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Autism : the International Journal of... Jul 2022The diagnostic criteria for autism are relatively vague and can lead to both under- and over-diagnosis if applied as a checklist. The highest level of agreement that a...
The diagnostic criteria for autism are relatively vague and can lead to both under- and over-diagnosis if applied as a checklist. The highest level of agreement that a person is autistic occurs when experienced clinicians are able to make use of their clinical judgment. However, it is not always clear what this judgment consists of. Given that particular issues exist when assessing for autism in adult women, we wanted to explore how expert clinicians address difficult diagnostic situations in this population. We interviewed 20 experienced psychologists and psychiatrists from seven countries and discussed how they conducted autism assessments in adult women. We then came up with a list of 35 statements that described participant views. Our participants completed an online survey where they rated their agreement with these statements and provided feedback on how the statements were worded and organized. We obtained a final list of 37 suggested clinical guidelines. Participants agreed that diagnostic tools and questionnaires had to be coupled with judgment and expertise. Participants felt that trauma and Borderline Personality Disorder could be difficult to differentiate from autism, and agreed on some ways to address this issue. Participants agreed that self-identification to the autism spectrum was frequent, and that it was important to provide alternative support when they did not ultimately diagnose autism.
Topics: Adult; Autism Spectrum Disorder; Autistic Disorder; Delphi Technique; Diagnosis, Differential; Female; Humans; Intelligence
PubMed: 34514874
DOI: 10.1177/13623613211042719 -
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 -
International Journal of Environmental... Apr 2023This study aimed to obtain a consensus agreement from an expert panel on the metaverse for exercise rehabilitation in stroke patients using the Delphi technique.
OBJECTIVES
This study aimed to obtain a consensus agreement from an expert panel on the metaverse for exercise rehabilitation in stroke patients using the Delphi technique.
METHODS
This study recruited twenty-two experts and conducted three rounds of online surveys between January and February 2023. The Delphi consensus technique was performed online to review and evaluate the framework module. A panel of experts, including scholars, physicians, physical therapists, and physical education specialists in the Republic of Korea, was invited to participate in this study. For each round, the expert consensus was defined as more than 90% of the expert panel agreeing or strongly agreeing with the proposed items.
RESULTS
A total of twenty experts completed the three Delphi rounds. First, virtual reality-assisted (VR) treadmill walking could improve cognitive function, concentration, muscular endurance, stroke prevention, proper weight maintenance, and cardiorespiratory function. Second, related technology, safety, price, place, and securing experts would be obstacles or challenges in VR-assisted treadmill walking for stroke patients. Third, the role of exercise instructors in exercise planning, performance, and assessment for VR-assisted treadmill walking is equally important, and reeducation for them is required. Fourth, VR-assisted treadmill walking for stroke patients requires an exercise intensity of at least five times a week, about one hour each time.
CONCLUSIONS
This study showed that the metaverse for exercise rehabilitation for stroke patients could be successfully developed and would be feasible to be implemented in the future. However, it would have limitations in terms of technology, safety, price, place, and expert factors to be overcome in the future.
Topics: Humans; Delphi Technique; Exercise Therapy; Forecasting; Stroke; Stroke Rehabilitation; Walking
PubMed: 37107765
DOI: 10.3390/ijerph20085483 -
Bulletin of the World Health... Apr 2022
Topics: Delphi Technique; Global Health; Humans; Public Health
PubMed: 35386554
DOI: 10.2471/BLT.22.010422 -
Bulletin of the World Health... Jan 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 36593783
DOI: 10.2471/BLT.23.010123 -
Bulletin of the World Health... Nov 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37961056
DOI: 10.2471/BLT.23.011123 -
Bulletin of the World Health... Dec 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38046368
DOI: 10.2471/BLT.23.011223 -
Bulletin of the World Health... Oct 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37780645
DOI: 10.2471/BLT.23.011023 -
Bulletin of the World Health... Jul 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37397172
DOI: 10.2471/BLT.23.010723 -
Bulletin of the World Health... May 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37131937
DOI: 10.2471/BLT.23.010523