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European Journal of Cardio-thoracic... Aug 2022
Topics: Consensus; Delphi Technique; Humans; Predictive Value of Tests; Respiration Disorders
PubMed: 35477789
DOI: 10.1093/ejcts/ezac277 -
Hip International : the Journal of... May 2023Primary total hip arthroplasty (THA) is a commonly performed and successful operation which orthopaedic trainees must demonstrate competence in prior to completion of...
AIMS
Primary total hip arthroplasty (THA) is a commonly performed and successful operation which orthopaedic trainees must demonstrate competence in prior to completion of surgical training. An assessment of agreement between surgical trainers regarding the critical steps of a primary THA has never been undertaken. The aim of this study was to define and rank the key steps of a primary THA regards ease of teaching and their importance in achieving the best patient outcome.
MATERIALS AND METHODS
The Delphi technique with 3 iterative rounds was used to establish expert group consensus. The benchmark for consensus was set at an 80% agreement in any category for each step of a THR. The intra-class correlation coefficient (ICC) was used to report on the inter- and intra-rater reliabilities between and within participants responses respectively in rounds 2 and 3.
RESULTS
50 consultant orthopaedic hip surgeons completed round 2, and 28 completed round 3. Overall, 27 steps (54 parameters) were identified, with 16 parameters achieving consensus agreement for their impact on patient outcome, and 17 for ease of teaching. The inter-rater ICC for patient outcome parameters was 0.89 and 0.92 in rounds 2 and 3 respectively while for teaching parameters it was 0.82 and 0.73. 50% of surgeons agreed that acetabular reaming, assessing and accurately restoring leg length, and acetabular cup anteversion were the 3 most difficult steps to teach trainees, while 90% agreed these 3 steps were substantially important to patient outcome. Another 5 steps achieved consensus for their substantial impact on patient outcome but failed to achieve consensus for ease of teaching.
CONCLUSIONS
The results of this expert consensus have produced a rank-order list of the key steps in primary THA, which may be used for orthopaedic curriculum development and guiding focused improvements for surgical training in primary THR including simulation.
Topics: Humans; Arthroplasty, Replacement, Hip; Consensus; Delphi Technique; Acetabulum
PubMed: 34748447
DOI: 10.1177/11207000211056864 -
International Journal of Environmental... Jan 2022Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages...
Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages lead to consumer disengagement. The study aimed to identify capabilities required by health professionals to deliver diabetes education and care to develop a national consensus capability-based framework to guide their training. A 3-staged modified technique was used to gain agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage I) a semi-structured consultation group and pre- pilot, (Stage II) a 2-phased online survey, and (Stage III) a semi-structured focus group and appraisal by health professional regulatory and training organisations. Descriptive statistics and central tendency measures calculated determined quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Eighty-four diabetes experts were recruited from nursing and midwifery ( = 60 [71%]), allied health ( = 17 [20%]), and pharmacy ( = 7 [9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care, and 2 to 16 statements attained consensus for each capability-259 in total. Additionally, workforce solutions were identified to expand capacity for diabetes care. The rigorous consultation process led to the design and validation of a that addresses workforce enablers identified by the . It recognises diversity, creating shared understandings of diabetes across health professional disciplines. The findings will inform diabetes policy, practice, education, and research.
Topics: Australia; Delivery of Health Care; Delphi Technique; Diabetes Mellitus; Humans; Workforce
PubMed: 35055832
DOI: 10.3390/ijerph19021012 -
Journal of Advanced Nursing Dec 2021To identify the non-technical skills of operating room nurses. This is the first empirical study that includes scrub and circulating operating room nurses.
AIM
To identify the non-technical skills of operating room nurses. This is the first empirical study that includes scrub and circulating operating room nurses.
DESIGN
A three-round modified online Delphi technique was used for this study.
METHODS
Eligible participants (n = 106) with a minimum of 2 years of operating room nursing experience were selected for the expert panel by self-recruitment from a population (N = 1640) of operating room nurses. Data were collected through online surveys, based on crew recourse management theory, between April and September 2020. Descriptive statistics analysis was used for the quantitative data, and deductive thematic analysis for the qualitative data. Consensus was determined using stability between the survey rounds.
RESULTS
A consensus was obtained to maintain the non-technical skills categories of situation awareness, leadership, decision-making, communication and teamwork. The qualitative data revealed several novel non-technical skills, including independent decision-making and leadership skills.
CONCLUSION
The non-technical skills of operating room nurses are more extensive than previously identified. This study has contributed to a verbalization of the tacit knowledge and skills of the operating room nurses. In addition, a list of non-technical skills that should be included in the education of operating room nurses to ensure patient safety in the operating room has been prepared.
IMPACT
This study addresses the lack of research on the non-technical skills of operating room nurses. When exploring the non-technical skills of scrub and circulating nurses, a diversity of novel non-technical skills was uncovered. This research will provide input for the development of a new training, supervision and assessment tool for accelerated development of the non-technical skills of operating room nurses. This contribution to the verbalization of the formerly tacit non-technical skills may facilitate clinical and formal teaching of such skills and may subsequently impact surgery-related patient safety.
Topics: Clinical Competence; Delphi Technique; Humans; Nurses; Operating Rooms; Perioperative Nursing
PubMed: 34626011
DOI: 10.1111/jan.15064 -
Health Expectations : An International... Dec 2022Psychological therapy assessments are a key point at which a person is accepted into a service or referred on. There is evidence of service users experiencing harm,...
BACKGROUND
Psychological therapy assessments are a key point at which a person is accepted into a service or referred on. There is evidence of service users experiencing harm, dropping out of services and potentially experiencing poor outcomes because of inadequate assessment practices. Approaches to assessment tend to be developed by individual services, with a lack of research identifying what makes a good assessment.
METHODS
This survivor-led study, based in England, aimed to generate guidelines for conducting trauma-informed psychological therapy assessments. The study was guided by a Service User Advisory Group and a Clinician Advisory Group. The study was conducted in three key stages: (i) identifying, modelling and drafting guideline content (ii) modified Delphi study and (iii) guideline finalization. Stage 1 was informed by literature reviews, qualitative research, data workshops with Advisory Groups and an expert consultation. Fifty-nine people with relevant experiences then participated in a single-stage modified Delphi (Stage 2). The guidelines were finalized through an analysis of Delphi open comments and a final expert consultation (Stage 3).
RESULTS
The guidelines evolved through each stage of the process, and all items were deemed important by >90% of Delphi participants. The final trauma-informed guidelines contain eight principles, including 'focus on relationships', 'from systems to people' and 'healing environments'.
CONCLUSIONS
Experiential knowledge was key in generating the guidelines and conceptualizing content, with a consequent focus on areas, such as recognizing power differentials, understanding oppression as trauma and the relational aspects of assessments. Future research should focus on guideline implementation and investigate whether this impacts service user dropout, engagement with therapy, and outcomes.
PATIENT OR PUBLIC CONTRIBUTION
This study is an example of survivor research, with several authors, including the study lead, identifying as survivors. We consider the ways in which our identities as survivor researchers impacted the study findings.
Topics: Humans; Delphi Technique; Psychotherapy; Qualitative Research; Mental Disorders; Survivors
PubMed: 36049032
DOI: 10.1111/hex.13585 -
Currents in Pharmacy Teaching & Learning Oct 2021As pharmacy educators, we often encounter situations such as designing new curricula or establishing shared values for an organization that may be ambiguous or... (Review)
Review
OUR SITUATION
As pharmacy educators, we often encounter situations such as designing new curricula or establishing shared values for an organization that may be ambiguous or controversial. To generate effective solutions, it is often necessary to build group consensus with key stakeholders. The purpose of this paper is to describe and provide recommendations for using the Delphi method, a process for facilitating discussions and aiding in decision making.
METHODOLOGICAL LITERATURE REVIEW
An overview of the Delphi method, including its multiple variations, is presented. Steps necessary to complete a Delphi study (building a protocol, developing a research question, defining panelists and panel size, piloting the protocol, round one item creation and analysis, round two and beyond, consensus, increasing clarity, and reporting) is described.
OUR RECOMMENDATIONS AND THEIR APPLICATION(S)
Practical recommendations are provided to support use the Delphi method to build consensus in research. These recommendations include: (1) clarify the purpose of the Delphi, (2) ensure the research questions are grounded in the literature and are relevant, (3) carefully consider panelist processes, (4) determine any definitions that should be given to or developed by panelists, (5) determine methods for enhancing clarity, and (6) employ methods to reduce attrition.
POTENTIAL IMPACT
The Delphi method provides a systematic approach to generating consensus in pharmacy education for commonly encountered situations such as committee meetings, research studies, faculty retreats, classroom activities, and lab meetings.
Topics: Consensus; Curriculum; Delphi Technique; Education, Pharmacy; Humans; Pharmacy
PubMed: 34521535
DOI: 10.1016/j.cptl.2021.07.018 -
The Laryngoscope Feb 2022To identify the most influential publications in laryngology since 2000.
OBJECTIVES/HYPOTHESIS
To identify the most influential publications in laryngology since 2000.
STUDY DESIGN
Modified Delphi process.
METHODS
Samples of laryngologists drawn from editors of leading journals, organization officers, and thought leaders were invited to participate in a modified Delphi identification of influential laryngology papers. Influential was defined as follows: yielding meaningful practice changes, catalyzing further work as a foundation for an important topic, altering traditional views, or demonstrating durability over time. Quality and validity were not among the selection criteria. Each participant nominated 5 to 10 papers in Round 1. These nominations, augmented with papers from bibliometric analysis, were narrowed further in Round 2 as participants identified their top 20. The 40 papers with the most Round 2 votes were discussed by video conference and then subjected to Round 3 voting, with each participant again selecting their top 20 most influential papers. Final results were collated by the number of Round 3 votes.
RESULTS
Sixteen of 18 invited laryngologists participated overall (all 16 in Rounds 1 and 3; 14 in Round 2). Twenty-one papers were identified as most influential. One paper appeared on all 16 Round 3 lists; three papers with eight (50%) votes each were lasted to make the list. Eleven of these 21 focused on voice; three each related to cancer, airway, and swallowing; and one encompassed all of these clinical areas.
CONCLUSIONS
This list of 21 influential laryngology papers serves to focus further research, provides perspective on recent advances within the field, and is an educational resource for trainees and practicing physicians.
LEVEL OF EVIDENCE
NA Laryngoscope, 132:406-412, 2022.
Topics: Delphi Technique; Otolaryngology; Periodicals as Topic; Publishing
PubMed: 34318936
DOI: 10.1002/lary.29781 -
JAMA Network Open Jul 2022
Topics: Delphi Technique; Humans; Medication Errors
PubMed: 35904790
DOI: 10.1001/jamanetworkopen.2022.27817 -
Arthroscopy : the Journal of... Feb 2022The diagnosis and treatment of an anterior glenohumeral instability remains controversial. Currently, there is no universally globally accepted approach. In addition to...
The diagnosis and treatment of an anterior glenohumeral instability remains controversial. Currently, there is no universally globally accepted approach. In addition to individual surgeon's experiences and preferences, surgical training, regional differences in patient's expectations, and demands confound decision-making. Evidence-based medicine and large randomized trials are not helpful, as they cannot possibly account for all potential confounders. The Delphi technique is an expert consensus-based evidence approach and a reasonable alternative to randomized trials. It pools the experience of experts in the field in a scientific fashion but has been criticized for only producing the lowest common denominator, resulting in oversimplification of a complex problem. However, this criticism is commonly a result of inadequate execution of the methods rather than the methodology itself. It could be that strict adherence to Delphi methodology could result in greater acceptance of Delphi (rather than "modified" Delphi) findings; a stricter approach also may lead to lower agreement between participating experts.
Topics: Biomedical Research; Consensus; Delphi Technique; Evidence-Based Medicine; Humans
PubMed: 35123707
DOI: 10.1016/j.arthro.2021.08.014 -
Translational Behavioral Medicine Jun 2024Collaborative data science requires standardized, harmonized, interoperable, and ethically sourced data. Developing an agreed-upon set of elements requires capturing...
Collaborative data science requires standardized, harmonized, interoperable, and ethically sourced data. Developing an agreed-upon set of elements requires capturing different perspectives on the importance and feasibility of the data elements through a consensus development approach. This study reports on the systematic scoping review of literature that examined the inclusion of diverse stakeholder groups and sources of social drivers of health variables in consensus-based common data element (CDE) sets. This systematic scoping review included sources from PubMed, Embase, CINAHL, WoS MEDLINE, and PsycINFO databases. Extracted data included the stakeholder groups engaged in the Delphi process, sources of CDE sets, and inclusion of social drivers data across 11 individual and 6 social domains. Of the 384 studies matching the search string, 22 were included in the final review. All studies involved experts with healthcare expertise directly relevant to the developed CDE set, and only six (27%) studies engaged health consumers. Literature reviews and expert input were the most frequent sources of CDE sets. Seven studies (32%) did not report the inclusion of any demographic variables in the CDE sets, and each demographic SDoH domain was included in at least one study with age and sex assigned at birth included in all studies, and social driver domains included only in four studies (18%). The Delphi technique engages diverse expert groups around the development of SDoH data elements. Future studies can benefit by involving health consumers as experts.
Topics: Delphi Technique; Humans; Consensus; Social Determinants of Health; Stakeholder Participation
PubMed: 38718172
DOI: 10.1093/tbm/ibae020