The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content ...experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms “nonalcoholic” and “fatty” were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction–associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction–associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction–associated steatotic liver disease, who consume greater amounts of alcohol per week (140–350 g/wk and 210–420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.
Abstract Objective To investigate how consensus is operationalized in Delphi studies and to explore the role of consensus in determining the results of these studies. Study Design and Settings ...Systematic review of a random sample of 100 English language Delphi studies, from two large multidisciplinary databases ISI Web of Science (Thompson Reuters, New York, NY) and Scopus (Elsevier, Amsterdam, NL), published between 2000 and 2009. Results About 98 of the Delphi studies purported to assess consensus, although a definition for consensus was only provided in 72 of the studies (64 a priori). The most common definition for consensus was percent agreement (25 studies), with 75% being the median threshold to define consensus. Although the authors concluded in 86 of the studies that consensus was achieved, consensus was only specified a priori (with a threshold value) in 42 of these studies. Achievement of consensus was related to the decision to stop the Delphi study in only 23 studies, with 70 studies terminating after a specified number of rounds. Conclusion Although consensus generally is felt to be of primary importance to the Delphi process, definitions of consensus vary widely and are poorly reported. Improved criteria for reporting of methods of Delphi studies are required.
Scores on an outcome measurement instrument depend on the type and settings of the instrument used, how instructions are given to patients, how professionals administer and score the instrument, etc. ...The impact of all these sources of variation on scores can be assessed in studies on reliability and measurement error, if properly designed and analyzed. The aim of this study was to develop standards to assess the quality of studies on reliability and measurement error of clinician-reported outcome measurement instruments, performance-based outcome measurement instrument, and laboratory values.
We conducted a 3-round Delphi study involving 52 panelists.
Consensus was reached on how a comprehensive research question can be deduced from the design of a reliability study to determine how the results of a study inform us about the quality of the outcome measurement instrument at issue. Consensus was reached on components of outcome measurement instruments, i.e. the potential sources of variation. Next, we reached consensus on standards on design requirements (n = 5), standards on preferred statistical methods for reliability (n = 3) and measurement error (n = 2), and their ratings on a four-point scale. There was one term for a component and one rating of one standard on which no consensus was reached, and therefore required a decision by the steering committee.
We developed a tool that enables researchers with and without thorough knowledge on measurement properties to assess the quality of a study on reliability and measurement error of outcome measurement instruments.
Methodology Update: Delphi Studies McPherson, Sara; Reese, Cynthia; Wendler, M Cecilia
Nursing research (New York),
09/2018, Letnik:
67, Številka:
5
Journal Article
Recenzirano
BACKGROUNDThe Delphi method is a research approach that is beneficial when wanting to solve real-world problems, and expert opinions are needed.
OBJECTIVESThe purpose of this study was to describe ...the Delphi method as a qualitative research approach and provide a case study example of a study using the Delphi method to demonstrate the advantages and challenges of this methodological approach.
METHODSA literature search was conducted to understand the Delphi method and examine its use in nursing.
RESULTSThe literature search revealed what the Delphi method was and how it could be used. To better help explain the method, a case study from the literature is presented.
DISCUSSIONUsing the Delphi method in nursing research is becoming easier. With emerging technology, communication with geographically diverse experts may be easily and affordably achieved. With updated software, results can be interpreted almost immediately, and additional rounds of the Delphi occur in a timely manner, increasing participation and decreasing attrition rates. The Delphi method is a viable option for nurse researchers looking for expert opinion.
A novel and innovative real-time Delphi technique is introduced in order to address previously identified weaknesses of the conventional Delphi method, such as complicated facilitator tasks, lack of ...real-time presentation of results, and difficulties in tracking progress over time. We demonstrate how the real-time (computer-based) method increases the efficiency of the process, accommodates expert availability, and reduces drop-out-rates. Modifications in the Delphi procedure (e.g. change of iteration principle) not only increase efficiency but also change the nature and process of the survey technique itself. By identifying and analysing three individual effects (initial condition effect, feedback effect, and iteration effect) we examine whether the modifications in the survey process cause deviations to the survey results. Empirical data obtained from both conventional as well as real-time Delphi studies is analysed based on multiple statistical analyses. The research findings indicate that significant differences between the two Delphi survey formats do not exist and final survey results are not affected by changes in the survey procedure.
Delphi: A brief look backward and forward Linstone, Harold A.; Turoff, Murray
Technological forecasting & social change,
11/2011, Letnik:
78, Številka:
9
Journal Article
Recenzirano
In response to a request by the guest editors, we have set down our thoughts regarding the evolution of Delphi, beginning with our immersion in the subject in the late 1960s and concluding with some ...rumination about its future. Our focus is on the changing roles of Delphi. Most importantly, with the profound impact of the internet on organizational and community planning systems, it will foster a new age of participation through communication, coordination, and collaboration.
What are Delphi studies? Barrett, David; Heale, Roberta
Evidence-based nursing
23, Številka:
3
Journal Article
Odprti dostop
Specifically, they developed an approach—named after the Ancient Greek Oracle of Delphi, who could predict the future—which promoted anonymity and avoided direct confrontation between experts, so ...that the methods employed “…appear to be more conducive to independent thought on the part of the experts and to aid them in the gradual formation of a considered opinion”.1 Though the original Delphi study was linked to the defence industry, the technique has spread to other research areas, including nursing.2 Characteristics of Delphi studies As with all research methods, the Delphi technique has evolved since it was first reported on in the 1960s. ...participants are able to see the results of previous rounds—including their own responses—allowing them to reflect on the views of others and reposition their own opinions accordingly.2 This also gives them the opportunity to consider and feedback on what they perceive to be the strengths and weaknesses of other’s responses. ...the findings of each round are always shared with the broader group anonymously. Analysis of this scoring then allowed for consensus conclusions on the top 10 human factors that contributed to nursing errors (with fatigue, heavy workload and communication problems the top three).3 In another example, nurse practitioners (NPs) were recruited to participate in a Delphi study to achieve consensus related to NP advance care planning competencies.
Delphi surveys are commonly used to prioritise critical outcomes in core outcome set (COS) development. This trial aims to compare a three-round (Multi-Round) Delphi (MRD) with a Real-Time Delphi ...(RTD) in the prioritisation of outcomes for inclusion in a COS for neonatal encephalopathy treatments and explore whether 'feedback', 'iteration', and 'initial condition' effects may occur in the two survey methods.
We recruited 269 participants (parents/caregivers, healthcare providers and researchers/academics) of which 222 were randomised to either the MRD or the RTD. We investigated the outcomes prioritised in each survey and the 'feedback', 'iteration', and 'initial condition' effects to identify differences between the two survey methods.
In the RTD, n = 92 participants (83%) fully completed the survey. In the MRD, n = 60 participants (54%) completed all three rounds. Of the 92 outcomes presented, 26 (28%) were prioritised differently between the RTD and MRD. Significantly fewer participants amended their scores when shown stakeholder responses in the RTD compared to the MRD ('feedback effect'). The 'iteration effect' analysis found most experts appeared satisfied with their initial ratings in the RTD and did not amend their scores following stakeholder response feedback. Where they did amend their scores, ratings were amended substantially, suggesting greater convergence. Variance in scores reduced with subsequent rounds of the MRD ('iteration effect'). Whilst most participants did not change their initial scores in the RTD, of those that did, later recruits tended to align their final score more closely to the group mean final score than earlier recruits (an 'initial condition' effect).
The feedback effect differed between the two Delphi methods but the magnitude of this difference was small and likely due to the large number of observations rather than because of a meaningfully large difference. It did not appear to be advantageous to require participants to engage in three rounds of a survey due to the low change in scores. Larger drop-out through successive rounds in the MRD, together with a lesser convergence of scores and longer time to completion, indicate considerable benefits of the RTD approach.
NCT04471103. Registered on 14 July 2020.
To define the essential elements of the intake questionnaire that will be a part of a larger multicenter registry for aerodigestive patients.
A modified Delphi method was utilized to obtain consensus ...on the data elements that should warrant inclusion in the final research database. Patient questionnaires from the eight participating institutions were reviewed and individual elements were aggregated into 14 categories.
A total of 198 initial elements were voted on for inclusion. The categories included demographics, respiratory symptoms, gastrointestinal symptoms, ear nose and throat symptoms, feeding, birth history, medical history, surgical history, family history, social history, medications prior to evaluation, devices used prior to evaluation, prior diagnostic evaluations, and prior evaluation by aerodigestive team members. 83 of the 198 elements met consensus for inclusion in the final registry for an inclusion rate of 41.9 %. Three separate rounds of ranking were required to obtain consensus.
The aerodigestive registry is an important initiative that will help foster research and help guide future management. The intake questionnaire of the registry is a critical component of this project, and the consensus obtained during this study should help create a streamlined and efficient registry that will help all aerodigestive patients on a national level.
•The Aerodigestive research collaborative is an organization seeking to create a research database for all complex aerodigestive patients.•The goal of this specific project was to establish consensus on which elements of a patient's history should be included in the registry.
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