Liver Transplantation Society of India Guidelines for the Management of Acute Liver Injury Secondary to Yellow Phosphorus–Containing Rodenticide Poisoning Using the Modified Delphi Technique of Consensus Development

AbstractPatients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.

Download Full-text

Building a neuroinfectious disease consensus curriculum

Neurology ◽

10.1212/wnl.0000000000007872 ◽

2019 ◽

Vol 93 (5) ◽

pp. 208-216

Author(s):

Arun Venkatesan ◽

Felicia C. Chow ◽

Allen Aksamit ◽

Russell Bartt ◽

Thomas P. Bleck ◽

...

Keyword(s):

American Academy ◽

Delphi Technique ◽

Fellowship Training ◽

Consensus Process ◽

Diverse Range ◽

Modified Delphi ◽

Delphi Approach ◽

Modified Delphi Technique ◽

Comprehensive Curriculum ◽

American Academy Of Neurology

ObjectiveTo delineate a comprehensive curriculum for fellowship training in neuroinfectious diseases, we conducted a modified Delphi approach to reach consensus among 11 experts in the field.MethodsThe authors invited a diverse range of experts from the American Academy of Neurology Neuro-Infectious Diseases (AAN Neuro-ID) Section to participate in a consensus process using a modified Delphi technique.ResultsA comprehensive list of topics was generated with 101 initial items. Through 3 rounds of voting and discussion, a curriculum with 83 items reached consensus.ConclusionsThe modified Delphi technique provides an efficient and rigorous means to reach consensus on topics requiring expert opinion. The AAN Neuro-ID section provided the pool of diverse experts, the infrastructure, and the community through which to accomplish the consensus project successfully. This process could be applied to other subspecialties and sections at the AAN.

Download Full-text

Subacromial decompression in patients with shoulder impingement with an intact rotator cuff: An expert consensus statement using the modified Delphi Technique comparing North American to European shoulder surgeons.

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2021.09.031 ◽

2021 ◽

Author(s):

Erik Hohmann ◽

Vaida Glatt ◽

Kevin Tetsworth ◽

Eduard Alentorn-Geli ◽

Klaus Bak ◽

...

Keyword(s):

Rotator Cuff ◽

North American ◽

Delphi Technique ◽

Consensus Statement ◽

Expert Consensus ◽

Subacromial Decompression ◽

Shoulder Impingement ◽

Modified Delphi ◽

Modified Delphi Technique

Download Full-text

Minimum standards of clinical practice for physiotherapists working in critical care settings in the United Kingdom: A modified Delphi technique

Journal of the Intensive Care Society ◽

10.1177/1751143718807019 ◽

2018 ◽

Vol 20 (2) ◽

pp. 118-131 ◽

Cited By ~ 9

Author(s):

Paul Twose ◽

Una Jones ◽

Gareth Cornell

Keyword(s):

Critical Care ◽

United Kingdom ◽

Clinical Practice ◽

Delphi Technique ◽

Minimum Standard ◽

Knowledge And Skills ◽

Critical Care Units ◽

Modified Delphi ◽

The United Kingdom ◽

Modified Delphi Technique

Introduction Across the United Kingdom, physiotherapy for critical care patients is provided 24 h a day, 7 days per week. There is a national drive to standardise the knowledge and skills of physiotherapists which will support training and reduce variability in clinical practice. Methods A modified Delphi technique using a questionnaire was used. The questionnaire, originally containing 214 items, was completed over three rounds. Items with no consensus were included in later rounds along with any additional items suggested. Results In all, 114 physiotherapists from across the United Kingdom participated in the first round, with 102 and 92 completing rounds 2 and 3, respectively. In total, 224 items were included: 107 were deemed essential as a minimum standard of clinical practice; 83 were not essential and consensus was not reached for 34 items. Analysis/Conclusion This study identified 107 items of knowledge and skills that are essential as a minimum standard for clinical practice by physiotherapists working in United Kingdom critical care units.

Download Full-text

Timing of milestone competency acquisition in neurology residency

Neurology ◽

10.1212/wnl.0000000000006361 ◽

2018 ◽

Vol 91 (16) ◽

pp. 748-754 ◽

Cited By ~ 3

Author(s):

Lyell K. Jones ◽

Scott D.Z. Eggers ◽

David J. Capobianco ◽

Christopher J. Boes

Keyword(s):

Delphi Technique ◽

Educational Expectations ◽

Residency Programs ◽

Modified Delphi ◽

Perceived Importance ◽

Modified Delphi Technique ◽

Individual Program ◽

Participant Characteristics ◽

The Individual ◽

The Relationship

ObjectiveTo determine the stage of training at which neurology residents should achieve individual elements of the Accreditation Council for Graduate Medical Education neurology Milestones and to examine the relationship between perceived importance of Milestones and the stage by which they should be achieved.MethodsA modified Delphi technique was used to establish consensus postgraduate year (PGY) expectations for neurology Milestone competencies across 3 geographically and administratively distinct Mayo Clinic neurology residency programs. Timing expectations were examined for relationships to perceived importance of the individual Milestones and effects of participant characteristics.ResultsPGY expectations for neurology Milestone elements ranged from PGY 1.3 to PGY 4.1. Extent of rater educational seniority had no effect on PGY competency expectations. There was a moderate inverse relationship between perceived importance of the Milestone element and the PGY by which it should be achieved (rs = −0.74, p < 0.0001).Conclusions and relevanceExpectations for neurology Milestone competency acquisition can be measured and may help inform individual program design, educational expectations, and future Milestone design.

Download Full-text

A Baker’s Dozen of Top Antimicrobial Stewardship Intervention Publications in 2020

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab422 ◽

2021 ◽

Author(s):

Sarah B Green ◽

Kayla R Stover ◽

Katie Barber ◽

Jeannette L Bouchard ◽

Matthew L Brown ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Research Group ◽

Delphi Technique ◽

Modified Delphi ◽

Modified Delphi Technique ◽

And Training

Abstract The number of articles related to antimicrobial stewardship published each year has increased significantly over the last decade. Keeping up with the literature, particularly the most innovative, well-designed, or applicable to one’s own practice area, can be challenging. The Southeastern Research Group Endeavor (SERGE-45) network reviewed antimicrobial stewardship-related, peer-reviewed literature from 2020 that detailed actionable interventions. The top 13 publications were summarized following identification using a modified Delphi technique. This article highlights the selected interventions and may serve as a key resource for teaching and training, and to identify novel or optimized stewardship opportunities within one’s institution.

Download Full-text