scholarly journals Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Antonia S. Stang ◽  
Melanie Trudeau ◽  
Otto G. Vanderkooi ◽  
Bonita E. Lee ◽  
Linda Chui ◽  
...  
Keyword(s):  
Diagnostic Test ◽  
Expert Panel ◽  
Enteric Pathogens ◽  
Molecular Diagnostic ◽  
Advisory Panel ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Web Based ◽  
Face To Face ◽  
Modified Delphi

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.

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

Determining the Information Needs of Puget Sound Boaters

2005 ◽  
Vol 49 (3) ◽  
pp. 553-556 ◽  
Author(s):  
David W. Jones ◽  
Janet I. Olsonbaker
Keyword(s):  
Situation Awareness ◽  
Information Needs ◽  
Puget Sound ◽  
Advisory Panel ◽  
Trip Planning ◽  
Web Based ◽  
Face To Face ◽  
Weather Forecasts ◽  
Wide Range ◽  
Challenging Environment

Puget Sound is known for its highly variable weather and ocean currents. Trip planning for this challenging environment is critical for boating safety. We conducted a survey of the Puget Sound boating community to determine their information needs. We used a web-based questionnaire supplemented with face-to-face surveys. We received 610 responses. The respondents represented a wide range of the boating community. The boaters' most important environmental need was for daily weather forecasts and their most desired forecast parameters were wind speed, currents, and wave height. Respondents also commented on their frustration with accessing the needed information. Analysis of this survey and guidance from an advisory panel are being used to develop a usercentered designed (UCD) web portal, the Boater Information System (BIS) that will attempt to improve the situation awareness (SA) for a diverse user group.

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.

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