P104. Evaluating Aesthetic Outcome for Breast Reconstruction; a Delphi Consensus Process for Expert Panel Assessment as a Baseline for an Objective Aesthetic Assessment Tool

Background. We sought to develop diagnostic test guidance definitions for pediatric enteric infections to facilitate the interpretation of positive test results in the era of multianalyte molecular diagnostic test platforms.Methods. We employed a systematic, two-phase, modified Delphi consensus process consisting of three web-based surveys and an expert panel face-to-face meeting. In phase 1, we surveyed an advisory panel of North American experts to select pathogens requiring diagnostic test guidance definition development. In phase 2, we convened a 14-member expert panel to develop, refine, and select the final definitions through two web-based questionnaires interspersed with a face-to-face meeting. Both questionnaires asked panelists to rate the degree to which they agreed that if the definition is met the pathogen is likely to be causative of clinical illness.Results. The advisory panel survey identified 19 pathogens requiring definitions. In the expert panel premeeting survey, 13 of the 19 definitions evaluated were rated as being highly likely (“agree” or “strongly agree”) to be responsible for acute gastroenteritis symptoms by ≥67% of respondent panel members. The definitions for the remaining six pathogens (Aeromonas, Clostridium difficile, Edwardsiella,nonenteric adenovirus, astrovirus, andEntamoeba histolytica) were indeterminate. After the expert panel meeting, only two of the modified definitions,C. difficileandE. histolytica/dispar, failed to achieve thea priorispecified threshold of ≥67% agreement.Conclusions.We developed diagnostic test guidance definitions to assist healthcare providers for 17 enteric pathogens. We identified two pathogens that require further research and definition development.

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A structured training program for minimally invasive esophagectomy for esophageal cancer— a Delphi consensus study in Europe

Diseases of the Esophagus ◽

10.1093/dote/dox124 ◽

2017 ◽

Vol 31 (3) ◽

Cited By ~ 6

Author(s):

E Visser ◽

P S N van Rossum ◽

H van Veer ◽

K Al-Naimi ◽

M A Chaudry ◽

...

Keyword(s):

Minimally Invasive ◽

Training Program ◽

Skill Acquisition ◽

Expert Panel ◽

Minimally Invasive Esophagectomy ◽

Independent Practice ◽

Delphi Consensus ◽

Consensus Process ◽

Invasive Esophagectomy ◽

Item Questionnaire

SUMMARY Evidence suggests that structured training programs for laparoscopic procedures can ensure a safe standard of skill acquisition prior to independent practice. Although minimally invasive esophagectomy (MIO) is technically demanding, no consensus on requirements for training for the MIO procedure exists. The aim of this study is to determine essential steps required for a structured training program in MIO using the Delphi consensus methodology. Eighteen MIO experts from 13 European hospitals were asked to participate in this study. The consensus process consisted of two structured meetings with the expert panel, and two Delphi questionnaire rounds. A list of items required for training MIO were constructed for three key domains of MIO, including (1) requisite criteria for units wishing to be trained and (2) to proctor MIO, and (3) a framework of a MIO training program. Items were rated by the experts on a scale 1–5, where 1 signified ‘not important’ and 5 represented ‘very important.’ Consensus for each domain was defined as achieving Cronbach alpha ≥0.70. Items were considered as fundamental when ≥75% of experts rated it important (4) or very important (5). Both Delphi rounds were completed by 16 (89%) of the 18 invited experts, with a median experience of 18 years with minimally invasive surgery. Consensus was achieved for all three key domains. Following two rounds of a 107-item questionnaire, 50 items were rated as essential for training MIO. A consensus among European MIO experts on essential items required for training MIO is presented. The identified items can serve as directive principles and core standards for creating a comprehensive training program for MIO.

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Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection

Pituitary ◽

10.1007/s11102-021-01162-3 ◽

2021 ◽

Author(s):

Hani J. Marcus ◽

Danyal Z. Khan ◽

Anouk Borg ◽

Michael Buchfelder ◽

Justin S. Cetas ◽

...

Keyword(s):

Pituitary Adenoma ◽

Expert Panel ◽

Technological Development ◽

International Expert ◽

Delphi Consensus ◽

Consensus Process ◽

Surgical Practice ◽

Surgical Workflow ◽

Wide Range ◽

Education Training

Abstract Purpose Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice. Methods A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached. Results There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured. Conclusions Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed “core” steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The “optional” steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world.

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Faculty Opinions recommendation of Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725447352.793539487 ◽

2017 ◽

Author(s):

David Spiegel

Keyword(s):

Cancer Patients ◽

Clinical Pathway ◽

Anxiety And Depression ◽

Delphi Consensus ◽

Consensus Process

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Vaccinations in patients with multiple sclerosis: A Delphi consensus statement

Multiple Sclerosis Journal ◽

10.1177/1352458520952310 ◽

2020 ◽

pp. 135245852095231 ◽

Cited By ~ 1

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.

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