Matthew

    2011-05-01

    Full Text Available Abstract Background There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care. Methods 18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings. Results There was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10 rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10. Mirtazapine (median 9 (7-10 and citalopram (median 9 (5-10 were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10 the best choice of psychological therapy. Conclusions The range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.

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

    Science.gov (United States)

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

    2016-04-18

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

  3. Healthcare Quality Indicators for Physiotherapy Management in Hip and Knee Osteoarthritis and Rheumatoid Arthritis: A Delphi Study.

    Science.gov (United States)

    Peter, W F; Hurkmans, E J; van der Wees, P J; Hendriks, E J M; van Bodegom-Vos, L; Vliet Vlieland, T P M

    2016-12-01

    The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. Two multidisciplinary expert panels, including patients, were instituted. A draft HCQI set was derived from recommendations included in two existing Dutch PT guidelines for HKOA and RA. The panels suggested additional topics, after which a Delphi procedure was performed. All propositions were scored for their potential to represent good-quality PT care (score range 0-9). Based on predefined rules, the Delphi panel HCQIs were discussed and selected. Lastly, every indicator was rephrased, resulting in its output consisting of a numerator and denominator, to facilitate comparisons within and among practices. After two Delphi rounds, two final sets of 17 HCQI - one for HKOA and one for RA - were composed, both containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator. Two sets of HCQIs for PT management in HKOA and RA were developed for measuring the quality of PT care in daily clinical practice. Each indicator was formulated in a measurable way. Future research should focus on the feasibility of both indicator sets for daily clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Designing a questionnaire on physical activity habits and lifestyle from the Delphi method

    Directory of Open Access Journals (Sweden)

    Estefanía Castillo Viera

    2012-02-01

    Full Text Available Nowadays there are numerous questionnaires studying physical activity habits, lifestyle and health (IPAQ, SF-36, EQ-5D. The problem arises when trying to design a new tool for use in a specific population that has specific characteristics and which seeks to explore aspects related to the area in which it develops. The main objective of this study was to design a questionnaire on physical activity and lifestyle of the university population. To prepare this Delphi method was used, a procedure based on expert consultation through a steering group and a group of experts to cast their opinions on a cyclical basis of the topic until they reach a consensus. In our case, a questionnaire was developed with seven dimensions and 55 items. The results lead us to make a positive assessment of the use of the Delphi method to design the questionnaire and ensuring greater validity.Key words: Physical activity habits, lifestyle, Delphi method.

  5. Incorporating Nonparametric Statistics into Delphi Studies in Library and Information Science

    Science.gov (United States)

    Ju, Boryung; Jin, Tao

    2013-01-01

    Introduction: The Delphi technique is widely used in library and information science research. However, many researchers in the field fail to employ standard statistical tests when using this technique. This makes the technique vulnerable to criticisms of its reliability and validity. The general goal of this article is to explore how…

  6. Identifying Competencies for Volunteer Administrators for the Coming Decade: A National Delphi Study.

    Science.gov (United States)

    Boyd, Barry L.

    2003-01-01

    A Delphi panel of 13 experts categorized 33 competencies for volunteer administration into 5 constructs: organizational leadership, systems leadership, organizational culture, personal skills, and management skills. Twelve barriers to acquiring competencies and 21 methods to address them were identified. (Contains 24 references.) (SK)

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

    Science.gov (United States)

    Davies, Emma; Martin, Jilly; Foxcroft, David

    2016-01-01

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

  8. Workplace Issues in Extension--A Delphi Study of Extension Educators

    Science.gov (United States)

    Kroth, Michael; Peutz, Joey

    2011-01-01

    Using the Delphi technique, expert Extension educators identified and prioritized those workplace issues they believe will be the most important to attract, motivate, and retain Extension educators/agents over the next 5 to 7 years. Obtaining and then utilizing a talented, highly motivated workforce during a period when many will be retiring will…

  9. The Delphi Method in Rehabilitation Counseling Research

    Science.gov (United States)

    Vazquez-Ramos, Robinson; Leahy, Michael; Estrada Hernandez, Noel

    2007-01-01

    Rehabilitation researchers have found in the application of the Delphi method a more sophisticated way of obtaining consensus from experts in the field on certain matters. The application of this research methodology has affected and certainly advanced the body of knowledge of the rehabilitation counseling practice. However, the rehabilitation…

  10. Increased care demand and medical costs after falls in nursing homes: A Delphi study.

    Science.gov (United States)

    Sterke, Carolyn Shanty; Panneman, Martien J; Erasmus, Vicki; Polinder, Suzanne; van Beeck, Ed F

    2018-04-21

    To estimate the increased care demand and medical costs caused by falls in nursing homes. There is compelling evidence that falls in nursing homes are preventable. However, proper implementation of evidence-based guidelines to prevent falls is often hindered by insufficient management support, staff time and funding. A three-round Delphi study. A panel of 41 experts, all working in nursing homes in the Netherlands, received three online questionnaires to estimate the extra hours of care needed during the first year after the fall. This was estimated for ten falls categories with different levels of injury severity, in three scenarios, that is a best-case, a typical-case and a worst-case scenario. We calculated the costs of falls by multiplying the mean amount of extra hours that the participants spent on the care for a resident after a fall with their hourly wages. In case of a noninjurious fall, the extra time spent on the faller is on average almost 5 hr, expressed in euros that add to € 193. The extra staff time and costs of falls increased with increasing severity of injury. In the case of a fracture of the lower limb, the extra staff time increased to 132 hr, expressed in euros that is € 4,604. In the worst-case scenario of a fracture of the lower limb, the extra staff time increased to 284 hr, expressed in euros that is € 10,170. Falls in nursing homes result in a great deal of extra staff time spent on care, with extra costs varying between € 193 for a noninjurious fall and € 10,170 for serious falls. This study could aid decision-making on investing in appropriate implementation of falls prevention interventions in nursing homes. © 2018 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-06-01

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

  12. Patient safety improvement programmes for primary care. Review of a Delphi procedure and pilot studies by the LINNEAUS collaboration on patient safety in primary care

    Science.gov (United States)

    Verstappen, Wim; Gaal, Sander; Esmail, Aneez; Wensing, Michel

    2015-01-01

    ABSTRACT Background: To improve patient safety it is necessary to identify the causes of patient safety incidents, devise solutions and measure the (cost-) effectiveness of improvement efforts. Objective: This paper provides a broad overview with practical guidance on how to improve patient safety. Methods: We used modified online Delphi procedures to reach consensus on methods to improve patient safety and to identify important features of patient safety management in primary care. Two pilot studies were carried out to assess the value of prospective risk analysis (PRA), as a means of identifying the causes of a patient safety incident. Results: A range of different methods can be used to improve patient safety but they have to be contextually specific. Practice organization, culture, diagnostic errors and medication safety were found to be important domains for further improvement. Improvement strategies for patient safety could benefit from insights gained from research on implementation of evidence-based practice. Patient involvement and prospective risk analysis are two promising and innovative strategies for improving patient safety in primary care. Conclusion: A range of methods is available to improve patient safety, but there is no ‘magic bullet.’ Besides better use of the available methods, it is important to use new and potentially more effective strategies, such as prospective risk analysis. PMID:26339837

  13. Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences.

    Science.gov (United States)

    Salehi, A; Harris, N; Lotfi, F; Hashemi, N; Kojouri, J; Amini, M

    2014-04-03

    Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society.

  14. Determining an Imaging Literacy Curriculum for Radiation Oncologists: An International Delphi Study

    Energy Technology Data Exchange (ETDEWEB)

    Giuliani, Meredith E., E-mail: Meredith.Giuliani@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Gillan, Caitlin [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Milne, Robin A. [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Uchino, Minako; Millar, Barbara-Ann; Catton, Pamela [Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada)

    2014-03-15

    Purpose: Rapid evolution of imaging technologies and their integration into radiation therapy practice demands that radiation oncology (RO) training curricula be updated. The purpose of this study was to develop an entry-to-practice image literacy competency profile. Methods and Materials: A list of 263 potential imaging competency items were assembled from international objectives of training. Expert panel eliminated redundant or irrelevant items to create a list of 97 unique potential competency items. An international 2-round Delphi process was conducted with experts in RO. In round 1, all experts scored, on a 9-point Likert scale, the degree to which they agreed an item should be included in the competency profile. Items with a mean score ≥7 were included, those 4 to 6 were reviewed in round 2, and items scored <4 were excluded. In round 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile. Results: Forty-nine radiation oncologists were invited to participate in round 1, and 32 (65%) did so. Participants represented 24 centers in 6 countries. Of the 97 items ranked in round 1, 80 had a mean score ≥7, 1 item had a score <4, and 16 items with a mean score of 4 to 6 were reviewed and rescored in round 2. In round 2, 4 items had >75% of participants voting for inclusion and were included; the remaining 12 were excluded. The final list of 84 items formed the final competency profile. The 84 enabling competency items were aggregated into the following 4 thematic groups of key competencies: (1) imaging fundamentals (42 items); (2) clinical application (27 items); (3) clinical management (5 items); and (4) professional practice (10 items). Conclusions: We present an imaging literacy competency profile which could constitute the minimum training standards in radiation oncology residency programs.

  15. Determining an Imaging Literacy Curriculum for Radiation Oncologists: An International Delphi Study

    International Nuclear Information System (INIS)

    Giuliani, Meredith E.; Gillan, Caitlin; Milne, Robin A.; Uchino, Minako; Millar, Barbara-Ann; Catton, Pamela

    2014-01-01

    Purpose: Rapid evolution of imaging technologies and their integration into radiation therapy practice demands that radiation oncology (RO) training curricula be updated. The purpose of this study was to develop an entry-to-practice image literacy competency profile. Methods and Materials: A list of 263 potential imaging competency items were assembled from international objectives of training. Expert panel eliminated redundant or irrelevant items to create a list of 97 unique potential competency items. An international 2-round Delphi process was conducted with experts in RO. In round 1, all experts scored, on a 9-point Likert scale, the degree to which they agreed an item should be included in the competency profile. Items with a mean score ≥7 were included, those 4 to 6 were reviewed in round 2, and items scored <4 were excluded. In round 2, items were discussed and subsequently ranked for inclusion or exclusion in the competency profile. Items with >75% voting for inclusion were included in the final competency profile. Results: Forty-nine radiation oncologists were invited to participate in round 1, and 32 (65%) did so. Participants represented 24 centers in 6 countries. Of the 97 items ranked in round 1, 80 had a mean score ≥7, 1 item had a score <4, and 16 items with a mean score of 4 to 6 were reviewed and rescored in round 2. In round 2, 4 items had >75% of participants voting for inclusion and were included; the remaining 12 were excluded. The final list of 84 items formed the final competency profile. The 84 enabling competency items were aggregated into the following 4 thematic groups of key competencies: (1) imaging fundamentals (42 items); (2) clinical application (27 items); (3) clinical management (5 items); and (4) professional practice (10 items). Conclusions: We present an imaging literacy competency profile which could constitute the minimum training standards in radiation oncology residency programs

  16. Information needs of patients with whiplash associated disorders: A Delphi study of patient beliefs.

    Science.gov (United States)

    Sterling, Joanna; Maujean, Annick; Sterling, Michele

    2018-02-01

    Whiplash associated disorders (WAD) result in significant personal and economic costs. Patient education and reassurance are recommended treatments for acute WAD but the information needs of patients have not been investigated. To determine what information whiplash-injured patients believe is important to help recovery in the acute stage of injury. A Delphi design survey series with three rounds. Thirty-three participants who had sustained a whiplash injury within the last three years were invited to participate. Participants were asked to provide five statements, in response to an open-ended question, regarding what they believed was the most important information to provide to patients following a whiplash injury. Nineteen patients responded and 85 statements were collected and reviewed independently by two of the authors to remove duplicates. The importance of the remaining items was rated by the participants in the second survey round. Items rated by >50% of participants as important were included in the third survey round. To be deemed key information, >80% of participants had to rate an item as important in this final round. Eighteen items met the criteria for key information. These points addressed four areas: assessment and treatment, recovery and symptoms, patient attitudes during treatment and relationships with health practitioners. The key information points endorsed by patients in this study may provide useful information to constitute a basis for reassurance and education provided to patients with WAD. The results also suggest that improved relationships between patients with whiplash and health practitioners is required. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The future of practical skills in undergraduate medical education - an explorative Delphi-Study.

    Science.gov (United States)

    Dannenberg, Katja Anne; Stroben, Fabian; Schröder, Therese; Thomas, Anke; Hautz, Wolf E

    2016-01-01

    , and 57 were deemed irrelevant for the short-term future. The theses on the future of healthcare, which were generated in this study and which were validated by numerous experts, provide indications of future developments of overall requirements for medical school graduates. For example, when applied to the content of the "Clinical-Practical Skills" NKLM chapter, they largely validate the future relevance of developing practical skills while also providing indications for their further development as applied to the consensus statement.

  18. The future of practical skills in undergraduate medical education – an explorative Delphi-Study

    Directory of Open Access Journals (Sweden)

    Dannenberg, Katja Anne

    2016-08-01

    the consensus statement, 231 of the goals were assessed as relevant, and 57 were deemed irrelevant for the short-term future. Discussion: The theses on the future of healthcare, which were generated in this study and which were validated by numerous experts, provide indications of future developments of overall requirements for medical school graduates. For example, when applied to the content of the “Clinical-Practical Skills” NKLM chapter, they largely validate the future relevance of developing practical skills while also providing indications for their further development as applied to the consensus statement.

  19. Determining content for a simulation-based curriculum in pediatric emergency medicine: results from a national Delphi process.

    Science.gov (United States)

    Bank, Ilana; Cheng, Adam; McLeod, Peter; Bhanji, Farhan

    2015-11-01

    By the end of residency training, pediatric emergency medicine (PEM) residents are expected to have developed the confidence and abilities required to manage acutely ill children. Acquisition of competence requires exposure and/or supplemental formal education for critical and noncritical medical clinical presentations. Simulation can provide experiential learning and can improve trainees' knowledge, skills, and attitudes. The primary objective of this project was to identify the content for a simulation-based national curriculum for PEM training. We recruited participants for the Delphi study by contacting current PEM program directors and immediate past program directors as well as simulation experts at all of the Canadian PEM fellowship sites. We determined the appropriate core content for the Delphi study by combining the PEM core content requirements of the Royal College of Physicians and Surgeons of Canada (RCPSC) and the American Board of Pediatrics (ABP). Using the Delphi method, we achieved consensus amongst the national group of PEM and simulation experts. The participants completed a three-round Delphi (using a four-point Likert scale). Response rates for the Delphi were 85% for the first round and 77% for second and third rounds. From the initial 224 topics, 53 were eliminated (scored <2). Eighty-five topics scored between 2 and 3, and 87 scored between 3 and 4. The 48 topics, which were scored between 3.5 and 4.0, were labeled as "key curriculum topics." We have iteratively identified a consensus for the content of a national simulation-based curriculum.

  20. Standards for midwife Practitioners of external cephalic version: A Delphi study

    OpenAIRE

    Walker, Shawn; Perilakalathil, Prasanth; Moore, Jenny; Gibbs, Claire; Reavell, Karen; Crozier, Kenda

    2015-01-01

    Introduction: Expansion of advanced and specialist midwifery practitioner roles across professional boundaries requires an evidence-based framework to evaluate achievement and maintenance of competency. In order to develop the role of Breech Specialist Midwife to include the autonomous performance of external cephalic version within one hospital, guidance was required on standards of training and skill development, particularly in the use of ultrasound. Methods: A three-round Delphi survey wa...

  1. Consensus development of core competencies in intensive and critical care medicine training in China

    OpenAIRE

    Hu, Xiaoyun; Xi, Xiuming; Ma, Penglin; Qiu, Haibo; Yu, Kaijiang; Tang, Yaoqing; Qian, Chuanyun; Fang, Qiang; Wang, Yushan; Yu, Xiangyou; Xu, Yuan; Du, Bin

    2016-01-01

    Background The aim of this study is to develop consensus on core competencies required for postgraduate training in intensive care medicine. Methods We used a combination of a modified Delphi method and a nominal group technique to create and modify the list of core competencies to ensure maximum consensus. Ideas were generated modified from Competency Based Training in Intensive Care Medicine in Europe collaboration (CoBaTrICE) core competencies. An online survey invited healthcare professio...

  2. Clinical practice guidelines for the surgical management of colon cancer: a consensus statement of the Hellenic and Cypriot Colorectal Cancer Study Group by the HeSMO.

    Science.gov (United States)

    Xynos, Evaghelos; Gouvas, Nikolaos; Triantopoulou, Charina; Tekkis, Paris; Vini, Louiza; Tzardi, Maria; Boukovinas, Ioannis; Androulakis, Nikolaos; Athanasiadis, Athanasios; Christodoulou, Christos; Chrysou, Evangelia; Dervenis, Christos; Emmanouilidis, Christos; Georgiou, Panagiotis; Katopodi, Ourania; Kountourakis, Panteleimon; Makatsoris, Thomas; Papakostas, Pavlos; Papamichael, Demetris; Pentheroudakis, Georgios; Pilpilidis, Ioannis; Sgouros, Joseph; Vassiliou, Vassilios; Xynogalos, Spyridon; Ziras, Nikolaos; Karachaliou, Niki; Zoras, Odysseas; Agalianos, Christos; Souglakos, John

    2016-01-01

    Despite considerable improvement in the management of colon cancer, there is a great deal of variation in the outcomes among European countries, and in particular among different hospital centers in Greece and Cyprus. Discrepancy in the approach strategies and lack of adherence to guidelines for the management of colon cancer may explain the situation. The aim was to elaborate a consensus on the multidisciplinary management of colon cancer, based on European guidelines (ESMO and EURECCA), and also taking into account local special characteristics of our healthcare system. Following discussion and online communication among members of an executive team, a consensus was developed. Statements entered the Delphi voting system on two rounds to achieve consensus by multidisciplinary international experts. Statements with an agreement rate of ≥80% achieved a large consensus, while those with an agreement rate of 60-80% a moderate consensus. Statements achieving an agreement of colon cancer were subjected to the Delphi methodology. Voting experts were 109. The median rate of abstain per statement was 10% (range: 0-41%). In the end of the voting process, all statements achieved a consensus by more than 80% of the experts. A consensus on the management of colon cancer was developed by applying the Delphi methodology. Guidelines are proposed along with algorithms of diagnosis and treatment. The importance of centralization, care by a multidisciplinary team, and adherence to guidelines is emphasized.

  3. Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

    Science.gov (United States)

    Qiblawi, Sara; Ghanayem, Haifa

    2018-01-01

    Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended. PMID:29849697

  4. Study of microstrip gas chambers for CMS experiment and measurement of the W boson mass in the DELPHI experiment

    International Nuclear Information System (INIS)

    Ripp-Baudot, I.

    2004-06-01

    In this document the author describes 3 fields of his research activities: first, the development and validation tests of micro-strip gas chambers for the CMS experiment; secondly, the measurements of the W boson mass and width by analysing the events: e + e - → W + W - → qq-bar qq-bar whose data have been collected in the DELPHI experiment (at the LEP-2 accelerator); and thirdly, the tagging of b-jets that is an essential tool for the study of the top quark. The last chapter is dedicated to what is expected from LHC experiments concerning the properties of the quark top: mass, spin, production and decay channels

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

    Science.gov (United States)

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

    2007-11-01

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

  6. A study on the overall economic risks of a hypothetical severe accident in nuclear power plant using the delphi method

    International Nuclear Information System (INIS)

    Jang, Han Ki; Kim, Joo Yeon; Lee, Jai Ki

    2008-01-01

    Potential economic impact of a hypothetical severe accident at a nuclear power plant(Uljin units 3/4) was estimated by applying the delphi method, which is based on the expert judgements and opinions, in the process of quantifying uncertain factor. For the purpose of this study, it is assumed that the radioactive plume directs the inland direction. Since the economic risk can be divided into direct costs and indirect effects and more uncertainties are involved in the latter, the direct costs were estimated first and the indirect effects were then estimated by applying a weighting factor to the direct cost. The delphi method however subjects to risk of distortion or discrimination of variables because of the human behavior pattern. A mathematical approach based on the Bayesian inferences was employed for data processing to improve the delphi results. For this task, a model for data processing was developed. One-dimensional Monte Carlo analysis was applied to get a distribution of values of the weighting factor. The mean and median values of the weighting factor for the indirect effects appeared to be 2.59 and 2.08, respectively. These values are higher than the value suggested by OECD/NEA, 1.25. Some factors such as small territory and public attitude sensitive to radiation could affect the judgement of panel. Then the parameters of the model for estimating the direct costs were classified as U- and V-types, and two-dimensional Monte Carlo analysis was applied to quantify the overall economic risk. The resulting median of the overall economic risk was about 3.9% of the Gross Domestic Products (GDP) of Korea in 2006. When the cost of electricity loss, the highest direct cost, was not taken into account, the overall economic risk was reduced to 2.2% of GDP. This assessment can be used as a reference for justifying the radiological emergency planning and preparedness

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

    DEFF Research Database (Denmark)

    Douglas, Raymond S; Tsirbas, Angelo; Gordon, Mark

    2009-01-01

    OBJECTIVE: To identify components of a provisional clinical response index for thyroid eye disease using a modified Delphi technique. METHODS: The International Thyroid Eye Disease Society conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical...... parsed into 11 domains for the Delphi surveys. Eighty-four respondents participated in the Delphi 1 survey, providing 220 unique items. Ninety-two members (100% of the respondents from Delphi 1 plus 8 new participants) responded in Delphi 2 and rated the same 220 items. Sixty-four members (76......% of participants) rated 153 criteria in Delphi 3 (67 criteria were excluded because of redundancy). Criteria with a mean greater than 6 (1 = least appropriate to 9 = most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. CONCLUSIONS: Using a Delphi...

  8. Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies.

    Science.gov (United States)

    Stoustrup, Peter; Twilt, Marinka; Spiegel, Lynn; Kristensen, Kasper Dahl; Koos, Bernd; Pedersen, Thomas Klit; Küseler, Annelise; Cron, Randy Q; Abramowicz, Shelly; Verna, Carlalberta; Peltomäki, Timo; Alstergren, Per; Petty, Ross; Ringold, Sarah; Nørholt, Sven Erik; Saurenmann, Rotraud K; Herlin, Troels

    2017-03-01

    To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations. Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies. Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.

  9. Using Delphi technique in a consensual curriculum for periodontics.

    Science.gov (United States)

    Fried, Hana; Leao, Anna Thereza

    2007-11-01

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

  10. The life and health challenges of young Malaysian couples: results from a stakeholder consensus and engagement study to support non-communicable disease prevention.

    Science.gov (United States)

    Norris, S A; Anuar, H; Matzen, P; Cheah, J C H; Jensen, B B; Hanson, M

    2014-01-01

    Malaysia faces burgeoning obesity and diabetes epidemics with a 250% and 88% increase respectively between 1996 and 2006. Identifying the health challenges of young adults in Malaysia, who constitute 27.5 % of the population, is critical for NCD prevention. The aim of the study was two-fold: (1) to achieve consensus amongst stakeholders on the most important challenge impacting the health of young adults, and (2) to engage with stakeholders to formulate a NCD prevention framework. The Delphi Technique was utilised to achieve group consensus around the most important life and health challenges that young adults face in Malaysia. Subsequently, the results of the consensus component were shared with the stakeholders in an engagement workshop to obtain input on a NCD prevention framework. We found that life stress was a significant concern. It would seem that the apathy towards pursuing or maintaining a healthy lifestyle among young adults may be significantly influenced by the broader distal determinant of life stress. The high cost of living is suggested to be the main push factor for young working adults towards attaining better financial security to improve their livelihood. In turn, this leads to a more stressful lifestyle with less time to focus on healthier lifestyle choices. The findings highlight a pivotal barrier to healthier lifestyles. By assisting young adults to cope with daily living coupled with realistic opportunities to make healthier dietary choices, be more active, and less sedentary could assist in the development of NCD health promotion strategies.

  11. Defining the Bobath concept using the Delphi technique.

    Science.gov (United States)

    Raine, Sue

    2006-03-01

    The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept. A four-round Delphi study design was used. The sample included all members of the British Bobath Tutor's Association, who are considered experts in the field. Initial statements were identified from the literature, with respondents generating additional statements during the study. The level of agreement was determined using a five-point Likert scale. The respondents were then provided with feedback on group opinions and given an opportunity to re-rate each statement. The level of group consensus was set at 80%. Fifteen experts took part. The response rate was 85% in the first round, and 93% in each subsequent round. Ten statements from the literature were rated with a further 12 generated by the experts. Thirteen statements achieved consensus for agreement and seven for disagreement. The Delphi study was an effective research tool, maintaining anonymity of responses and exploring expert opinions on the Bobath concept. The experts stated that Bobath's work has been misunderstood if it is considered as the inhibition of spasticity and the facilitation of normal movement, as described in some literature. They agreed that the Bobath concept was developed by the Bobaths as a living concept, understanding that as therapists' knowledge base grows their view of treatment broadens.

  12. Delphi report 1995 on developments in science and technology. Mini Delphi; Delphi-Bericht 1995 zur Entwicklung von Wissenschaft und Technik. Mini-Delphi

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    In August 1993 the first German `Delphi Report on Developments in Science and Technology` was published. It was elaborated by the Fraunhofer Institute for System Engineering and Innovation Research (FhG-ISI) in cooperation with the Japanese National Institute of Science and Technology Policy (NISTEP). The `MINI-DELPHI` now completed by FhG-ISI, again in cooperation with NISTEP, is a further development of the Delphi approach in that it is more differentiated in its questions and assessment criteria than its predecessors. `MINI-DELPHI` is not intended as a comprehensive forecast on technology in general but rather focusses on key topics. Its emphasis is on technology demand and the relevance of technologies to social issues. Although the Mini-Delphi study was primarily aimed at further refining the methodology employed, it nevertheless contains a wealth of information and details on circumscript questions. The requisite database is provided by tables on the results of two inquiry rounds among Japanese and German experts. (orig./RHM) [Deutsch] Im August 1993 wurde der erste deutsche `Delphi-Bericht zur Entwicklung von Wissenschaft und Technik` veroeffentlicht. Er war vom Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (FhG-ISI) in Zusammenarbeit mit dem japanischen National Institute of Science and Technology Policy (NISTEP) erarbeitet worden. Mit dem jetzt vorliegenden `MINI-DELPHI` hat das FhG-ISI - wieder in Zusammenarbeit mit dem NISTEP - den Delphi-Ansatz fortentwickelt und sowohl hinsichtlich der Fragen als auch der Beurteilungskriterien weiter ausdifferenziert. `MINI-DELPHI` bezweckt keine umfassende Technologievorausschau, sondern konzentriert sich auf Schluesselthemen. Im Vordergrund steht der Gedanke des Technikbedarfs und die Relevanz fuer gesellschaftliche Fragestellungen. Obwohl die Mini-Delphi-Studie vorrangig der Weiterentwicklung der Methodik dient, enthaelt sich eine Fuelle von Informationen und Details zu Einzelfragen. Die im Bericht

  13. The impact of the internet on community pharmacy practice: a comparison of a Delphi panel's forecast with emerging trends.

    Science.gov (United States)

    Holmes, Erin R; Tipton, David J; Desselle, Shane P

    2002-01-01

    The purpose of this study was to forecast the impact of Internet pharmacy commerce on various stakeholders. A panel of experts assembled from a list of academicians in the social and administrative pharmaceutical sciences participated in a three-iteration Delphi procedure. Feedback from the aggregate responses of the panel was used to construct questionnaires employed in subsequent iterations of the Delphi. The panel converged to form a consensus upon a variety of issues. They forecasted the attainment of a 10-15% share in the market of prescription and over-the-counter pharmaceuticals through on-line purchases, the formation of strategic alliances among stakeholders in the drug distribution process, a shift in marketing strategies by brick-and-mortar stores, an increase in the prevalence of niching among pharmacy service providers and a subsequent growth in the implementation of cognitive services throughout the industry. With few exceptions, the forecast produced by the Delphi panel appears to be coming to fruition.

  14. Developing standards for an integrated approach to workplace facilitation for interprofessional teams in health and social care contexts: a Delphi study.

    Science.gov (United States)

    Martin, Anne; Manley, Kim

    2018-01-01

    Integration of health and social care forms part of health and social care policy in many countries worldwide in response to changing health and social care needs. The World Health Organization's appeal for systems to manage the global epidemiologic transition advocates for provision of care that crosses boundaries between primary, community, hospital, and social care. However, the focus on structural and process changes has not yielded the full benefit of expected advances in care delivery. Facilitating practice in the workplace is a widely recognised cornerstone for developments in the delivery of health and social care as collaborative and inclusive relationships enable frontline staff to develop effective workplace cultures that influence whether transformational change is achieved and maintained. Workplace facilitation embraces a number of different purposes which may not independently lead to better quality of care or improved patient outcomes. Holistic workplace facilitation of learning, development, and improvement supports the integration remit across health and social care systems and avoids duplication of effort and waste of valuable resources. To date, no standards to guide the quality and effectiveness of integrated facilitation have been published. This study aimed to identify key elements constitute standards for an integrated approach to facilitating work-based learning, development, improvement, inquiry, knowledge translation, and innovation in health and social care contexts using a three rounds Delphi survey of facilitation experts from 10 countries. Consensus about priority elements was determined in the final round, following an iteration process that involved modifications to validate content. The findings helped to identify key qualities and skills facilitators need to support interprofessional teams to flourish and optimise performance. Further research could evaluate the impact of skilled integrated facilitation on health and social care

  15. Delphi Accounts Receivable Module -

    Data.gov (United States)

    Department of Transportation — Delphi accounts receivable module contains the following data elements, but are not limited to customer information, cash receipts, line of accounting details, bill...

  16. An exploration of factors related to dissemination of and exposure to internet-delivered behavior change interventions aimed at adults: a Delphi study approach.

    Science.gov (United States)

    Brouwer, Wendy; Oenema, Anke; Crutzen, Rik; de Nooijer, Jascha; de Vries, Nanne K; Brug, Johannes

    2008-04-16

    The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD word-of-mouth by family and friends, a publicity campaign with simultaneous use of various mass media, and recommendation by health professionals, were indicated as effective ways to encourage adults to visit an Internet intervention. This systematic study identified important factors related to the dissemination of and exposure to Internet interventions aimed at adults. In order to improve optimal use of and exposure to Internet interventions, potential users may

  17. Developing the International Business Curriculum: Results and Implications of a Delphi Study on the Futures of Teaching and Learning in International Business

    Science.gov (United States)

    Zettinig, Peter; Vincze, Zsuzsanna

    2008-01-01

    This article presents the results of a Delphi study concerning the futures of teaching and learning in International Business (IB), a topic that has been receiving a lot of discussion during recent years. Based on our findings we identify two dimensions which may be at the core and instrumental for developing the value proposition of IB. The first…

  18. Evaluation of a Delphi technique based expert judgement method for LCA valuation - DELPHI II

    Energy Technology Data Exchange (ETDEWEB)

    Virtanen, Y.; Torkkeli, S. [VTT Chemical Technology, Espoo (Finland). Environmental Technology; Wilson, B. [Landbank Environmental Research and Consulting, London (United Kingdom)

    1999-07-01

    interventions, and classification in typologies of cultural theory. The quality of results and methodological aspects, such as effects of task instructions, selection of the index basis, and effects of the final standardisation were analysed statistically. Accordingly, the effects of various postulates made on the conformity of the environmental harm conceptions of the experts, and the influence of the moderators' decisions were assessed on the basis of standard statistical indicators. The state of consensus and its development in the Delphi process were studied with the aid of K-entropy analysis. The study showed that transparency and certainty, which are essential qualities for an acceptable and trusted valuation method, are only partially accomplished by the expert judgement method in the format in which it was developed in the analysed case. As for the technical procedure, the method is well documented and transparency is good. Argumentation of the judgements, however, should be increased. The quality of the valuation indexes is explicitly available, but their certainty is very low for most interventions. The opinions of the experts vary greatly. How much this depends on different values and how much on differences in knowledge etc. is impossible to assess. Also, how much the technique used and the statistical processing of the experts' answers may have influenced the eventual scores of different interventions is difficult to assess. The application of expert judgement to LCA valuation is a new idea, and the method is still very much under development and far from maturity. Nevertheless, utilisation of expert knowledge can be a significant addition to model approaches to ecological impact assessment, which, because of the chaotic behaviour of ecosystems, are limited and uncertain in predicting the ecological consequences of interventions to the environment. This should be taken into account when considering the results of the evaluation of the case study, which

  19. Evaluation of a Delphi technique based expert judgement method for LCA valuation - DELPHI II

    International Nuclear Information System (INIS)

    Virtanen, Y.; Torkkeli, S.

    1999-01-01

    , and classification in typologies of cultural theory. The quality of results and methodological aspects, such as effects of task instructions, selection of the index basis, and effects of the final standardisation were analysed statistically. Accordingly, the effects of various postulates made on the conformity of the environmental harm conceptions of the experts, and the influence of the moderators' decisions were assessed on the basis of standard statistical indicators. The state of consensus and its development in the Delphi process were studied with the aid of K-entropy analysis. The study showed that transparency and certainty, which are essential qualities for an acceptable and trusted valuation method, are only partially accomplished by the expert judgement method in the format in which it was developed in the analysed case. As for the technical procedure, the method is well documented and transparency is good. Argumentation of the judgements, however, should be increased. The quality of the valuation indexes is explicitly available, but their certainty is very low for most interventions. The opinions of the experts vary greatly. How much this depends on different values and how much on differences in knowledge etc. is impossible to assess. Also, how much the technique used and the statistical processing of the experts' answers may have influenced the eventual scores of different interventions is difficult to assess. The application of expert judgement to LCA valuation is a new idea, and the method is still very much under development and far from maturity. Nevertheless, utilisation of expert knowledge can be a significant addition to model approaches to ecological impact assessment, which, because of the chaotic behaviour of ecosystems, are limited and uncertain in predicting the ecological consequences of interventions to the environment. This should be taken into account when considering the results of the evaluation of the case study, which was the third of

  20. Scenario Development and Delphi Application in Life Cycle Assessment for Assessing Environmental Impact of New Technology Case Study: Removal of Wind Turbines Project

    Directory of Open Access Journals (Sweden)

    Devina Fitrika Dewi

    2016-05-01

    Full Text Available Certain technology is intended to create eco-efficient products or process or is developed as answer to the recent challenge. This kind of technology consequently can also create another impact therefore it shall be assessed and analyzed.The focus of the study is on assessment method namely Life Cycle Analysis (LCA, Scenario development and Delphi application. The objective is to understand benefits and drawbacks of the combined methodology and observe practicality of its implementation for assessing new technology. The distinctive feature comes from the combination of social and technological foresight (as Delphi application and future studies (as Scenario development which are applied in the environmental assessment of a product (by Life Cycle Analysis.The utilization of LCA-Scenario-Delphi case study as an explanatory example is presented in the Removal Wind Turbines Project by the Danish Energy Agency. The wind turbine is considered new technology with some of it phases are yet to occur, for example: removal of turbines after phase out stage. Technology Assessment by LCA-Scenario-Delphi is complicated procedure, but necessary to validate the results. The drawbacks of this procedure are extensive time it consumes and the dependency on public participation and/or expert willingness to participate. Nonetheless, its advantages are due to its interactive feature; integration of knowledge from different areas of expertise and its assessment’s characteristic which focuses on process.

  1. Consensus on Exercise Reporting Template (CERT)

    DEFF Research Database (Denmark)

    Slade, Susan C; Dionne, Clermont E; Underwood, Martin

    2016-01-01

    the reporting of exercise programs in all evaluative study designs and contains 7 categories: materials, provider, delivery, location, dosage, tailoring, and compliance. The CERT will encourage transparency, improve trial interpretation and replication, and facilitate implementation of effective exercise......BACKGROUND: Exercise interventions are often incompletely described in reports of clinical trials, hampering evaluation of results and replication and implementation into practice. OBJECTIVE: The aim of this study was to develop a standardized method for reporting exercise programs in clinical...... trials: the Consensus on Exercise Reporting Template (CERT). DESIGN AND METHODS: Using the EQUATOR Network's methodological framework, 137 exercise experts were invited to participate in a Delphi consensus study. A list of 41 items was identified from a meta-epidemiologic study of 73 systematic reviews...

  2. Expert consensus statement to guide the evidence-based classification of Paralympic athletes with vision impairment: a Delphi study

    NARCIS (Netherlands)

    Ravensbergen, H.J.C.; Mann, D.L.; Kamper, S.J.

    2016-01-01

    Background Paralympic sports are required to develop evidence-based systems that allocate athletes into 'classes' on the basis of the impact of their impairment on sport performance. However, sports for athletes with vision impairment (VI) classify athletes solely based on the WHO criteria for low

  3. Study of final states involving 2 particle jets and missing energy with the DELPHI detector at LEP

    International Nuclear Information System (INIS)

    Ferrer Ribas, E.

    2000-01-01

    The observation of the Higgs boson would be of great importance for the understanding of the electroweak symmetry breaking. In the framework of the Minimal Supersymmetric extension of the Standard Model (MSSM), the lightest Higgs boson is neutral and scalar, and its mass must be less than 130 GeV/c 2 . In this thesis, we have studied events characterized by the presence of two particle jets and missing energy. This is a very clear signature of the production of the Higgs boson in association with a Z 0 boson. This production is followed by the decay of the Higgs boson into a bb-bar pair and the Z 0 boson in νν-bar pair. In these studies, it is important to detect all particles in order to achieve a good resolution in energy. For these reasons, we have devoted ourselves to improving DELPHI's hermeticity mainly in the regions located at 40 deg C and 140 deg C. Using the data collected by the DELPHI detector at LEP in 1998 and in 1999 at four different energies in the centre of mass (√s = 189, 196, 200 and 202 GeV), no signal has been observed, allowing us to exclude the Higgs boson at 95 % confidence level up to a mass of: m H > 98.0 (98.5) GeV/c 2 at 95% C.L. this analysis; m H > 103.9 (106.3) GeV/c 2 at 95% C.L. DELPHI combined. The values in parentheses show the expected limits and indicate the sensitivity of the analysis. If these results are interpreted in the framework of the MSSM we obtain: m h > 85.0 (85.3) GeV/c 2 at 95% C.L. Studying the same topology, we have also searched for a Higgs boson decaying into a pair of non detectable particles (Invisible Higgs) in association with a Z 0 boson decaying into a quark/antiquark pair. In this case too, no signal has been observed, which can be translated into a lower limit on the mass of the Higgs boson at 95% confidence level: m h inv > 105.5 (105.3) GeV/c 2 at 95% C.L. Finally, we have measured the production cross section of a pair of Z 0 bosons where one decays to a quark/antiquark pair (all flavours) and

  4. Using a web-based survey tool to undertake a Delphi study: application for nurse education research.

    Science.gov (United States)

    Gill, Fenella J; Leslie, Gavin D; Grech, Carol; Latour, Jos M

    2013-11-01

    The Internet is increasingly being used as a data collection medium to access research participants. This paper reports on the experience and value of using web-survey software to conduct an eDelphi study to develop Australian critical care course graduate practice standards. The eDelphi technique used involved the iterative process of administering three rounds of surveys to a national expert panel. The survey was developed online using SurveyMonkey. Panel members responded to statements using one rating scale for round one and two scales for rounds two and three. Text boxes for panel comments were provided. For each round, the SurveyMonkey's email tool was used to distribute an individualized email invitation containing the survey web link. The distribution of panel responses, individual responses and a summary of comments were emailed to panel members. Stacked bar charts representing the distribution of responses were generated using the SurveyMonkey software. Panel response rates remained greater than 85% over all rounds. An online survey provided numerous advantages over traditional survey approaches including high quality data collection, ease and speed of survey administration, direct communication with the panel and rapid collation of feedback allowing data collection to be undertaken in 12 weeks. Only minor challenges were experienced using the technology. Ethical issues, specific to using the Internet to conduct research and external hosting of web-based software, lacked formal guidance. High response rates and an increased level of data quality were achieved in this study using web-survey software and the process was efficient and user-friendly. However, when considering online survey software, it is important to match the research design with the computer capabilities of participants and recognize that ethical review guidelines and processes have not yet kept pace with online research practices. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. DELPHI time projection chamber

    CERN Multimedia

    1989-01-01

    The time projection chamber is inserted inside the central detector of the DELPHI experiment. Gas is ionised in the chamber as a charged particle passes through, producing an electric signal from which the path of the particle can be found. DELPHI, which ran from 1989 to 2000 on the LEP accelerator, was primarily concerned with particle identification.

  6. Ethical Delphi Manual

    NARCIS (Netherlands)

    Millar, K.; Tomkins, S.; Thorstensen, E.; Mepham, B.; Kaiser, M.

    2006-01-01

    An ethical Delphi is an iterative participatory process between experts for exchanging views and arguments on ethical issues. The method is structured around the notion of a virtual committee where the exchange of ideas is conducted remotely through a series of opinion exchanges. The ethical Delphi

  7. Addressing the workplace needs of Western Australian midwives: a Delphi study.

    Science.gov (United States)

    Hauck, Yvonne L; Bayes, Sara J; Robertson, Jeanette M

    2012-05-01

    To determine the workplace needs of Western Australian midwives working in public metropolitan secondary hospitals. Using a three-round Delphi approach, Round 1 incorporated focus groups and a questionnaire. Fifteen focus groups were conducted with midwives also having the option of contributing through an open-ended questionnaire. During Round 2, 38 items reflecting seven themes were prioritised with a final ranking performed in Round 3. In total, 114 midwives participated in Round 1, 72 in Round 2 and 89 in Round 3. During Round 1, workplace needs identified as being met included: working across all areas of midwifery; ability to work in areas of interest; opportunity to work with low to moderate risk women; supportive colleagues; accessible parking; hospital close to home and friendly work atmosphere. Round 2 items revealed the five top unmet needs as: adequate midwifery staff coverage; access to maintained equipment; competitive pay scales; patient safety issues and opportunities to implement midwifery models. The top ranked needs from Round 3 included: recognising the unpredictable nature of midwifery services; provision of competent medical coverage, and adequate midwifery staff coverage. Demand for maternity services is unpredictable; however, in order to maintain a sustainable maternity workforce, WA midwives' prioritised needs would suggest health management focus upon expanding the availability of midwifery models of care, fostering flexible working conditions and ensuring collaboration between maternity health professionals occurs within clinically safe staffing levels.

  8. EFP Delphi study on the trends in Periodontology and Periodontics in Europe for the year 2025.

    Science.gov (United States)

    Madianos, Phoebus; Papaioannou, William; Herrera, David; Sanz, Mariano; Baeumer, Amelie; Bogren, Anna; Bouchard, Philippe; Chomyszyn-Gajewska, Maria; Demirel, Korkud; Gaspersic, Rok; Giurgiu, Marina; Graziani, Filippo; Jepsen, Karin; Jepsen, Sören; O Brien, Tiernan; Polyzois, Ioannis; Preshaw, Philip M; Rakic, Mia; Reners, Michele; Rincic, Nives; Stavropoulos, Andreas; Sütcü, Serdar; Verner, Christian; Llodra, Juan Carlos

    2016-06-01

    The aim was to assess the potential trends in Periodontology and Periodontics in Europe that might be anticipated by the year 2025, using the Delphi method. The expert opinion of 120 experts was sought through the use of an open-ended questionnaire, developed by an advisory group, containing 40 questions concerning the various trends in periodontology. The experts (113 responders) expect a stabilization of the prevalence of periodontitis, both for the chronic as well as the aggressive cases, but an increase in implant-related diseases up to the year 2025. Concurrently, the importance of implants is seen to be increasing. They foresee an increased demand for postgraduate periodontology and implantology training. This is mirrored in an increase in publications for implant dentistry and increase in demand and need for training. Concerning the patients, better-informed individuals seeking more routine check-ups are expected. A continued need for specialized periodontists, but also well trained dental practitioners is foreseen for next decade in Europe. Apart from periodontology they will be increasingly exposed to and trained in implant dentistry. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Key performance indicators to benchmark hospital information systems - a delphi study.

    Science.gov (United States)

    Hübner-Bloder, G; Ammenwerth, E

    2009-01-01

    To identify the key performance indicators for hospital information systems (HIS) that can be used for HIS benchmarking. A Delphi survey with one qualitative and two quantitative rounds. Forty-four HIS experts from health care IT practice and academia participated in all three rounds. Seventy-seven performance indicators were identified and organized into eight categories: technical quality, software quality, architecture and interface quality, IT vendor quality, IT support and IT department quality, workflow support quality, IT outcome quality, and IT costs. The highest ranked indicators are related to clinical workflow support and user satisfaction. Isolated technical indicators or cost indicators were not seen as useful. The experts favored an interdisciplinary group of all the stakeholders, led by hospital management, to conduct the HIS benchmarking. They proposed benchmarking activities both in regular (annual) intervals as well as at defined events (for example after IT introduction). Most of the experts stated that in their institutions no HIS benchmarking activities are being performed at the moment. In the context of IT governance, IT benchmarking is gaining importance in the healthcare area. The found indicators reflect the view of health care IT professionals and researchers. Research is needed to further validate and operationalize key performance indicators, to provide an IT benchmarking framework, and to provide open repositories for a comparison of the HIS benchmarks of different hospitals.

  10. A Delphi study on research priorities in radiation therapy: The Norwegian perspective

    International Nuclear Information System (INIS)

    Egestad, H.; Halkett, G.K.B.

    2016-01-01

    Introduction: Although radiation therapists (RTs) need to engage more in research to establish an evidence base for their daily practice the majority conduct little research themselves. This project is the second stage of a Delphi process aimed at determining research priorities in radiation therapy in Norway. The aim of this article is to prioritize the research areas radiation therapists in Norway think are most important in their own profession. Methods: A questionnaire was administered using responses to a previous questionnaire, which identified the research interests of Norwegian RTs. The survey was sent to all Norwegian departments of radiation oncology, and RTs were asked to form interest groups to discuss and prioritize the research areas. Results: There was a 70% response rate, seven of 10 departments participated. The highest ranked research categories were imaging in radiation therapy and radiation therapist education. Seven of the top ten ranked research areas were in these categories. Conclusion: Prioritization of research areas and categories provides a useful list of future research for Norwegian RTs, which will enable them to decide whether their research ideas are a high priority, and spend less time deciding on a relevant research topic that needs investigation in their own workplaces. - Highlights: • Norwegian RTs prioritize research about performing their professional practice. • Main points of research interests are about new techniques and competence. • The top ten are about treatment plan, doses, safety and relationship with patients. • Prioritization of research areas provides a useful list of future research.

  11. A Delphi study on research priorities in radiation therapy: The Australian perspective

    International Nuclear Information System (INIS)

    Cox, Jennifer; Halkett, Georgia; Anderson, Claudia; Heard, Robert

    2010-01-01

    Radiation therapists (RTs) need to engage more in research to establish an evidence base for their daily practice. However, RTs world-wide conduct little research themselves, although positive moves have been made in some countries. This project is the second stage of a Delphi process aimed at prioritising RT areas of research interest. A questionnaire was constructed using responses to a previous questionnaire which identified the research interests of Australian RTs. Fifty-three Research Areas were identified from these responses and grouped into 12 categories such as 'imaging in radiation therapy', 'symptom management', 'accuracy of patient positioning' and 'techniques/equipment'. The survey was sent to all Australian departments of radiation oncology, and RTs were asked to form interest groups to discuss and prioritise the Research Areas. There was a 50% response rate (18 of 36 departments surveyed). The highest ranked research Category was 'imaging in radiation therapy'. Six of the top 10 ranked Research Areas were within Central RT practice ('imaging in radiation therapy'; 'symptom management'; 'accuracy of patient positioning' and 'techniques/equipment') and the other four were within broader RT practice ('diversification, recognition and other professional issues'; and 'management and staff issues'). Patient Care was also considered to be an area requiring more research. This prioritization of Research Areas and categories provides a useful list of future research for RTs, which will enable them to decide whether their research ideas are a high priority, and spend less time deciding on a relevant research topic that needs investigation in their own workplaces.

  12. Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

    Science.gov (United States)

    Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

    2015-10-01

    The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to

  13. Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders.

    Science.gov (United States)

    Vanmeerbeek, Marc; Govers, Patrick; Schippers, Nathalie; Rieppi, Stéphane; Mortelmans, Katrien; Mairiaux, Philippe

    2016-02-17

    In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient's ability to return to work. The objective of this study was to identify ways to improve these physicians' mutual collaboration. Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders. From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training. The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities.

  14. A Delphi study on research priorities in radiation therapy: The Australian perspective

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Jennifer [Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: jenny.cox@usyd.edu.au; Halkett, Georgia [Western Australia Centre for Cancer and Palliative Care, Curtin University of Technology, Health Research Campus, GPO Box U1987, Perth, WA 6845 (Australia)], E-mail: g.halkett@curtin.edu.au; Anderson, Claudia [Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: claudia.anderson@usyd.edu.au; Heard, Robert [Faculty of Health Sciences, University of Sydney, P.O. Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: r.heard@staff.usyd.edu.au

    2010-02-15

    Radiation therapists (RTs) need to engage more in research to establish an evidence base for their daily practice. However, RTs world-wide conduct little research themselves, although positive moves have been made in some countries. This project is the second stage of a Delphi process aimed at prioritising RT areas of research interest. A questionnaire was constructed using responses to a previous questionnaire which identified the research interests of Australian RTs. Fifty-three Research Areas were identified from these responses and grouped into 12 categories such as 'imaging in radiation therapy', 'symptom management', 'accuracy of patient positioning' and 'techniques/equipment'. The survey was sent to all Australian departments of radiation oncology, and RTs were asked to form interest groups to discuss and prioritise the Research Areas. There was a 50% response rate (18 of 36 departments surveyed). The highest ranked research Category was 'imaging in radiation therapy'. Six of the top 10 ranked Research Areas were within Central RT practice ('imaging in radiation therapy'; 'symptom management'; 'accuracy of patient positioning' and 'techniques/equipment') and the other four were within broader RT practice ('diversification, recognition and other professional issues'; and 'management and staff issues'). Patient Care was also considered to be an area requiring more research. This prioritization of Research Areas and categories provides a useful list of future research for RTs, which will enable them to decide whether their research ideas are a high priority, and spend less time deciding on a relevant research topic that needs investigation in their own workplaces.

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

    Science.gov (United States)

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

    2015-09-01

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

  16. Defining the activities of publicness for Korea's public community hospitals using the Delphi method.

    Science.gov (United States)

    Lee, Kunsei; Kim, Hyun Joo; You, Myoungsoon; Lee, Jin-Seok; Eun, Sang Jun; Jeong, Hyoseon; Ahn, Hye Mi; Lee, Jin Yong

    2017-03-01

    This study aims to identify which activities of a public community hospital (PHC) should be included in their definition of publicness and tries to achieve a consensus among experts using the Delphi method. We conduct 2 rounds of the Delphi process with 17 panel members using a developed draft of tentative activities for publicness including 5 main categories covering 27 items. The questions remain the same in both rounds and the applicability of each of the 27 items to publicness is measured on a 9-point scale. If the participants believe government funding is needed, we ask how much they think the government should support each item on a 0% to 100% scale. After conducting 2 rounds of the Delphi process, 22 out of the 27 items reached a consensus as activities defining the publicness of the PHCs. Among the 5 major categories, in category C, activities preventing market failure, all 10 items were considered activities of publicness. Nine of these were evaluated as items that should be compensated at 100% of total financial loss by the Korean government. Throughout results, we were able to define the activities of the PCH that encompassed its publicness and confirm that there are "good deficits" in the context of the PCHs. Thus, some PCH deficits are unavoidable and not wasted as these monies support a necessary role and function in providing public health. The Korean government should therefore consider taking actions such as exempting such "good deficits" or providing additional financial aid to reimburse the PHCs for "good deficits."

  17. Establishing key components of yoga interventions for musculoskeletal conditions: a Delphi survey

    Science.gov (United States)

    2014-01-01

    Background Evidence suggests yoga is a safe and effective intervention for the management of physical and psychosocial symptoms associated with musculoskeletal conditions. However, heterogeneity in the components and reporting of clinical yoga trials impedes both the generalization of study results and the replication of study protocols. The aim of this Delphi survey was to address these issues of heterogeneity, by developing a list of recommendations of key components for the design and reporting of yoga interventions for musculoskeletal conditions. Methods Recognised experts involved in the design, conduct, and teaching of yoga for musculoskeletal conditions were identified from a systematic review, and invited to contribute to the Delphi survey. Forty-one of the 58 experts contacted, representing six countries, agreed to participate. A three-round Delphi was conducted via electronic surveys. Round 1 presented an open-ended question, allowing panellists to individually identify components they considered key to the design and reporting of yoga interventions for musculoskeletal conditions. Thematic analysis of Round 1 identified items for quantitative rating in Round 2; items not reaching consensus were forwarded to Round 3 for re-rating. Results Thirty-six panellists (36/41; 88%) completed the three rounds of the Delphi survey. Panellists provided 348 comments to the Round 1 question. These comments were reduced to 49 items, grouped under five themes, for rating in subsequent rounds. A priori group consensus of ≥80% was reached on 28 items related to five themes concerning defining the yoga intervention, types of yoga practices to include in an intervention, delivery of the yoga protocol, domains of outcome measures, and reporting of yoga interventions for musculoskeletal conditions. Additionally, a priori consensus of ≥50% was reached on five items relating to minimum values for intervention parameters. Conclusions Expert consensus has provided a non

  18. Collecting core data in severely injured patients using a consensus trauma template: an international multicentre study

    DEFF Research Database (Denmark)

    Ringdal, Kjetil G; Lossius, Hans Morten; Jones, J Mary

    2011-01-01

    ABSTRACT: INTRODUCTION: No worldwide, standardised definitions exist for documenting, reporting, and comparing data from severely injured trauma patients. This study evaluated the feasibility of collecting the data variables of the international consensus-derived Utstein Trauma Template. METHODS:...

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

    Science.gov (United States)

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

    2014-07-01

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

  20. Development of a standardized training course for laparoscopic procedures using Delphi methodology.

    Science.gov (United States)

    Bethlehem, Martijn S; Kramp, Kelvin H; van Det, Marc J; ten Cate Hoedemaker, Henk O; Veeger, Nicolaas J G M; Pierie, Jean Pierre E N

    2014-01-01

    Content, evaluation, and certification of laparoscopic skills and procedure training lack uniformity among different hospitals in The Netherlands. Within the process of developing a new regional laparoscopic training curriculum, a uniform and transferrable curriculum was constructed for a series of laparoscopic procedures. The aim of this study was to determine regional expert consensus regarding the key steps for laparoscopic appendectomy and cholecystectomy using Delphi methodology. Lists of suggested key steps for laparoscopic appendectomy and cholecystectomy were created using surgical textbooks, available guidelines, and local practice. A total of 22 experts, working for teaching hospitals throughout the region, were asked to rate the suggested key steps for both procedures on a Likert scale from 1-5. Consensus was reached with Crohnbach's α ≥ 0.90. Of the 22 experts, 21 completed and returned the survey (95%). Data analysis already showed consensus after the first round of Delphi on the key steps for laparoscopic appendectomy (Crohnbach's α = 0.92) and laparoscopic cholecystectomy (Crohnbach's α = 0.90). After the second round, 15 proposed key steps for laparoscopic appendectomy and 30 proposed key steps for laparoscopic cholecystectomy were rated as important (≥4 by at least 80% of the expert panel). These key steps were used for the further development of the training curriculum. By using the Delphi methodology, regional consensus was reached on the key steps for laparoscopic appendectomy and cholecystectomy. These key steps are going to be used for standardized training and evaluation purposes in a new regional laparoscopic curriculum. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Study of D* charmed meson production in Z0 boson decays observed by the DELPHI experiment at LEP

    International Nuclear Information System (INIS)

    Benedic, D.

    1991-12-01

    The work presented in this thesis has been performed on the DELPHI experiment, at the CERN large electron-positron collider LEP. The main purpose of this thesis is the study of charmed mesons D * produced in the hadronic decays of the Z neutral. At first we will describe the theoretical framework by presenting the Standard Model, the fragmentation models and the heavy quark physics. The DELPHI detector is then described and especially the track detectors which are the main detectors in our analysis. Two studies of charged D * mesons are then presented. In the first one around 170 D *+ decaying into D neutral π + were reconstructed, where the D neutral decays into K - π + or K - π + π - π + . From the X E = E(D *+ )/E beam distribution, the production rate of D *+ in Z neutral hadronic decays is computed. Fixing the b quark fragmentation function, the D *+ rate from charm quark and the average E > c are measured. The partial width Γ c is also measured. The following results were obtained: Br(Z had → D *+ X). B * B o = (4.54 + - 0.54 (stat) ± 0.55(syst)).10 -3 E > c 0.51 ± 0.03(stat) ± 0.02(syst) Γ c /Γ had = 0.157 ± 0.031(stat) ± 0.041(syst) where B * B o is the product Br(D *+ → D neutral π + ).Br(D neutral → K - π + ). In the second study the production rate of cantic events is derived from the inclusive analysis of charged pions coming from the decay of charmed mesons D *+ → D neutral π + where the π + is constrained by kinematics to have a low P T with respect to the jet axis. The amount of D *+ counted by this method is ten times greater than in the first study. We have thus measured: Γ c /Γ had = 0.122 ± 0.011stat) ± 0.028(syst)

  2. Study of final states involving 2 particle jets and missing energy with the DELPHI detector at LEP; Etude des etats finals contenant deux jets de particules et de l'energie manquante avec le detecteur DELPHI a LEP

    Energy Technology Data Exchange (ETDEWEB)

    Ferrer Ribas, E

    2000-05-09

    The observation of the Higgs boson would be of great importance for the understanding of the electroweak symmetry breaking. In the framework of the Minimal Supersymmetric extension of the Standard Model (MSSM), the lightest Higgs boson is neutral and scalar, and its mass must be less than 130 GeV/c{sup 2}. In this thesis, we have studied events characterized by the presence of two particle jets and missing energy. This is a very clear signature of the production of the Higgs boson in association with a Z{sup 0} boson. This production is followed by the decay of the Higgs boson into a bb-bar pair and the Z{sup 0} boson in {nu}{nu}-bar pair. In these studies, it is important to detect all particles in order to achieve a good resolution in energy. For these reasons, we have devoted ourselves to improving DELPHI's hermeticity mainly in the regions located at 40 deg C and 140 deg C. Using the data collected by the DELPHI detector at LEP in 1998 and in 1999 at four different energies in the centre of mass ({radical}s = 189, 196, 200 and 202 GeV), no signal has been observed, allowing us to exclude the Higgs boson at 95 % confidence level up to a mass of: m{sub H} > 98.0 (98.5) GeV/c{sup 2} at 95% C.L. this analysis; m{sub H} > 103.9 (106.3) GeV/c{sup 2} at 95% C.L. DELPHI combined. The values in parentheses show the expected limits and indicate the sensitivity of the analysis. If these results are interpreted in the framework of the MSSM we obtain: m{sub h} > 85.0 (85.3) GeV/c{sup 2} at 95% C.L. Studying the same topology, we have also searched for a Higgs boson decaying into a pair of non detectable particles (Invisible Higgs) in association with a Z{sup 0} boson decaying into a quark/antiquark pair. In this case too, no signal has been observed, which can be translated into a lower limit on the mass of the Higgs boson at 95% confidence level: m{sub h{sub inv}} > 105.5 (105.3) GeV/c{sup 2} at 95% C.L. Finally, we have measured the production cross section of a pair

  3. Delphi General Ledger -

    Data.gov (United States)

    Department of Transportation — Delphi general ledger contains the following data elements, but is not limited to the United States Standard General Ledger (USSGL) chart of accounts, stores actual,...

  4. A Delphi study among internal medicine clinicians to determine which therapeutic information is essential to record in a medical record.

    Science.gov (United States)

    van Unen, Robert J; Tichelaar, Jelle; Nanayakkara, Prabath W B; van Agtmael, Michiel A; Richir, Milan C; de Vries, Theo P G M

    2015-12-01

    Several studies have demonstrated that using a template for recording general and diagnostic information in the medical record (MR) improves the completeness of MR documentation, communication between doctors, and performance of doctors. However, little is known about how therapeutic information should be structured in the MR. The aim of this study was to investigate which specific therapeutic information registrars and consultants in internal medicine consider essential to record in the MR. Therefore, we carried out a 2-round Internet Delphi study. Fifty-nine items were assessed on a 5-point scale; an item was considered important if ≥ 80% of the respondents awarded it a score of 4 or 5. In total, 26 registrars and 30 consultants in internal medicine completed both rounds of the study. Overall, they considered it essential to include information about 11 items in the MR. Subgroup analyses revealed that the registrars considered 8 additional items essential, whereas the consultants considered 1 additional item essential to record. Study findings can be used as a starting point to develop a structured section of the MR for therapeutic information for both paper and electronic MRs. This section should contain at least 11 items considered essential by registrars and clinical consultants in internal medicine. © 2015, The American College of Clinical Pharmacology.

  5. Consensus statement on genetic research in dementia

    DEFF Research Database (Denmark)

    Rikkert, M.G. Olde; der, V van; Burns, A.

    2008-01-01

    In this article, the authors describe how the European Dementia Consensus Network developed a consensus on research ethics in dementia, taking into account the questions posed by the era of genetic research and its new research methods. The consensus process started with a Delphi procedure...... to analyze relevant stakeholders' positions by describing their statements on the possibilities and limitations of research into genetic determinants of Alzheimer disease and to describe and analyze the moral desirability of genetic research on Alzheimer disease. The conclusions drawn from the Delphi...... procedure fuelled the development of the consensus statement, which is presented in this paper. The consensus statement aims to stimulate ethically acceptable research in the field of dementia and the protection of vulnerable elderly patients with dementia from application of inadequate research methods...

  6. Development of Instructional Competencies for Assessing and Managing Suicide Risk for Baccalaureate Nursing Education: A Modified Delphi Study.

    Science.gov (United States)

    Kotowski, Abigail; Roye, Carol

    2017-03-01

    Suicide is a major health problem and a leading cause of death throughout the world. A primary goal for suicide prevention is reforming health professional education in order to increase the competence of health professionals in assessing and managing suicide risk. Nursing leadership is involved in this reform, yet nurses frequently lack the competence to care for patients in suicidal crisis. An identified gap in baccalaureate nursing education is instructional competencies for assessing and managing suicide risk. A modified Delphi study was used. The study began with a focus group which was conducted in order to develop the Round I Survey which included forty-four competencies. After scoring these competencies, thirty-four were scored for inclusion, two were dropped and eight were revised according to panel members' comments. The Round II Survey comprised the eight revised competencies which were scored for inclusion, resulting in forty-two competencies in the final set of instructional competencies. Forty-two instructional competencies were developed: fourteen pre-assessment instructional competencies, fifteen assessment instructional competencies, and thirteen management instructional competencies. Incorporating these instructional competencies into baccalaureate nursing education might increase the competence of nursing students, and thus new nurses, in caring for patients at risk for suicide. These instructional competencies provide a first step to address the challenging task of intervening with patients at risk for suicide.

  7. Algorithms for monitoring warfarin use: Results from Delphi Method.

    Science.gov (United States)

    Kano, Eunice Kazue; Borges, Jessica Bassani; Scomparini, Erika Burim; Curi, Ana Paula; Ribeiro, Eliane

    2017-10-01

    Warfarin stands as the most prescribed oral anticoagulant. New oral anticoagulants have been approved recently; however, their use is limited and the reversibility techniques of the anticoagulation effect are little known. Thus, our study's purpose was to develop algorithms for therapeutic monitoring of patients taking warfarin based on the opinion of physicians who prescribe this medicine in their clinical practice. The development of the algorithm was performed in two stages, namely: (i) literature review and (ii) algorithm evaluation by physicians using a Delphi Method. Based on the articles analyzed, two algorithms were developed: "Recommendations for the use of warfarin in anticoagulation therapy" and "Recommendations for the use of warfarin in anticoagulation therapy: dose adjustment and bleeding control." Later, these algorithms were analyzed by 19 medical doctors that responded to the invitation and agreed to participate in the study. Of these, 16 responded to the first round, 11 to the second and eight to the third round. A 70% consensus or higher was reached for most issues and at least 50% for six questions. We were able to develop algorithms to monitor the use of warfarin by physicians using a Delphi Method. The proposed method is inexpensive and involves the participation of specialists, and it has proved adequate for the intended purpose. Further studies are needed to validate these algorithms, enabling them to be used in clinical practice.

  8. Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II*

    Science.gov (United States)

    Thorlacius, L.; Garg, A.; Ingram, J.R.; Villumsen, B.; Riis, P. Theut; Gottlieb, A.B.; Merola, J.F.; Dellavalle, R.; Ardon, C.; Baba, R.; Bechara, F.G.; Cohen, A.D.; Daham, N.; Davis, M.; Emtestam, L.; Fernández-Peñas, P.; Filippelli, M.; Gibbons, A.; Grant, T.; Guilbault, S.; Gulliver, S.; Harris, C; Harvent, C.; Houston, K.; Kirby, J.S.; Matusiak, L.; Mehdizadeh, A.; Mojica, T.; Okun, M.; Orgill, D.; Pallack, L.; Parks-Miller, A.; Prens, E.P.; Randell, S.; Rogers, C.; Rosen, C.F.; Choon, S.E.; van der Zee, H.H.; Christensen, R.; Jemec, G.B.E.

    2018-01-01

    Summary Background A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items. Objectives To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains. Methods The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey. Results Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments. Conclusions The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings. PMID:29080368

  9. A Quality, Benefit, Cost, and Financial Framework for Health Information Technology, E-Prescribing: A Delphi Study.

    Science.gov (United States)

    DeMuro, Paul R; Ash, Joan; Middleton, Blackford; Fletcher, Justin; Madison, Cecelia J

    2017-01-01

    Little research has been conducted about the quality, benefits, costs, and financial considerations associated with health information technology (HIT), particularly informatics technologies, such as e-prescribing, from the perspective of all its stakeholders. This research effort sought to identify the stakeholders involved in e-prescribing and to identify and rank-order the positives and the negatives from the perspective of the stakeholders to create a framework to assist in the development of incentives and payment mechanisms which result in better managed care. The Delphi method was employed by enlisting a panel of experts. They were presented with the results of initial research in an online survey of questions which sought to prioritize the quality, benefit, cost, and financial effects of e-prescribing from the perspective of each stakeholder. From the results of this study, a framework was presented to framework experts. The experts added stakeholders and positives and negatives to the initial lists and rank-ordered the positives and negatives of e-prescribing from the perspective of each stakeholder. The aggregate results were summarized by category of stakeholder. The framework experts evaluated the framework. Positives and negatives can be rank-ordered from the perspective of each stakeholder. A useful framework was created.

  10. Strategies for the prevention of MP3-induced hearing loss among adolescents: expert opinions from a Delphi study.

    Science.gov (United States)

    Vogel, Ineke; Brug, Johannes; van der Ploeg, Catharina P B; Raat, Hein

    2009-05-01

    To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth work, music entertainment, and enforcement authorities participated in a qualitative, electronic, 3-round, Web-based Delphi study. Multiple parties involved in the prevention of MP3-induced hearing loss among adolescents were identified; the most relevant are the adolescents themselves, their parents, manufacturers of MP3 players and earphones, and the authorities. The experts did not expect that adolescents in general would perform the necessary protective behaviors to prevent MP3-induced hearing loss. Two environmental health protection measures were identified as both relevant and feasible to be implemented (ie, authorities encourage manufacturers to produce safer products, and public health campaigns will be held to improve knowledge of the risks of high-volume music, possible protective measures, and consequences of hearing loss). Authorities, the music industry in general, and especially manufacturers of MP3 players and earphones should recognize their responsibility and create a safer MP3-listening environment by taking measures to protect today's youth from the dangers of listening to high-volume music on MP3 players.

  11. Clinical classification criteria for nonspecific low back pain: A Delphi-survey of clinical experts.

    Science.gov (United States)

    Dewitte, Vincent; De Pauw, Robby; De Meulemeester, Kayleigh; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

    2018-04-01

    Nonspecific low back pain (NSLBP) is a common problem. Attempts have been made to classify NSLBP patients into homogenous subgroups. Classification systems based on identifying the underlying mechanism(s) driving the disorder are clinically useful to guide specific interventions. To establish consensus among experts regarding clinical criteria suggestive of a dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns (DPs) in NSLBP patients. A 2-phase sequential design of a focus group and Delphi-study. A focus group with 10 academic experts was organized to elaborate on the different DPs discernible in LBP patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 DPs resulting from the focus group. Fifteen musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating LBP patients completed the Delphi-survey. Respectively, 34 (response rate, 100.0%), 20 (58.8%) and 15 (44.12%) respondents replied to rounds 1, 2 and 3. Twenty-two 'articular', 20 'myofascial', 21 'neural', 18 'central' and 11 'sensorimotor control' criteria reached a predefined ≥80% consensus level. For example, after round 2, 85.0% of the Delphi-experts agreed to identify 'referred pain below the knee' as a subjective examination criterion suggestive for a predominant 'neural DP'. These indicators suggestive of a clinical dominance of the proposed DPs could help clinicians to assess and diagnose NSLBP patients. Future reliability and validity testing is needed to determine how these criteria may help to improve physical therapy outcome for NSLBP patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. The use of qualitative methods to inform Delphi surveys in core outcome set development.

    Science.gov (United States)

    Keeley, T; Williamson, P; Callery, P; Jones, L L; Mathers, J; Jones, J; Young, B; Calvert, M

    2016-05-04

    Core outcome sets (COS) help to minimise bias in trials and facilitate evidence synthesis. Delphi surveys are increasingly being used as part of a wider process to reach consensus about what outcomes should be included in a COS. Qualitative research can be used to inform the development of Delphi surveys. This is an advance in the field of COS development and one which is potentially valuable; however, little guidance exists for COS developers on how best to use qualitative methods and what the challenges are. This paper aims to provide early guidance on the potential role and contribution of qualitative research in this area. We hope the ideas we present will be challenged, critiqued and built upon by others exploring the role of qualitative research in COS development. This paper draws upon the experiences of using qualitative methods in the pre-Delphi stage of the development of three different COS. Using these studies as examples, we identify some of the ways that qualitative research might contribute to COS development, the challenges in using such methods and areas where future research is required. Qualitative research can help to identify what outcomes are important to stakeholders; facilitate understanding of why some outcomes may be more important than others, determine the scope of outcomes; identify appropriate language for use in the Delphi survey and inform comparisons between stakeholder data and other sources, such as systematic reviews. Developers need to consider a number of methodological points when using qualitative research: specifically, which stakeholders to involve, how to sample participants, which data collection methods are most appropriate, how to consider outcomes with stakeholders and how to analyse these data. A number of areas for future research are identified. Qualitative research has the potential to increase the research community's confidence in COS, although this will be dependent upon using rigorous and appropriate

  13. A Study of J/psi Production at the LEP $e^{+} e{-}$ Collider; and the Implementation of the DELPHI Slow Controls System

    CERN Document Server

    Adye, T J

    1998-01-01

    This thesis describes two separate areas of work conducted for the DELPHI detector at LEP. The first concerns the Slow Controls of the DELPHI detector, which enable a single operator to oversee the proper functioning of the apparatus and to diagnose faults as they occur. The hardware and software of this system, as well as their interface to the experiment and the operator, are described. Some conclusions are drawn from seven years' design work and the initial six years' operation of DELPHI. Secondly, a study is made of the production, at e+e- collision centre of mass energies close to the Z0 resonance, of J/psi mesons, decaying to mu+ mu-. J/psi mesons produced via a B-hadron are used to measure the mean B lifetime, tau_B = (1.53 +- 0.11 (stat.) +- 0.06 (syst.)) ps A measurement is also made of the fraction of J/psis produced promptly at the e+e- collision point, N(Z0 -> prompt J/psi X) / N(Z0 -> J/psi X) = (9.6 +- 3.2 (stat.) +- 1.2 (syst.))%. This method is largely model-independent.

  14. Toward a Consensus in Ethics Education for the Doctor of Nursing Practice.

    Science.gov (United States)

    Laabs, Carolyn A

    2015-01-01

    The purpose of this study was to begin to develop a consensus as to the essential content and methods of ethics education for advanced practice nurses. An online Delphi technique was used to survey ethics experts to determine whether items were essential, desirable, or unnecessary to ethics education for students in doctor of nursing practice programs. Only the American Nurses Association Code of Ethics and ethics terminology were deemed essential foundational knowledge.

  15. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union

    Science.gov (United States)

    Fuller, Colin W; Molloy, Michael G; Bagate, Christian; Bahr, Roald; Brooks, John H M; Donson, Hilton; Kemp, Simon P T; McCrory, Paul; McIntosh, Andrew S; Meeuwisse, Willem H; Quarrie, Kenneth L; Raftery, Martin; Wiley, Preston

    2007-01-01

    Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow‐up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non‐fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union. PMID:17452684

  16. Multidisciplinary convalescence recommendations after gynaecological surgery: a modified Delphi method among experts

    NARCIS (Netherlands)

    Vonk Noordegraaf, A.; Huirne, J.A.F.; Brölmann, H.A.M.; van Mechelen, W.; Anema, J.R.

    2011-01-01

    Objective: To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians. Design: Modified Delphi study. Setting: Expert physicians recruited by their respective medical boards

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

    Science.gov (United States)

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

    2018-03-01

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

  18. Um modelo de organização e partilha de informação de enfermagem entre hospital e centro de saúde: estudo delphi Un modelo de organización e intercambio de información de enfermeria entre un hospital y un centro de salud: estudio delphi A model of organization and nursing exchange information: a delphi study

    Directory of Open Access Journals (Sweden)

    Paulino Artur Ferreira de Sousa

    2005-12-01

    enfermeros de diferentes áreas de actuación. RESULTADOS: Los consensos obtenidos permitieron la jerarquizacíon de los aspectos principales de lo problema en estudio. Son presentados los consensos relativamente a los presupuestos que deben guiar el desarrollo del Sistema de Comparto de Información de Enfermería y la información que deberá efectivamente ser compartida entre hospital y centro de salud, con indicación de los niveles de prioridad de acceso. CONCLUSIÓN: La articulación entre los diferentes medios de salud debe ser asegurada por un modelo que garantiza lo comparto recíproco y confidencial de la información de enfermería, en tiempo real, con recurso a las tecnologías de la información y comunicación.BACKGROUND: An adequate exchange of nursing information between health care facilities should be taken as a fundamental strategy to promote continuity of nursing care. The actual system used to exchange nursing information between nursing staff from health care services in Matosinhos, Portugal, appears to be unsatisfactory. OBJECTIVE: This paper reports the development and use o a model of organization and nursing information exchange. METHODS: The study used the Delphi technique whose focus was to reach a consensus from a panel of expert nurses from different areas of practice. RESULTS: The consensus of the panel allowed reaching hierarchical aspects of the problem in exchanging nursing information. It was possible to define the presupposed information that should guide the Nursing Exchange Information System development, and to identify the information that effectively should be exchanged between health care facilities at different levels of access. CONCLUSION: The exchange of information among different health care facilities should be guided by a model that guarantees the reciprocal and confidential nursing information, in real time, using appropriate information and communication technologies.

  19. The DELPHI pixels

    International Nuclear Information System (INIS)

    Becks, K.H.; Brunet, J.M.

    1997-01-01

    To improve tracking in the very forward direction for running at LEP200, the angular acceptance of the DELPHI Vertex detector has been extended from 45 to 11 with respect to the beam axis. Pixel detector crowns cover the region between 25 and 13 . Due to very tight space and material thickness constraints it was necessary to develop new techniques (integrated busses in the detector substrate, high density layout on Kapton, etc.). About 1000 cm 2 of pixels are already installed and working in DELPHI. Techniques, tests and production of these detectors will be described, as well as the main problems encountered during this work. (orig.)

  20. Pesticide applicators questionnaire content validation: A fuzzy delphi method.

    Science.gov (United States)

    Manakandan, S K; Rosnah, I; Mohd Ridhuan, J; Priya, R

    2017-08-01

    The most crucial step in forming a set of survey questionnaire is deciding the appropriate items in a construct. Retaining irrelevant items and removing important items will certainly mislead the direction of a particular study. This article demonstrates Fuzzy Delphi method as one of the scientific analysis technique to consolidate consensus agreement within a panel of experts pertaining to each item's appropriateness. This method reduces the ambiguity, diversity, and discrepancy of the opinions among the experts hence enhances the quality of the selected items. The main purpose of this study was to obtain experts' consensus on the suitability of the preselected items on the questionnaire. The panel consists of sixteen experts from the Occupational and Environmental Health Unit of Ministry of Health, Vector-borne Disease Control Unit of Ministry of Health and Occupational and Safety Health Unit of both public and private universities. A set of questionnaires related to noise and chemical exposure were compiled based on the literature search. There was a total of six constructs with 60 items in which three constructs for knowledge, attitude, and practice of noise exposure and three constructs for knowledge, attitude, and practice of chemical exposure. The validation process replicated recent Fuzzy Delphi method that using a concept of Triangular Fuzzy Numbers and Defuzzification process. A 100% response rate was obtained from all the sixteen experts with an average Likert scoring of four to five. Post FDM analysis, the first prerequisite was fulfilled with a threshold value (d) ≤ 0.2, hence all the six constructs were accepted. For the second prerequisite, three items (21%) from noise-attitude construct and four items (40%) from chemical-practice construct had expert consensus lesser than 75%, which giving rise to about 12% from the total items in the questionnaire. The third prerequisite was used to rank the items within the constructs by calculating the average

  1. Ocular allergy latin american consensus

    Directory of Open Access Journals (Sweden)

    Myrna Serapião dos Santos

    2011-12-01

    Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

  2. Consensus-based training and assessment model for general surgery.

    Science.gov (United States)

    Szasz, P; Louridas, M; de Montbrun, S; Harris, K A; Grantcharov, T P

    2016-05-01

    Surgical education is becoming competency-based with the implementation of in-training milestones. Training guidelines should reflect these changes and determine the specific procedures for such milestone assessments. This study aimed to develop a consensus view regarding operative procedures and tasks considered appropriate for junior and senior trainees, and the procedures that can be used as technical milestone assessments for trainee progression in general surgery. A Delphi process was followed where questionnaires were distributed to all 17 Canadian general surgery programme directors. Items were ranked on a 5-point Likert scale, with consensus defined as Cronbach's α of at least 0·70. Items rated 4 or above on the 5-point Likert scale by 80 per cent of the programme directors were included in the models. Two Delphi rounds were completed, with 14 programme directors taking part in round one and 11 in round two. The overall consensus was high (Cronbach's α = 0·98). The training model included 101 unique procedures and tasks, 24 specific to junior trainees, 68 specific to senior trainees, and nine appropriate to all. The assessment model included four procedures. A system of operative procedures and tasks for junior- and senior-level trainees has been developed along with an assessment model for trainee progression. These can be used as milestones in competency-based assessments. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  3. Study of the inclusive decay of B mesons into D{sup *+} mesons in the DELPHI experiment; Etude de la desintegration inclusive des mesons B en mesons D{sup *+} dans l`experience DELPHI

    Energy Technology Data Exchange (ETDEWEB)

    Baudot, J.

    1997-12-01

    The measurement of the inclusive branching ratio P(b {yields} D{sup *+}) improves the knowledge of beauty decays, specially regarding the strong interaction influence. The DELPHI experiment at LEP provides a power full tool to study such heavy flavor processus. The analysis of the data relies on one hand on the exclusive reconstruction of the decay D{sup *+} {yields} D{sup 0}(K{sup -}{pi}{sup +}){pi}{sup +} and on the other hand on the statistical separation of the two contributions b {yields} D{sup *+} and c {yields} D{sup *+} based on the D{sup 0} flight time. The following results are obtained: Br(Z{sub h} {yields} D{sup *+} {yields} D{sup 0} (K{sup -}{pi}{sup +}){pi}{sup +}) = (0,4364 {+-} 0,0112(stat) {+-} 0,0205(syst)) %; P(b {yields} D{sup *+}) = (0,2022 {+-}) 0,0121(stat) {+-} 0,0130(syst); R{sub c} X P(c {yields} D{sup *+} {yields} D{sup 0}(K{sup -}{pi}{sup +}){pi}{sup +}) = (0,9027 {+-} 0,0673(stat) {+-} 0,0533(syst)) x 10{sup -3}. The uncertainty on the efficiency for reconstructing tracks and the knowledge of background contribution represent the main systematics sources, whereas the influence of fragmentation model is negligible. (author).

  4. DELPHI Silicon Tracker

    CERN Multimedia

    DELPHI was one of the four experiments installed at the LEP particle accelerator from 1989 - 2000. The silicon tracking detector was nearest to the collision point in the centre of the detector. It was used to pinpoint the collision and catch short-lived particles.

  5. Use of the Delphi process in paediatric cataract management.

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

    Vantamay, Nottakrit

    2015-09-01

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

  7. The Role of Scientific Studies in Building Consensus in Environmental Decision Making: a Coral Reef Example

    Science.gov (United States)

    We present a new approach for characterizing the potential of scientific studies to reduce conflict among stakeholders in an analytic-deliberative environmental decision-making process. The approach computes a normalized metric, the Expected Consensus Index of New Research (ECINR...

  8. Operationalizing quality of life for people with profound multiple disabilities : a Delphi study

    NARCIS (Netherlands)

    Petry, K.; Maes, B.; Vlaskamp, C.

    Background: In a recent study, we constructed an item pool that contains items on the quality of life (QOL) and related aspects of support of people with profound multiple disabilities (PMD). In the present study, a panel of experts assessed the content and the structure of this item pool in order

  9. Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative.

    Science.gov (United States)

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

    2013-01-01

    There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators. We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided. This study established a national consensus defining the core competencies for EM clerkship in Canada.

  10. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Neri, E.; Boraschi, P.; Bartolozzi, C. [University of Pisa, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Bali, M.A.; Matos, C. [Hopital Erasme, MRI Clinics, Department of Radiology, Bruxelles (Belgium); Ba-Ssalamah, A. [The General Hospital of the Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Brancatelli, G. [University of Palermo, Department of Radiology, Palermo (Italy); Alves, F.C. [University Hospital of Coimbra, Medical Imaging Department and Faculty of Medicine, Coimbra (Portugal); Grazioli, L. [Spedali Civili di Brescia, Department of Radiology, Brescia (Italy); Helmberger, T. [Academic Teaching Hospital of the Technical University, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Munich (Germany); Lee, J.M. [Seoul National University College of Medicine, Division of Abdominal Imaging, Department of Radiology, Seoul (Korea, Republic of); Manfredi, R. [University of Verona, Department of Radiology, Verona (Italy); Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Area Clinica de Imagen Medica, Valencia (Spain); Merkle, E.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Op De Beeck, B. [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Schima, W. [KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Department of Diagnostic and Interventional Radiology, Vienna (Austria); Skehan, S. [St Vincent' s University Hospital, Department of Radiology, Dublin (Ireland); Vilgrain, V. [Assistance Publique-Hopitaux de Paris, APHP, Hopital Beaujon, Radiology Department, Clichy, Paris (France); Zech, C. [Universitaetsspital Basel, Abteilungsleiter Interventionelle Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)

    2016-04-15

    To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach's statistics were used to rate levels of agreement and internal reliability of the consensus. Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. (orig.)

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

    Science.gov (United States)

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

    2018-05-01

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

  12. Using the Delphi Method for Qualitative, Participatory Action Research in Health Leadership

    Directory of Open Access Journals (Sweden)

    Amber J. Fletcher PhD

    2014-02-01

    Full Text Available Current pressures on public health systems have led to increased emphasis on restructuring, which is seen as a potential solution to crises of accessibility, quality, and funding. Leadership is an important factor in the success or failure of these initiatives. Despite its importance, health leadership evades easy articulation, and its study requires a thoughtful methodological approach. We used a modified Delphi method in a Participatory Action Research (PAR project on health leadership in Canada. Little has been written about the combination of Delphi method with PAR. We offer a rationale for the combination and describe its usefulness in researching the role of leadership in a restructuring initiative in “real time” with the participation of health system decision makers. Recommendations are provided to researchers wishing to use the Delphi method qualitatively (i.e., without statistical consensus in a PAR framework while protecting the confidentiality of participants who work at different levels of authority. We propose a modification of Kaiser's (2009 post-interview confidentiality form to address power differentials between participants and to enhance confidentiality in the PAR process.

  13. Identifying factors for optimal development of health-related websites: a delphi study among experts and potential future users.

    Science.gov (United States)

    Schneider, Francine; van Osch, Liesbeth; de Vries, Hein

    2012-02-14

    The Internet has become a popular medium for offering tailored and targeted health promotion programs to the general public. However, suboptimal levels of program use in the target population limit the public health impact of these programs. Optimizing program development is considered as one of the main processes to increase usage rates. To distinguish factors potentially related to optimal development of health-related websites by involving both experts and potential users. By considering and incorporating the opinions of experts and potential users in the development process, involvement in the program is expected to increase, consequently resulting in increased appreciation, lower levels of attrition, and higher levels of sustained use. We conducted a systematic three-round Delphi study through the Internet. Both national and international experts (from the fields of health promotion, health psychology, e-communication, and technical Web design) and potential users were invited via email to participate. During this study an extensive list of factors potentially related to optimal development of health-related websites was identified, by focusing on factors related to layout, general and risk information provision, questionnaire use, additional services, and ease of use. Furthermore, we assessed the extent to which experts and potential users agreed on the importance of these factors. Differences as well as similarities among experts and potentials users were deduced. In total, 20 of 62 contacted experts participated in the first round (32% response rate); 60 of 200 contacted experts (30% response rate) and 210 potential users (95% response rate) completed the second-round questionnaire, and 32 of 60 contacted experts completed the third round (53% response rate). Results revealed important factors consented upon by experts and potential users (eg, ease of use, clear structure, and detailed health information provision), as well as differences regarding

  14. [Austrian guideline for palliative sedation therapy (long version) : Results of a Delphi process of the Austrian Palliative Society (OPG)].

    Science.gov (United States)

    Weixler, Dietmar; Roider-Schur, Sophie; Likar, Rudolf; Bozzaro, Claudia; Daniczek, Thomas; Feichtner, Angelika; Gabl, Christoph; Hammerl-Ferrari, Bernhard; Kletecka-Pulker, Maria; Körtner, Ulrich H J; Kössler, Hilde; Meran, Johannes G; Miksovsky, Aurelia; Pusswald, Bettina; Wienerroither, Thomas; Watzke, Herbert

    2017-02-01

    Palliative sedation therapy (PST) is an important and ethically accepted therapy in the care of selected palliative care patients with otherwise unbearable suffering from refractory distress. PST is increasingly used in end-of-life care. Austria does not have a standardized ethical guideline for this exceptional practice near end of life, but there is evidence that practice varies throughout the country. The Austrian Palliative Society (OPG) nominated a multidisciplinary working group of 16 palliative care experts and ethicists who established the national guideline on the basis of recent review work with the aim to adhere to the Europeans Association of Palliative Care's (EAPC) framework on palliative sedation therapy respecting Austrians legal, structural and cultural background. Consensus was achieved by a four-step sequential Delphi process. The Delphi-process was strictly orientated to the recently published EUROIMPACT-sedation-study-checklist and to the AGREE-2-tool. Additionally national stakeholders participated in the reflection of the results. As a result of a rigorous consensus process the long version of the Austrian National Palliative Sedation Guideline contains 112 statements within eleven domains and is supplemented by a philosophers excursus on suffering. By establishing a national guideline for palliative sedation therapy using the Delphi technique for consensus and stakeholder involvement the Austrian Palliative Society aims to ensure nationwide good practice of palliative sedation therapy. Screening for the practicability and efficacy of this guideline will be a future task.

  15. Teaching Strategies and Practices that Promote a Culturally Sensitive Nursing Education: A Delphi Study

    Science.gov (United States)

    Dewald, Robin J.

    2010-01-01

    The purpose of this study was to explore teaching strategies that promote a culturally sensitive nursing education and culturally sensitive nursing. The diversity of Americans has increased. Thus, the nursing student population and patient population have both become more diverse. Nursing education programs, therefore, need to know the best…

  16. A Delphi Study on Collaborative Learning in Distance Education: The Faculty Perspective

    Science.gov (United States)

    O'Neill, Susan; Scott, Murray; Conboy, Kieran

    2011-01-01

    This paper focuses on the factors that influence collaborative learning in distance education. Distance education has been around for many years and the use of collaborative learning techniques in distance education is becoming increasingly popular. Several studies have demonstrated the superiority of collaborative learning over traditional modes…

  17. Conditions for the Successful Implementation of Teacher Educator Design Teams for ICT Integration: A Delphi Study

    Science.gov (United States)

    Becuwe, Heleen; Roblin, Natalie Pareja; Tondeur, Jo; Thys, Jeroen; Castelein, Els; Voogt, Joke

    2017-01-01

    Teacher educators often struggle to model effective integration of technology. Several studies suggest that the involvement of teacher educators in collaborative design is effective in developing the competences necessary for integrating information and communication technology (ICT) in teaching. In a teacher educator design team (TeDT), two or…

  18. Identification of Industry Needs with Hospitality Management Curriculum Development: A Delphi Study

    Science.gov (United States)

    Mayburry, Thomas

    2010-01-01

    The purpose of this research was to identify a well-defined, comprehensive portrait of knowledge, skills, and abilities (KSAs) expected of students graduating from baccalaureate institutions conferring four-year degrees in hospitality management and further, to utilize those KSAs as foundations for curriculum development. This study provided a…

  19. Which dimensions of fatigue should be measured in patients with rheumatoid arthritis? A Delphi study

    NARCIS (Netherlands)

    Nikolaus, Stephanie; Bode, Christina; Taal, Erik; van de Laar, Mart A F J

    2012-01-01

    Objective: Rheumatoid arthritis (RA) patients experience fatigue as a multidimensional symptom. The aim of the present study was to use health professionals and patients alike to identify which dimensions of fatigue should be measured in RA. Methods: Twelve fatigue dimensions were constructed, based

  20. Factors and Traits Attributed to the Success of Virtual Managers: A Delphi Study

    Science.gov (United States)

    Garrett, Leslie A.

    2012-01-01

    This study explored the factors and traits impacting the success of virtual managers. It can be argued that given technology's role in working virtually, one would deem technology as the most important factor impacting one's work in a virtual environment, however, there are other factors "including support from the organization and one's personal…