scholarly journals Refining diagnosis and management of chronic venous disease: Outcomes of a modified Delphi consensus process

2019 ◽  
Vol 65 ◽  
pp. 78-85 ◽  
Author(s):  
Teresa Lucia Aloi ◽  
Giuseppe Camporese ◽  
Marcello Izzo ◽  
Dimitris Kontothanassis ◽  
Angelo Santoliquido
Keyword(s):  
Chronic Venous Disease ◽  
Venous Disease ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Diagnosis And Management ◽  
Modified Delphi ◽  
Disease Outcomes

Vaccinations in patients with multiple sclerosis: A Delphi consensus statement

2020 ◽  
pp. 135245852095231 ◽  
Author(s):  
Agostino Riva ◽  
Valeria Barcella ◽  
Simone V Benatti ◽  
Marco Capobianco ◽  
Ruggero Capra ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Seasonal Influenza ◽  
Careful Consideration ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Disease Modifying Drugs ◽  
Risks And Benefits ◽  
Modified Delphi ◽  
Increased Risk ◽  
Evidence Based Decision Making

Background: Patients with multiple sclerosis (MS) are at increased risk of infection. Vaccination can mitigate these risks but only if safe and effective in MS patients, including those taking disease-modifying drugs. Methods: A modified Delphi consensus process (October 2017–June 2018) was used to develop clinically relevant recommendations for making decisions about vaccinations in patients with MS. A series of statements and recommendations regarding the efficacy, safety and timing of vaccine administration in patients with MS were generated in April 2018 by a panel of experts based on a review of the published literature performed in October 2017. Results: Recommendations include the need for an ‘infectious diseases card’ of each patient’s infectious and immunisation history at diagnosis in order to exclude and eventually treat latent infections. We suggest the implementation of the locally recommended vaccinations, if possible at MS diagnosis, otherwise with vaccination timing tailored to the planned/current MS treatment, and yearly administration of the seasonal influenza vaccine regardless of the treatment received. Conclusion: Patients with MS should be vaccinated with careful consideration of risks and benefits. However, there is an urgent need for more research into vaccinations in patients with MS to guide evidence-based decision making.

scholarly journals Home therapy for inherited bleeding disorders in South Africa: Results of a modified Delphi consensus process

2019 ◽  
Vol 109 (9) ◽  
pp. 639
Author(s):  
J N Mahlangu ◽  
Y Naidoo ◽  
Y Goga ◽  
M Vaithlingum ◽  
J Joubert ◽  
...  
Keyword(s):  
South Africa ◽  
Bleeding Disorders ◽  
Home Therapy ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Modified Delphi

Quality Indicators for Non-Small Cell Lung Cancer Operations With Use of a Modified Delphi Consensus Process

2014 ◽  
Vol 98 (1) ◽  
pp. 183-190 ◽  
Author(s):  
Gail Darling ◽  
Richard Malthaner ◽  
John Dickie ◽  
Leigh McKnight ◽  
Cindy Nhan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Quality Indicators ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Modified Delphi

scholarly journals Developing a Scoring Guide for the Appraisal of Guidelines for Research and Evaluation II Instrument in Korea: A Modified Delphi Consensus Process

2013 ◽  
Vol 28 (2) ◽  
pp. 190 ◽  
Author(s):  
You Kyoung Lee ◽  
Ein Soon Shin ◽  
Jae-Yong Shim ◽  
Kyung Joon Min ◽  
Jun-Mo Kim ◽  
...  
Keyword(s):  
Delphi Consensus ◽  
Consensus Process ◽  
Modified Delphi

Pediatric Disposition Classification (Reverse Triage) System to Create Surge Capacity

2015 ◽  
Vol 9 (3) ◽  
pp. 283-290 ◽  
Author(s):  
Gabor D. Kelen ◽  
Lauren Sauer ◽  
Eben Clattenburg ◽  
Mithya Lewis-Newby ◽  
James Fackler
Keyword(s):  
Classification System ◽  
Early Discharge ◽  
Likert Scale ◽  
Risk Tolerance ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Surge Capacity ◽  
Hospital Capacity ◽  
Modified Delphi ◽  
Pediatric Inpatient

AbstractBackgroundCritically insufficient pediatric hospital capacity may develop during a disaster or surge event. Research is lacking on the creation of pediatric surge capacity. A system of “reverse triage,” with early discharge of hospitalized patients, has been developed for adults and shows great potential but is unexplored in pediatrics.MethodsWe conducted an evidence-based modified-Delphi consensus process with 25 expert panelists to derive a disposition classification system for pediatric inpatients on the basis of risk tolerance for a consequential medical event (CME). For potential validation, critical interventions (CIs) were derived and ranked by using a Likert scale to indicate CME risk should the CI be withdrawn or withheld for early disposition.ResultsPanelists unanimously agreed on a 5-category risk-based disposition classification system. The panelists established upper limit (mean) CME risk for each category as <2% (interquartile range [IQR]: 1–2%); 7% (5–10%), 18% (10–20%), 46% (20–65%), and 72% (50–90%), respectively. Panelists identified 25 CIs with varying degrees of CME likelihood if withdrawn or withheld. Of these, 40% were ranked high risk (Likert scale mean ≥7) and 32% were ranked modest risk (≤3).ConclusionsThe classification system has potential for an ethically acceptable risk-based taxonomy for pediatric inpatient reverse triage, including identification of those deemed safe for early discharge during surge events. (Disaster Med Public Health Preparedness. 2015;9:283-290)

Establishing gold standards for System-Level Measures: a modified Delphi consensus process

2018 ◽  
Vol 31 (3) ◽  
pp. 205-211
Author(s):  
Fiona Doolan-Noble ◽  
Stuart Barson ◽  
M Lyndon ◽  
F Cullinane ◽  
J Gray ◽  
...  
Keyword(s):  
System Level ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Modified Delphi ◽  
Gold Standards

scholarly journals Study of Optimal Perimetric Testing In Children (OPTIC): developing consensus and setting research priorities for perimetry in the management of children with glaucoma

Eye ◽  
2021 ◽  
Author(s):  
Dipesh E. Patel ◽  
Phillippa M. Cumberland ◽  
Bronwen C. Walters ◽  
Joseph Abbott ◽  
John Brookes ◽  
...  
Keyword(s):  
Visual Field ◽  
Research Priorities ◽  
Healthcare Setting ◽  
Evidence Based ◽  
Limited Evidence ◽  
Delphi Consensus ◽  
Test Quality ◽  
Consensus Process ◽  
Reliability Indices ◽  
Modified Delphi

Abstract Background Perimetry is important in the management of children with glaucoma, but there is limited evidence-based guidance on its use. We report an expert consensus-based study to update guidance and identify areas requiring further research. Methods Experts were invited to participate in a modified Delphi consensus process. Panel selection was based on clinical experience of managing children with glaucoma and UK-based training to minimise diversity of view due to healthcare setting. Questionnaires were delivered electronically, and analysed to establish ‘agreement’. Divergence of opinions was investigated and resolved where possible through further iterations. Results 7/9 experts invited agreed to participate. Consensus (≥5/7 (71%) in agreement) was achieved for 21/26 (80.8%) items in 2 rounds, generating recommendations to start perimetry from approximately 7 years of age (IQR: 6.75–7.25), and use qualitative methods in conjunction with automated reliability indices to assess test quality. There was a lack of agreement about defining progressive visual field (VF) loss and methods for implementing perimetry longitudinally. Panel members highlighted the importance of informing decisions based upon individual circumstances—from gauging maturity/capability when selecting tests and interpreting outcomes, to accounting for specific clinical features (e.g. poor IOP control and/or suspected progressive VF loss) when making decisions about frequency of testing. Conclusions There is commonality of expert views in relation to implementing perimetry and interpreting test quality in the management of children with glaucoma. However, there remains a lack of agreement about defining progressive VF loss, and utilising perimetry over an individuals’ lifetime, highlighting the need for further research.

Expert consensus on the conservative management of patients with chronic venous disease in CEAP clinical classes C0s-C3 in Italy

2019 ◽  
Vol 35 (5) ◽  
pp. 316-324
Author(s):  
Cristiana Vitale ◽  
Massimo Lucchi ◽  
Daniele Bissacco ◽  
Salvino Bilancini ◽  
Fabrizio D’Abate ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Steering Committee ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Second Phase ◽  
Delphi Consensus ◽  
The Third ◽  
Two Phases ◽  
Consensual Approach

Objectives To define a consensual approach for the conservative treatment of patients C0s-C3. Method The project was structured into two phases. The first one involved a group of Italian specialists in angiology and/or vascular surgery with the aim to compare their therapeutic choices in the management of patients in CEAP C0s-C3. The second phase used a Delphi consensus in order to elaborate practical statements on the conservative management of these patients. Results The first phase involved a group of 166 Italian specialists while the second phase involved a Steering Committee of 6 specialists and a panel of 20 specialists. At the end of the third round, a consensus >80% was reached on seven assertions. Conclusion Seven statements have been drafted by a group of Italian specialists to provide physicians with practical guidance for the conservative treatment of C0s-C3 patients. Outstanding issues on the management of these patients were identified, confirming the urgent need of further research.

scholarly journals Towards an individualized management strategy for patients with chronic venous disease: Results of a Delphi consensus

2017 ◽  
Vol 33 (7) ◽  
pp. 492-499 ◽  
Author(s):  
SK van der Velden ◽  
RR van den Bos ◽  
O Pichot ◽  
T Nijsten ◽  
MGR De Maeseneer
Keyword(s):  
Morbid Obesity ◽  
Delphi Method ◽  
Management Strategy ◽  
Arterial Disease ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Delphi Consensus ◽  
Peripheral Arterial ◽  
Individualized Management ◽  
Different Characteristics

Objective To obtain consensus on management criteria for symptomatic patients with chronic venous disease (CVD; C2–C6) and superficial venous reflux. Method We used a Delphi method by means of 36 statements sent by email to experts in the field of phlebology across the world over the course of three rounds. The statements addressed criteria for different venous treatments in patients with different characteristics (e.g. extensive comorbidities, morbid obesity and peripheral arterial disease). If at least 70% of the ratings for a specific statement were between 6 and 9 (agreement) or between 1 and 3 (disagreement), experts’ consensus was reached. Results Twenty-five experts were invited to participate, of whom 24 accepted and completed all three rounds. Consensus was reached in 25/32 statements (78%). However, several statements addressing UGFS, single phlebectomies, patients with extensive comorbidities and morbid obesity remained equivocal. Conclusion Considerable consensus was reached within a group of experts but also some gaps in available research were highlighted.

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