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British Journal of Anaesthesia Jul 2024Using a modified Delphi technique, an international group of regional anaesthetists generated a list of top research priorities in regional anaesthesia. The list of...
Using a modified Delphi technique, an international group of regional anaesthetists generated a list of top research priorities in regional anaesthesia. The list of unanswered research questions was created from a questionnaire completed by >500 anaesthetists and distilled into 11 priorities grouped into four themes: clinical practice and efficacy, pain management, technology and equipment, and training and assessment.
Topics: Humans; Anesthesia, Conduction; Delphi Technique; Surveys and Questionnaires; Biomedical Research; Research; Pain Management; Anesthesiology
PubMed: 38702237
DOI: 10.1016/j.bja.2024.04.009 -
JAMA Network Open Aug 2023The ideal hospitalist workload and optimal way to measure it are not well understood.
IMPORTANCE
The ideal hospitalist workload and optimal way to measure it are not well understood.
OBJECTIVE
To obtain expert consensus on the salient measures of hospitalist workload.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study used a 3-round Delphi technique between April 5 and July 13, 2022, involving national experts within and external to the field. Experts included hospitalist clinicians, leaders, and administrators, as well as researchers with expertise in human factors engineering and cognitive load theory.
MAIN OUTCOMES AND MEASURES
Three rounds of surveys were conducted, during which participants provided input on the salient measures of hospitalist workload across various domains. In the first round, free-text data collected from the surveys were analyzed using a directed qualitative content approach. In the second and third rounds, participants rated each measure's relevance on a Likert scale, and consensus was evaluated using the IQR. Percentage agreement was also calculated.
RESULTS
Seventeen individuals from 14 organizations, encompassing clinicians, leaders, administrators, and researchers, participated in 3 rounds of surveys. In round 1, participants provided 135 unique qualitative comments across 10 domains, with 192 unique measures identified. Of the 192 measures presented in the second round, 6 (3%) were considered highly relevant, and 25 (13%) were considered moderately relevant. In round 3, 161 measures not meeting consensus were evaluated, with 25 (16%) considered highly relevant and 95 (59%) considered moderately relevant. Examples of measures considered highly relevant included a patient complexity score and outcome measures such as savings from hospital days avoided and clinician turnover.
CONCLUSIONS AND RELEVANCE
In this qualitative study measuring hospitalist workload, multiple measures, including those quantifying work demands and the association of those demands with outcomes, were considered relevant for measuring and understanding workloads. The findings suggest that relying on traditional measures, such as productivity-related measures and financial measures, may offer an incomplete understanding of workloads and their association with key outcomes. By embracing a broader range of measures, organizations may be able to better capture the complexity and nuances of hospitalist work demands and their outcomes on clinicians, patients, and organizations.
Topics: Humans; Workload; Hospitalists; Outcome Assessment, Health Care; Consensus; Delphi Technique
PubMed: 37561462
DOI: 10.1001/jamanetworkopen.2023.28165 -
Physical Therapy Oct 2023The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be...
OBJECTIVE
The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be useful for prescribing exercise to patients with migraine.
METHODS
This was an international study conducted between April 9, 2022 and June 30, 2022. An expert panel of health care and exercise professionals was assembled, and a 3-round Delphi survey was performed. Consensus was reached for each item if an Aiken V Validity Index ≥ 0.7 was obtained.
RESULTS
The study included 14 experts who reached consensus on 42 items by the third round. The most approved prescription parameters were 30 to 60 minutes of exercise per session, 3 days per week of moderate-intensity continuous aerobic exercise, and relaxation and breathing exercises for 5 to 20 minutes every day. When considering an exercise prescription, initial exercise supervision should progress to patient self-regulation; catastrophizing, fear-avoidance beliefs, headache-related disability, anxiety, depression, physical activity baseline level, and self-efficacy could influence the patients' exercise participation and efficacy; and gradual exposure to exercise could help improve these psychological variables and increase exercise efficacy. Yoga and concurrent exercise were also included as recommended interventions.
CONCLUSION
From the experts in the study, exercise prescriptions should be adapted to patients with migraine considering different exercise modalities, such as moderate-intensity aerobic exercise, relaxation, yoga, and concurrent exercise, based on the patients' preferences and psychological considerations, level of physical activity, and possible adverse effects.
IMPACT
The consensus reached by the experts can help prescribe exercise accurately to patients with migraine. Offering various exercise modalities can improve exercise participation in this population. The evaluation of the patients' psychological and physical status can also facilitate the adaptation of the exercise prescription to their abilities and diminish the risk of adverse events.
Topics: Humans; Delphi Technique; Exercise Therapy; Exercise; Yoga; Migraine Disorders
PubMed: 37410390
DOI: 10.1093/ptj/pzad080 -
Bulletin of the World Health... Apr 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38562196
DOI: 10.2471/BLT.24.010424 -
Bulletin of the World Health... Jan 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38164326
DOI: 10.2471/BLT.24.010124 -
Bulletin of the World Health... Feb 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38313149
DOI: 10.2471/BLT.24.010224 -
British Journal of Anaesthesia Oct 2023Consensus guidelines on the anaesthetic management of endoscopic retrograde cholangiopancreatography (ERCP) have recently been published. The rigorous synthesis of... (Review)
Review
Consensus guidelines on the anaesthetic management of endoscopic retrograde cholangiopancreatography (ERCP) have recently been published. The rigorous synthesis of expert opinion is invaluable when there are limited data, and these guidelines are a significant step forward. This review both guides practice and identifies important research questions. We challenge those working in this field to collaborate and produce the evidence for whether monitored anaesthesia care (MAC) is associated with a lower incidence of adverse events and better outcomes than general anaesthesia for ERCP.
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Delphi Technique; Anesthetics; Anesthesiology; Anesthesia, General
PubMed: 37718092
DOI: 10.1016/j.bja.2023.07.001 -
Revista de Gastroenterologia de Mexico... 2024Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown.
INTRODUCTION
Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown.
OBJECTIVE
The aim of this consensus was to establish the most relevant aspects related to definitions, diagnosis, follow-up, medical treatment, and surgical treatment of Crohn's disease in Mexico.
MATERIAL AND METHODS
Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned. The consensus was divided into five modules, with 69 statements. Applying the Delphi panel method, the pre-meeting questions were sent to the participants, to be edited and weighted. At the face-to-face meeting, all the selected articles were shown, underlining their level of clinical evidence; all the statements were discussed, and a final vote was carried out, determining the percentage of agreement for each statement.
RESULTS
The first Mexican consensus on Crohn's disease was produced, in which recommendations for definitions, classifications, diagnostic aspects, follow-up, medical treatment, and surgical treatment were established.
CONCLUSIONS
Updated recommendations are provided that focus on definitions, classifications, diagnostic criteria, follow-up, and guidelines for conventional medical treatment, biologic therapy, and small molecule treatment, as well as surgical management.
Topics: Crohn Disease; Humans; Mexico; Delphi Technique; Consensus
PubMed: 38762431
DOI: 10.1016/j.rgmxen.2024.03.001 -
CoDAS 2023To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a... (Review)
Review
PURPOSE
To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a Delphi based development and validation process for developing one such tool. The objectives of the research were to conceptualize and construct the tool, validate its content, and assess its feasibility through pilot testing.
METHODS
The study followed a Delphi approach to develop and validate the tool across four phases i.e. conceptualization; construction; content validation; and pilot testing. The first three phases were performed with a panel of six experts including speech-language pathologists and preschool teachers while the pilot testing was done with 20 typically developing preschoolers. A literature review was also conducted with the Delphi rounds to support the developmental process.
RESULTS
The first two rounds of the Delphi aided in the construction of a culturally and linguistically suitable story-based cognitive-communication assessment tool with the memory (free recall, recognition, and literary recall) and executive function (reasoning, inhibition, and switching) related tasks relevant for preschoolers. The content validation of the tool was continued with the experts till the revisions were satisfactory and yielded an optimum Content Validity Index. The pilot test of the finalized version confirmed its feasibility and appropriateness to assess developmental changes in the cognitive-communication abilities of preschoolers.
CONCLUSION
The study describes the Delphi-based conceptualization, construction, content validation, and feasibility check of a tool to assess cognitive-communication skills in preschool children.
Topics: Humans; Child, Preschool; Delphi Technique; School Teachers; Communication Disorders; Communication; Cognition
PubMed: 37909524
DOI: 10.1590/2317-1782/20232022309 -
British Journal of Anaesthesia Dec 2023Standardised and universal perioperative endpoint reporting are the cornerstone for outcomes assessment, reliable clinical trials, and health services research. The...
Standardised and universal perioperative endpoint reporting are the cornerstone for outcomes assessment, reliable clinical trials, and health services research. The Outcome4medicine initiative recently reported consensus recommendations on how to assess the quality of surgical interventions, proposing a framework for surgical outcome assessment and quality improvement after medical interventions. In the same field, the Standardised Endpoints in Perioperative Medicine - Core Outcome Measures for Perioperative and Anaesthetic Care (StEP-COMPAC) group recently proposed standardised and valid measures of mortality and morbidity, derived from a three-stage Delphi process. Here a core group of the Outcome4medicine conference discusses how these two initiatives are aligned and emphasises the importance of standardised outcome assessment by integrating the perspectives of different stakeholders.
Topics: Humans; Perioperative Care; Outcome Assessment, Health Care; Quality Improvement; Delphi Technique; Treatment Outcome; Research Design
PubMed: 37879999
DOI: 10.1016/j.bja.2023.09.014