DEFINING RAPID REVIEWS: A MODIFIED DELPHI CONSENSUS APPROACH

2016 ◽  
Vol 32 (4) ◽  
pp. 265-275 ◽  
Author(s):  
Shannon E. Kelly ◽  
David Moher ◽  
Tammy J. Clifford
Keyword(s):  
Decision Maker ◽  
Evidence Synthesis ◽  
Time Frame ◽  
Rapid Review ◽  
Synthesis Process ◽  
Free Text ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Rapid Reviews

Objectives: Rapid reviews are characterized as an accelerated evidence synthesis approach with no universally accepted methodology or definition. This modified Delphi consensus study aimed to develop a comprehensive set of defining characteristics for rapid reviews that may be used as a functional definition.Methods: Expert panelists with knowledge in rapid reviews and evidence synthesis were identified. In the first round, panelists were asked to answer a seventeen-item survey addressing a variety of rapid review topics. Results led to the development of statements describing the characteristics of rapid reviews that were circulated to experts for agreement in a second survey round and further revised in a third round. Consensus was reached if ≥70 percent of experts agreed and there was stability in free-text comments.Results: A panel of sixty-six experts participated. Consensus was reached on ten of eleven statements describing the characteristics of rapid reviews. According to the panel, rapid reviews aim to meet the requirements and timelines of a decision maker and should be conducted in less time than a systematic review. They use a variety of approaches to accelerate the evidence synthesis process, tailor the methods conventionally used to carry out systematic reviews, and use the most rigorous methods that the delivery time frame will allow.Conclusions: This study achieved consensus on ten statements describing the defining characteristics of rapid reviews based on the opinion of a panel of knowledgeable experts. Areas of disagreement were also highlighted. Findings emphasize the role of the decision maker and stress the importance of transparent reporting.

scholarly journals Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2522 ◽  
Author(s):  
Shannon E. Kelly ◽  
David Moher ◽  
Tammy J. Clifford
Keyword(s):  
Decision Making ◽  
Q Methodology ◽  
Evidence Synthesis ◽  
Synthesis Process ◽  
Free Text ◽  
Healthcare Decision ◽  
Rapid Reviews ◽  
Healthcare Decision Making ◽  
Attitudes And Perceptions ◽  
Factor C

BackgroundRapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews.MethodsA Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation). Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described.ResultsAnalysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process.ConclusionResults show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments.

scholarly journals Rapid reviews as an emerging approach to evidence synthesis in education

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sabine Wollscheid ◽  
Janice Tripney
Keyword(s):  
Decision Making ◽  
Evidence Synthesis ◽  
Synthesis Method ◽  
Time Frame ◽  
Evidence Base ◽  
Informed Decision ◽  
Rapid Review ◽  
Informed Decision Making ◽  
Postgraduate Students ◽  
Rapid Reviews

Rapid reviews using abbreviated systematic review methods are of increasing importance for evidence-informed decision-making in education, although there is little guidance about the most suitable approach. Three recently completed rapid review reports are compared to inform discussions on the utility of this type of review in education and to highlight appropriate methods for producing evidence syntheses in a limited time frame. Rapid review methods need to be chosen to fit the needs of the review, which involves: thinking broadly about different kinds of team experience and expertise; estimating the size and nature of the literature to be reviewed; considering the review purpose and nature of the topic; choosing an appropriate synthesis method for the review purpose, evidence base and reviewers’ expertise; fully describing the review approach, and discussing the potential limitations of chosen methods; and understanding the anticipated audiences and tailoring outputs accordingly. Rapid reviews to address urgent and high-priority questions provide the benefits of timeliness and reduced resource requirements. However, it is crucial to understand caveats and limitations to the rapid conduct of evidence syntheses for decision-making purposes. This article offers guidance to support researchers, postgraduate students and commissioners who wish to conduct rapid reviews in a transparent and systematic way, addressing complex questions of relevance to evidence-informed decision-making in education.

scholarly journals Areas of agreement in the management of childhood non-infectious chronic anterior uveitis in the UK

2019 ◽  
Vol 104 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi ◽  
Andrew D Dick ◽  
Athimalaipet V Ramanan ◽  
Jane Ashworth ◽  
...  
Keyword(s):  
Anterior Uveitis ◽  
Severe Disease ◽  
Evidence Base ◽  
Future Research ◽  
Multiple Sources ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
The Uk ◽  
High Level

Background/aimsThere is a paucity of high-level evidence to support the management of childhood uveitis, particularly for those children without juvenile idiopathic arthritis uveitis (JIA). We undertook a modified Delphi consensus exercise to identify agreement in the management of chronic anterior uveitis (CAU), the most common manifestation of childhood disease.MethodsA four-round, two-panel process was undertaken between June and December 2017. Paediatric uveitis specialists identified through multiple sources, including a multicentre network (the Paediatric Ocular Inflammation Group), were invited to participate. They were asked whether they agreed with items derived from existing guidelines on the management of JIA-U when extrapolated to the population of all children with CAU. Consensus was defined as agreement greater than or equal to 75% of respondents.Results26 of the 38 (68%) invited specialists participated with the exercise, and response rates were 100% for rounds one to three, and 92% for round four. Consensus was reached on 23 of the 44 items. Items for which consensus was not reached included management at presentation, use of systemic and periocular steroids for children with severe disease and the role of conventional steroid sparing immunosuppressants beyond methotrexate.ConclusionThe areas of management uncertainty at the level of the group, as indicated by absence of consensus, reflect the areas where the evidence base is particularly poor. Our findings identify the key areas for the future research needed to ensure better outcomes for this blinding childhood ocular inflammatory disorders.

scholarly journals Investigating the Implementation of SMS and Mobile Messaging in Population Screening (the SIPS Study): Protocol for a Delphi Study (Preprint)

2021 ◽  
Author(s):  
Amish Acharya ◽  
Gaby Judah ◽  
Hutan Ashrafian ◽  
Viknesh Sounderajah ◽  
Nick Johnstone-Waddell ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Delphi Study ◽  
Evidence Synthesis ◽  
Population Screening ◽  
Free Text ◽  
Screening Programs ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Screening Services

BACKGROUND The use of mobile messaging, including SMS, and web-based messaging in health care has grown significantly. Using messaging to facilitate patient communication has been advocated in several circumstances, including population screening. These programs, however, pose unique challenges to mobile communication, as messaging is often sent from a central hub to a diverse population with differing needs. Despite this, there is a paucity of robust frameworks to guide implementation. OBJECTIVE The aim of this protocol is to describe the methods that will be used to develop a guide for the principles of use of mobile messaging for population screening programs in England. METHODS This modified Delphi study will be conducted in two parts: evidence synthesis and consensus generation. The former will include a review of literature published from January 1, 2000, to October 1, 2021. This will elicit key themes to inform an online scoping questionnaire posed to a group of experts from academia, clinical medicine, industry, and public health. Thematic analysis of free-text responses by two independent authors will elicit items to be used during consensus generation. Patient and Public Involvement and Engagement groups will be convened to ensure that a comprehensive item list is generated that represents the public’s perspective. Each item will then be anonymously voted on by experts as to its importance and feasibility of implementation in screening during three rounds of a Delphi process. Consensus will be defined a priori at 70%, with items considered important and feasible being eligible for inclusion in the final recommendation. A list of desirable items (ie, important but not currently feasible) will be developed to guide future work. RESULTS The Institutional Review Board at Imperial College London has granted ethical approval for this study (reference 20IC6088). Results are expected to involve a list of recommendations to screening services, with findings being made available to screening services through Public Health England. This study will, thus, provide a formal guideline for the use of mobile messaging in screening services and will provide future directions in this field. CONCLUSIONS The use of mobile messaging has grown significantly across health care services, especially given the COVID-19 pandemic, but its implementation in screening programs remains challenging. This modified Delphi approach with leading experts will provide invaluable insights into facilitating the incorporation of messaging into these programs and will create awareness of future developments in this area. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/32660

scholarly journals Investigating the Implementation of SMS and Mobile Messaging in Population Screening (the SIPS Study): Protocol for a Delphi Study

10.2196/32660 ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. e32660
Author(s):  
Amish Acharya ◽  
Gaby Judah ◽  
Hutan Ashrafian ◽  
Viknesh Sounderajah ◽  
Nick Johnstone-Waddell ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Delphi Study ◽  
Evidence Synthesis ◽  
Population Screening ◽  
Free Text ◽  
Screening Programs ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Screening Services

Background The use of mobile messaging, including SMS, and web-based messaging in health care has grown significantly. Using messaging to facilitate patient communication has been advocated in several circumstances, including population screening. These programs, however, pose unique challenges to mobile communication, as messaging is often sent from a central hub to a diverse population with differing needs. Despite this, there is a paucity of robust frameworks to guide implementation. Objective The aim of this protocol is to describe the methods that will be used to develop a guide for the principles of use of mobile messaging for population screening programs in England. Methods This modified Delphi study will be conducted in two parts: evidence synthesis and consensus generation. The former will include a review of literature published from January 1, 2000, to October 1, 2021. This will elicit key themes to inform an online scoping questionnaire posed to a group of experts from academia, clinical medicine, industry, and public health. Thematic analysis of free-text responses by two independent authors will elicit items to be used during consensus generation. Patient and Public Involvement and Engagement groups will be convened to ensure that a comprehensive item list is generated that represents the public’s perspective. Each item will then be anonymously voted on by experts as to its importance and feasibility of implementation in screening during three rounds of a Delphi process. Consensus will be defined a priori at 70%, with items considered important and feasible being eligible for inclusion in the final recommendation. A list of desirable items (ie, important but not currently feasible) will be developed to guide future work. Results The Institutional Review Board at Imperial College London has granted ethical approval for this study (reference 20IC6088). Results are expected to involve a list of recommendations to screening services, with findings being made available to screening services through Public Health England. This study will, thus, provide a formal guideline for the use of mobile messaging in screening services and will provide future directions in this field. Conclusions The use of mobile messaging has grown significantly across health care services, especially given the COVID-19 pandemic, but its implementation in screening programs remains challenging. This modified Delphi approach with leading experts will provide invaluable insights into facilitating the incorporation of messaging into these programs and will create awareness of future developments in this area. International Registered Report Identifier (IRRID) PRR1-10.2196/32660

scholarly journals Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anna M. Anderson ◽  
Christine Comer ◽  
Toby O. Smith ◽  
Benjamin T. Drew ◽  
Hemant Pandit ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Delphi Study ◽  
Functional Limitations ◽  
Rapid Review ◽  
Free Text ◽  
Definitive Evidence ◽  
Modified Delphi ◽  
Importance Ratings ◽  
Total Knee

Abstract Background Over 90,000 total knee replacement (TKR) procedures are performed annually in the United Kingdom (UK). Patients awaiting TKR face long delays whilst enduring severe pain and functional limitations. Almost 20% of patients who undergo TKR are not satisfied post-operatively. Optimising pre-operative TKR education and prehabilitation could help improve patient outcomes pre- and post-operatively; however, current pre-operative TKR care varies widely. Definitive evidence on the optimal content and delivery of pre-operative TKR care is lacking. This study aimed to develop evidence- and consensus-based recommendations on pre-operative TKR education and prehabilitation. Methods A UK-based, three-round, online modified Delphi study was conducted with a 60-member expert panel. All panellists had experience of TKR services as patients (n = 30) or professionals (n = 30). Round 1 included initial recommendations developed from a mixed methods rapid review. Panellists rated the importance of each item on a five-point Likert scale. Panellists could also suggest additional items in Round 1. Rounds 2 and 3 included all items from Round 1, new items suggested in Round 1 and charts summarising panellists’ importance ratings from the preceding round. Free-text responses were analysed using content analysis. Quantitative data were analysed descriptively. All items rated as ‘Important’ or ‘Very important’ by at least 70% of all respondents in Round 3 were included in the final set of recommendations. Results Fifty-five panellists (92%) (patients n = 26; professionals n = 29) completed Round 3. Eighty-six recommendation items were included in Round 1. Fifteen new items were added in Round 2. Rounds 2 and 3 therefore included 101 items. Seventy-seven of these reached consensus in Round 3. Six items reached consensus amongst patient or professional panellists only in Round 3. The final set of recommendations comprises 34 education topics, 18 education delivery approaches, 10 exercise types, 13 exercise delivery approaches and two other treatments. Conclusions This modified Delphi study developed a comprehensive set of recommendations that represent a useful resource for guiding decision-making on the content and delivery of pre-operative TKR education and prehabilitation. The recommendations will need to be interpreted and reviewed periodically in light of emerging evidence.

scholarly journals Developing a methodological framework for organisational case studies: a rapid review and consensus development process

2016 ◽  
Vol 4 (1) ◽  
pp. 1-142 ◽  
Author(s):  
Mark Rodgers ◽  
Sian Thomas ◽  
Melissa Harden ◽  
Gillian Parker ◽  
Andrew Street ◽  
...  
Keyword(s):  
Case Studies ◽  
Evidence Synthesis ◽  
Case Study Research ◽  
Rapid Review ◽  
Reporting Standards ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Study Research ◽  
Two Samples

BackgroundOrganisational case study proposals can be poorly articulated and methodologically weak, raising the possible need for publication standards in this area.ObjectivesTo develop reporting standards for organisational case study research, with particular application to the UK National Health Service.DesignRapid evidence synthesis and Delphi consensus process.Data sourcesRelevant case studies and methods texts were identified through searches of library catalogues, key text and author searches, focused searching of health and social science databases and some targeted website searching.Review methodsThe reporting standards were developed in three stages: (1) a rapid review of the existing literature to identify items; (2) a modified Delphi consensus process to develop and refine content and structure; and (3) application of the high-consensus Delphi items to two samples of organisational case studies to assess their feasibility as reporting standards. Items for the Delphi consultation were identified from published organisational case studies and related methodological texts. Identified items were sent to a Delphi expert panel for rating over two rounds. Participants were also asked whether or not the provisional framework in which items were presented was appropriate, and were given the opportunity to adapt this alongside the content. In both rounds, the high-consensus threshold was set at 70% agreement among respondents for each item. High-consensus items from the Delphi consultation were then applied to previously identified case study publications to determine their relevance to the reporting of real-world organisational case studies and to better understand how the results of the Delphi consultation might best be implemented as a reporting standard.ResultsOne hundred and three unique reporting items were identified from 25 methodological texts; eight example case studies and 12 exemplar case studies did not provide any additional unique items. Thirteen items were ultimately rated as ‘Should be reported for all organisational case studies’ by at least 70% of respondents, with the degree of consensus ranging from 73% to 100%. As a whole, exemplar case studies [which had been provided by the National Institute for Health Research (NIHR)’s Health Services and Delivery Research (HSDR) programme as examples of methodologically strong projects] more consistently reported the high-consensus Delphi items than did case studies drawn from the literature more broadly.LimitationsTime and resource constraints prevented an initial ‘item-generation’ round in the Delphi consensus process. Items are therefore likely to have been influenced by the content, wording and assumptions of available literature.ConclusionsThe high-consensus items were translated into a set of 13 reporting standards that aim to improve the consistency, rigour and reporting of organisational case study research, thereby making it more accessible and useful to different audiences. The reporting standards themselves are intended primarily as a tool for authors of organisational case studies. They briefly outline broad requirements for rigorous and consistent reporting without constraining methodological freedom.Future workThese reporting standards should be included as part of the submission requirements for all organisational case studies seeking funding. Though these reporting standards do not mandate specific methods, if a reporting item is not reported for legitimate methodological reasons, the onus is on the author to outline their rationale for the reader.FundingThe NIHR HSDR programme.

scholarly journals Early indicators of disease progression in Fabry disease that may indicate the need for disease-specific treatment initiation: findings from the opinion-based PREDICT-FD modified Delphi consensus initiative

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035182 ◽  
Author(s):  
Derralynn A Hughes ◽  
Patricio Aguiar ◽  
Patrick B Deegan ◽  
Fatih Ezgu ◽  
Andrea Frustaci ◽  
...  
Keyword(s):  
Fabry Disease ◽  
Disease Progression ◽  
Treatment Initiation ◽  
Specific Treatment ◽  
Free Text ◽  
Point Scale ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Patient Reported ◽  
Early Indicators

ObjectivesThe PRoposing Early Disease Indicators for Clinical Tracking in Fabry Disease (PREDICT-FD) initiative aimed to reach consensus among a panel of global experts on early indicators of disease progression that may justify FD-specific treatment initiation.Design and settingAnonymous feedback from panellists via online questionnaires was analysed using a modified Delphi consensus technique. Questionnaires and data were managed by an independent administrator directed by two non-voting cochairs. First, possible early indicators of renal, cardiac and central/peripheral nervous system (CNS/PNS) damage, and other disease and patient-reported indicators assessable in routine clinical practice were compiled by the cochairs and administrator from panellists’ free-text responses. Second, the panel scored indicators for importance (5-point scale: 1=not important; 5=extremely important); indicators scoring ≥3 among >75% of panellists were then rated for agreement (5-point scale: 1=strongly disagree; 5=strongly agree). Indicators awarded an agreement score ≥4 by >67% of panellists achieved consensus. Finally, any panel-proposed refinements to consensus indicator definitions were adopted if >75% of panellists agreed.ResultsA panel of 21 expert clinicians from 15 countries provided information from which 83 possible current indicators of damage (kidney, 15; cardiac, 15; CNS/PNS, 13; other, 16; patient reported, 24) were compiled. Of 45 indicators meeting the importance criteria, consensus was reached for 29 and consolidated as 27 indicators (kidney, 6; cardiac, 10; CNS/PNS, 2; other, 6; patient reported, 3) including: (kidney) elevated albumin:creatinine ratio, histological damage, microalbuminuria; (cardiac) markers of early systolic/diastolic dysfunction, elevated serum cardiac troponin; (CNS/PNS) neuropathic pain, gastrointestinal symptoms suggestive of gastrointestinal neuropathy; (other) pain in extremities/neuropathy, angiokeratoma; (patient-reported) febrile crises, progression of symptoms/signs. Panellists revised and approved proposed chronologies of when the consensus indicators manifest. The panel response rate was >95% at all stages.ConclusionsPREDICT-FD captured global opinion regarding current clinical indicators that could prompt FD-specific treatment initiation earlier than is currently practised.

57 Evidence into practice: novel approaches to underpinning evidence-based innovations in care

2018 ◽  
Vol 8 (3) ◽  
pp. 382.1-382
Author(s):  
Mala Mann ◽  
Annmarie Nelson ◽  
Amanda Woodward ◽  
Ishrat Islam ◽  
Anthony Byrne
Keyword(s):  
Palliative Care ◽  
Resource Constraints ◽  
Data Extraction ◽  
Evidence Synthesis ◽  
Rapid Review ◽  
Research Centre ◽  
List Type ◽  
Systematic Review Methodology ◽  
Rapid Reviews ◽  
Evidence Review

BackgroundDeveloping and implementing novel models of care requires a robust approach to identifying and assessing existing evidence. Rapid reviews have emerged as an efficient approach. There is a growing number of rapid review ‘methods’ but no accepted standardised methodology. We describe the methodological options and an example the Palliative Care Evidence Review Service (PaCERS) where streamlined systematic review methodology is used to conduct rapid reviews requested by clinicians/clinical services.AimsTo describe evidence synthesis options including PaCERS for producing rapid evidence summaries on questions of direct importance to service delivery. To identify related methodological challenges.MethodsWe examine various rapid review methods and describe in full PaCERS methodology. This uses a focussed search strategy across a limited set of databases and other sources. Study selection data extraction and critical appraisal are performed independently by at least two reviewers. Results are published online using a template co-produced with users which describes key clinical messages evidence quality and summaries of included studies.ResultsWe will describe the pros and cons of conducting rapid reviews and highlight methodology development unique to PaCERS. We will discuss specific issues encountered during the review process to produce rigorous reviews in a short time frame for palliative services.ConclusionRapid reviews have tremendous methodological variation however they are an important tool for evidence-informed decision making especially when time resource constraints and health needs are an issue. Therefore using rapid reviews can be used in implementing new models of palliative care.Reference. Wales Cancer Research Centre. Palliative Care Evidence Review Service (PaCERS)2016. Available at: http://palliativecare.walescancerresearchcentre.com/palliative-care-evidence-review-service/ [Accessed: 30 May 2018]

scholarly journals What are the most important unanswered research questions on rapid review methodology? A James Lind Alliance research methodology Priority Setting Partnership: the Priority III study protocol

2021 ◽  
Vol 4 ◽  
pp. 80
Author(s):  
Claire Beecher ◽  
Elaine Toomey ◽  
Beccy Maeso ◽  
Caroline Whiting ◽  
Derek C. Stewart ◽  
...  
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Priority Setting ◽  
Evidence Synthesis ◽  
Rapid Review ◽  
High Quality ◽  
Rapid Reviews ◽  
James Lind Alliance ◽  
Research Questions ◽  
Priority Setting Partnership

Background: The value of rapid reviews in informing health care decisions is more evident since the onset of the coronavirus disease 2019 (COVID-19) pandemic. While systematic reviews can be completed rapidly, rapid reviews are usually a type of evidence synthesis in which components of the systematic review process may be simplified or omitted to produce information more efficiently within constraints of time, expertise, funding or any combination thereof. There is an absence of high-quality evidence underpinning some decisions about how we plan, do and share rapid reviews. We will conduct a modified James Lind Alliance Priority Setting Partnership to determine the top 10 unanswered research questions about how we plan, do and share rapid reviews in collaboration with patients, public, reviewers, researchers, clinicians, policymakers and funders. Methods: An international steering group consisting of key stakeholder perspectives (patients, the public, reviewers, researchers, clinicians, policymakers and funders) will facilitate broad reach, recruitment and participation across stakeholder groups. An initial online survey will identify stakeholders’ perceptions of research uncertainties about how we plan, do and share rapid reviews. Responses will be categorised to generate a long list of questions. The list will be checked against systematic reviews published within the past three years to identify if the question is unanswered. A second online stakeholder survey will rank the long list in order of priority. Finally, a virtual consensus workshop of key stakeholders will agree on the top 10 unanswered questions. Discussion: Research prioritisation is an important means for minimising research waste and ensuring that research resources are targeted towards answering the most important questions. Identifying the top 10 rapid review methodology research priorities will help target research to improve how we plan, do and share rapid reviews and ultimately enhance the use of high-quality synthesised evidence to inform health care policy and practice.

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