A decision support tool for the detection of pancreatic cancer in general practice: A modified Delphi consensus

INTRODUCTION:Healthcare organizations should assess the relevance of both existing and new practices. Involving patients in decisions regarding which health technologies and interventions should be prioritized could favor a better fit between strategic choices and patients needs.METHODS:Following a systematic review of existing multi-criteria decision support tools and a consultation with hospital clinicians and managers, a set of potentially relevant criteria was identified. A three-round modified Delphi study was then conducted among four groups (hospital managers, heads of department, clinicians, and patient representatives) in order to reach consensus on criteria that should be considered in the tool.RESULTS:In total, seventy-four participants completed the third round of the Delphi study. Consensus was obtained on twelve criteria. There were some significant differences between groups in priority scores given to criteria. Patient representatives differed significantly from other groups on two criteria. Their ranking of the accessibility criteria was higher, and their ranking of the organizational aspect criteria was lower than for the other groups.CONCLUSIONS:Patient representatives can be involved in the development of a multi-criteria decision support tool to identify, evaluate and prioritize high value-added health technologies and interventions in order to enhancing clinical appropriateness The fact that accessibility aspects were more important for patient representatives calls for specific attention to these criteria when prioritizing health technologies or interventions. Furthermore, we need to ensure that the decisions made regarding the relevance of these technologies and interventions also reflect patients’ preferences.

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Development of an ‘Enteral tube feeding decision support tool’ for hip fracture patients: A modified Delphi approach

Australasian Journal on Ageing ◽

10.1111/ajag.12575 ◽

2018 ◽

Vol 37 (3) ◽

pp. 217-223 ◽

Cited By ~ 1

Author(s):

Aye Su Mon ◽

Chrys Pulle ◽

Jack Bell

Keyword(s):

Decision Support ◽

Hip Fracture ◽

Tube Feeding ◽

Decision Support Tool ◽

Support Tool ◽

Enteral Tube Feeding ◽

Modified Delphi ◽

Delphi Approach ◽

Feeding Decision

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Treatment patterns in pancreatic cancer: Differences between expert and community practitioners.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19207 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19207-e19207

Author(s):

Ryan P. Topping ◽

E. Gabriela Chiorean ◽

Dan Laheru ◽

Michael J. Pishvaian ◽

Andrea Wang-Gillam ◽

...

Keyword(s):

Pancreatic Cancer ◽

Decision Support ◽

Healthcare Providers ◽

Decision Support Tool ◽

Support Tool ◽

Community Healthcare ◽

Online Treatment ◽

Full Analysis ◽

The Impact ◽

Expert Recommendations

e19207 Background: Expanding systemic therapy options continue to improve outcomes for patients (pts) with pancreatic cancer (PCa) in both the unresectable and resectable disease settings. We developed an online treatment (Tx) decision support tool designed to provide community healthcare providers (HCPs) with case-specific recommendations from 5 PCa experts. Here, we report an analysis of cases entered into the tool by HCPs, comparing their planned Tx with expert recommendations and assessing the impact of those recommendations on intended HCP Tx decisions. Methods: In July 2019, 5 expert panelists provided Tx recommendations for numerous distinct PCa cases. To use the tool, HCPs entered specific pt/disease factors along with their intended Tx plan for the case, after which they received expert Tx recommendations followed by a survey asking if the recommendations had changed their planned Tx course. Results: 251 HCPs entered 347 pt cases into the tool (83% by physicians). 68% of respondents reported treating < 15 pts with PCa per yr, and 60% sought recommendations for a specific pt. Variance was observed between experts and HCPs for cases in several Tx settings (Table); eg, although FOLFIRINOX was the primary panel recommendation for many younger, healthier pts requiring neoadjuvant or adjuvant therapy or first-line Tx for unresectable disease, most HCPs did not select this therapy for these pts at baseline. Among HCPs whose planned Tx differed from the experts, 51% indicated that they would change their Tx based on panel recommendations. Conclusions: Analysis of data from an online Tx decision support tool for PCa revealed variance between expert recommendations and the intended Tx of HCPs for numerous scenarios, with education provided by the tool potentially increasing the number of clinicians who made optimal Tx decisions. A full analysis of Tx trends will be presented. [Table: see text]

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O-BN01 The para-oesophageal hernia symptom tool (post): A modified delphi consensus study

British Journal of Surgery ◽

10.1093/bjs/znab429.006 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Aiysha Puri ◽

Nikhil Patel ◽

Viknesh Sounderajah ◽

Lorenzo Ferri ◽

Ewen Griffiths ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Intervention ◽

A Priori ◽

Decision Support Tool ◽

Delphi Consensus ◽

Support Tool ◽

Modified Delphi ◽

Related Quality ◽

Specific Symptoms

Abstract Background Patients with a para-oesophageal hernia (POH) report a complex range of symptoms and quality of life (QOL) issues. Clinicians often utilise existing health related quality of life tools to (1) identify patients who are eligible for surgical management and (2) to evaluate the benefit of surgical intervention. However, the most commonly used tools for this purpose are not disease specific. As such, crucial POH specific symptoms which impact QOL may not be captured. In order to address this issue, a modified Delphi consensus study was undertaken to establish a HRQOL instrument specific to POH. Methods A two-round modified Delphi consensus study was conducted with a group of international experts. Participants were identified through (1) their authorship in landmark POH studies and (2) the professional networks of the study investigators. Prior to the Delphi process, a scoping survey was undertaken in order to generate a list of candidate items. Participants were asked to rate the items’ importance in assessing patients with POH using a 5-point Likert scale. The a priori threshold for inclusion was 80% for scores of 4 or 5. If consensus was not achieved, the item was carried through to the next round. Results The candidate list of items consisted of 64 symptoms, refined to 20 for inclusion within the first modified Delphi round. Four symptoms; ‘difficulty getting solid foods down’, ‘chest pain after meals’, ‘difficulty getting liquids down’ and ‘shortness of breath only after meals’, reached consensus threshold of 80% in the first round and one additional symptom, ‘early feeling of fullness after eating’, reached consensus in the second. A total of 26 participants took part in the first and 24 in the second round. These five symptoms have been identified to form the initial version of the Para-Oesophageal Hernia Symptom Tool (POST). Conclusions POST is the first tool that aims to capture POH-specific symptoms that impact upon HRQOL. Prior to clinical use, this tool will be presented in international patient workshops to assess its construct validity. Following this, we aim to assess the content validity of the tool through a longitudinal study in a cohort of patients with POH who are undergoing repair. We hope that this tool will serve as a decision support tool for clinicians who are evaluating the risk-benefit of surgical intervention in this cohort of patients.

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