Consensus on revised definitions of morphological uterus sonographic assessment ( MUSA ) features of adenomyosis: results of a modified Delphi procedure

Objective In 2015, the Canadian Vasculitis Research Network (CanVasc) created recommendations for the management of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) in Canada. The current update aimed to revise existing recommendations and create additional recommendations, as needed, based on a review of new available evidence. Methods A needs assessment survey of CanVasc members informed questions for an updated systematic literature review (publications spanning May 2014-September 2019) using Medline, Embase, and Cochrane. New and revised recommendations were developed and categorized according to the level of evidence and strength of each recommendation. The CanVasc working group used a two-step modified Delphi procedure to reach >80% consensus on the inclusion, wording and grading of each new and revised recommendation. Results Eleven new and 16 revised recommendations were created, and 12 original (2015) recommendations were retained. New and revised recommendations are discussed in detail within this document. Five original recommendations were removed, of which 4 were incorporated into the explanatory text. The supplementary appendix for practical use was revised to reflect the updated recommendations. Conclusion The 2020 updated recommendations provide rheumatologists, nephrologists, and other specialists caring for patients with AAV in Canada with new management guidance, based on current evidence and consensus from Canadian experts.

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Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure

Clinical Infectious Diseases ◽

10.1093/cid/ciz362 ◽

2019 ◽

Vol 70 (6) ◽

pp. 1075-1082 ◽

Cited By ~ 2

Author(s):

Marvin A H Berrevoets ◽

Jaap ten Oever ◽

Anke J M Oerlemans ◽

Bart Jan Kullberg ◽

Marlies E Hulscher ◽

...

Keyword(s):

Systematic Review ◽

Quality Indicators ◽

Antimicrobial Therapy ◽

Expert Panel ◽

Outpatient Parenteral Antimicrobial Therapy ◽

Modified Delphi ◽

Delphi Procedure ◽

Antimicrobial Management ◽

Patient Selection Criteria

Abstract Background Our aim in this study was to develop quality indicators (QIs) for outpatient parenteral antimicrobial therapy (OPAT) care that can be used as metrics for quality assessment and improvement. Methods A RAND-modified Delphi procedure was used to develop a set of QIs. Recommendations on appropriate OPAT care in adults were retrieved from the literature using a systematic review and translated into potential QIs. These QIs were appraised and prioritized by a multidisciplinary panel of international OPAT experts in 2 questionnaire rounds combined with a meeting between rounds. Results The procedure resulted in 33 OPAT-specific recommendations. The following QIs that describe recommended OPAT care were prioritized by the expert panel: the presence of a structured OPAT program, a formal OPAT care team, a policy on patient selection criteria, and a treatment and monitoring plan; assessment for OPAT should be performed by the OPAT team; patients and family should be informed about OPAT; there should be a mechanism in place for urgent discussion and review of emergent clinical problems, and a system in place for rapid communication; laboratory results should be delivered to physicians within 24 hours; and the OPAT team should document clinical response to antimicrobial management, document adverse events, and monitor QIs for OPAT care and make these data available. Conclusions We systematically developed a set of 33 QIs for optimal OPAT care, of which 12 were prioritized by the expert panel. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

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The use of a modified Delphi procedure for the determination of 26 prognostic factors in the sub-acute stage of stroke

International Journal of Rehabilitation Research ◽

10.1097/00004356-200312000-00003 ◽

2003 ◽

Vol 26 (4) ◽

pp. 265-270 ◽

Cited By ~ 16

Author(s):

Ronald Meijer ◽

Daniela Ihnenfeldt ◽

Marinus Vermeulen ◽

Rob De Haan ◽

Jacques Van Limbeek

Keyword(s):

Prognostic Factors ◽

Acute Stage ◽

Modified Delphi ◽

Delphi Procedure

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Identifying challenges in neurofibromatosis: a modified Delphi procedure

European Journal of Human Genetics ◽

10.1038/s41431-021-00892-z ◽

2021 ◽

Author(s):

Britt A. E. Dhaenens ◽

Rosalie E. Ferner ◽

Annette Bakker ◽

Marco Nievo ◽

D. Gareth Evans ◽

...

Keyword(s):

Peripheral Nerve ◽

Plexiform Neurofibroma ◽

Neurofibromatosis Type ◽

Consensus Meeting ◽

Drug Trials ◽

Cutaneous Manifestations ◽

Modified Delphi ◽

Nerve Sheath ◽

Delphi Procedure ◽

Patient Representatives

AbstractNeurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SWN) are rare conditions with pronounced variability of clinical expression. We aimed to reach consensus on the most important manifestations meriting the development of drug trials. The five-staged modified Delphi procedure consisted of two questionnaires and a consensus meeting for 40 NF experts, a survey for 63 patient representatives, and a final workshop. In the questionnaires, manifestations were scored on multiple items on a 4-point Likert scale. The highest average scores for NF experts deciding the ‘need for new treatment’ were for malignant peripheral nerve sheath tumour (MPNST) (4,0) and high grade glioma (HGG) (3,9) for NF1; meningioma (3,9) for NF2 and pain (3,9) for SWN. The patient representatives assigned high scores to all manifestations, with plexiform neurofibroma being highest in NF1 (4,0), vestibular schwannoma in NF2 (4,0), and pain in SWN (3,9). Twelve experts participated in the consensus meeting and prioritised manifestations. MPNST was ranked the highest for NF1, followed by benign peripheral nerve sheath tumours. Tumour manifestations received highest ranking in NF2, and pain was the most prominent problem for SWN. Patient representative ratings for NF1 were similar to the experts’ opinions, except that they ranked HGG as the most important manifestation. For NF2 and SWN, the patient representatives agreed with the experts. We conclude that NF experts and patient representatives consent to prioritise development of drug trials for MPNST, benign peripheral nerve sheath tumours, cutaneous manifestations and HGG for NF1; tumours for NF2; and pain for SWN.

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Sonographic examination of uterine niche in non‐pregnant women: a modified Delphi procedure

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19049 ◽

2019 ◽

Vol 53 (1) ◽

pp. 107-115 ◽

Cited By ~ 27

Author(s):

I. P. M. Jordans ◽

R. A. de Leeuw ◽

S. I. Stegwee ◽

N. N. Amso ◽

P. N. Barri‐Soldevila ◽

...

Keyword(s):

Pregnant Women ◽

Sonographic Examination ◽

Modified Delphi ◽

Delphi Procedure

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The use of a modified Delphi procedure for the determination of 26 prognostic factors in the sub-acute stage of stroke

International Journal of Rehabilitation Research ◽

10.1097/01.mrr.0000102660.02099.8f ◽

2003 ◽

Vol 26 (4) ◽

pp. 265-270

Author(s):

Ronald Meijer ◽

Daniela Ihnenfeldt ◽

Marinus Vermeulen ◽

Rob De Haan ◽

Jacques Van Limbeek

Keyword(s):

Prognostic Factors ◽

Acute Stage ◽

Modified Delphi ◽

Delphi Procedure

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The development of a geriatric postgraduate education assessment instrument using a modified Delphi procedure

Age and Ageing ◽

10.1093/ageing/afw086 ◽

2016 ◽

Vol 45 (5) ◽

pp. 716-720 ◽

Cited By ~ 5

Author(s):

Katrin Singler ◽

Adam Lee Gordon ◽

Gillian Robertson ◽

Regina Elisabeth Roller

Keyword(s):

Postgraduate Education ◽

Assessment Instrument ◽

Education Assessment ◽

Modified Delphi ◽

Delphi Procedure

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National Institute of Neurological Disorders and Stroke Consensus Diagnostic Criteria for Traumatic Encephalopathy Syndrome

Neurology ◽

10.1212/wnl.0000000000011850 ◽

2021 ◽

pp. 10.1212/WNL.0000000000011850

Author(s):

Douglas I. Katz ◽

Charles Bernick ◽

David W. Dodick ◽

Jesse Mez ◽

Megan L Mariani ◽

...

Keyword(s):

Diagnostic Criteria ◽

Clinical Features ◽

Military Service ◽

Chronic Traumatic Encephalopathy ◽

Functional Dependence ◽

Validity Data ◽

Clinical Disorder ◽

Modified Delphi ◽

Delphi Procedure

Objective:To develop evidence-informed, expert consensus research diagnostic criteria for Traumatic Encephalopathy Syndrome (TES), the clinical disorder associated with neuropathologically diagnosed Chronic Traumatic Encephalopathy (CTE).Methods:A panel of 20 expert clinician-scientists in neurology, neuropsychology, psychiatry, neurosurgery, and physical medicine and rehabilitation, from 11 academic institutions, participated in a modified Delphi procedure to achieve consensus, initiated at the First NINDS Consensus Workshop to Define the Diagnostic Criteria for TES, April, 2019. Prior to consensus, panelists reviewed evidence from all published cases of CTE with neuropathological confirmation and they examined the predictive validity data on clinical features in relation to CTE pathology from a large clinicopathological study (n = 298).Results:Consensus was achieved in 4 rounds of the Delphi procedure. Diagnosis of TES requires: 1) substantial exposure to repetitive head impacts (RHI) from contact sports, military service, or other causes; 2) core clinical features of cognitive impairment (in episodic memory and/or executive functioning) and/or neurobehavioral dysregulation; 3) a progressive course; and 4) that the clinical features are not fully accounted for by any other neurologic, psychiatric, or medical conditions. For those meeting criteria for TES, functional dependence is graded on 5 levels, ranging from independent to severe dementia. A provisional level of certainty for CTE pathology is determined based on specific RHI exposure thresholds, core clinical features, functional status, and additional supportive features, including delayed onset, motor signs, and psychiatric features.Conclusions:New consensus diagnostic criteria for TES were developed with a primary goal of facilitating future CTE research. These criteria will be revised as updated clinical and pathological information and in vivo biomarkers become available.

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