Pneumothoraxmanagement nach bronchoskopischer Lungenvolumenreduktion mit Einwegventilen. Ein aktuelles Expertenstatement

For selected patients with advanced emphysema, bronchoscopic lung volume reduction with one-way valves can lead to clinically relevant improvements of airflow obstruction, hyperinflation, exercise capacity, and quality of life. The most common complication of this procedure is pneumothorax with a prevalence of up to ±34% of the treated patients. Patients who develop a pneumothorax also experience meaningful clinical benefits once the pneumothorax is resolved. Timely resolution of a post-valve treatment pneumothorax requires skilled and adequate pneumothorax management. This expert panel statement is an updated recommendation of the 2014 statement developed to help guide pneumothorax management after valve placement. Additionally, mechanisms for pneumothorax development, risk assessment, prevention of pneumothorax, and outcomes after pneumothorax are addressed. This recommendation is based on a combination of the current scientific literature and expert opinion, which was obtained through a modified Delphi method.

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WED 127 Update on the questionnaire for brain donors at queen square brain bank

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-abn.50 ◽

2018 ◽

Vol 89 (10) ◽

pp. A14.1-A14

Author(s):

Yoganathan Katie ◽

Barbosa Pedro ◽

Noyce Alastair ◽

Fernandez Eduardo ◽

Shaw Karen ◽

...

Keyword(s):

Risk Factors ◽

Delphi Method ◽

Expert Panel ◽

Self Report ◽

Self Assessment ◽

Brain Bank ◽

Parkinsonian Syndromes ◽

Modified Delphi ◽

Data Interchange

The Queen Square Brain Bank (QSBB) is recognised as a world leading neuropathological resource for brain tissue for study into Parkinson’s disease (PD) and Parkinson-plus syndromes. At recruitment to the donor register, a self-assessment form is given to every donor and used for administrative and research purposes. Due to the recent increase in donations from individuals with Parkinsonian syndromes and the latest advances on risk factors and symptomatology of PD, a new questionnaire is needed. This study is a literature review of existing self-report questionnaires used in PD, Parkinson-plus syndromes, hyperkinetic disorders and cognitive impairment, to assess their suitability for inclusion in the new questionnaire for QSBB brain donors. This is the first systematic review of our knowledge to include all five domains of Parkinsonian symptoms. Subsequently, the modified Delphi method was used to reach a consensus of the domains from an expert panel. This information was cross-referenced with the Clinical Data Interchange Standards Consortium. Through the creation of this new questionnaire, we hope to improve the quality of the data collected from brain donors, which hopefully will ultimately help improve our understanding and management of these disorders.

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Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): international expert consensus

Critical Care ◽

10.1186/s13054-020-03369-5 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Arif Hussain ◽

Gabriele Via ◽

Lawrence Melniker ◽

Alberto Goffi ◽

Guido Tavazzi ◽

...

Keyword(s):

Lung Ultrasound ◽

Expert Panel ◽

Point Of Care ◽

Expert Consensus ◽

Future Research ◽

Point Of Care Ultrasound ◽

The Past ◽

Modified Delphi ◽

Grade Methodology

AbstractCOVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.

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Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure

Clinical Infectious Diseases ◽

10.1093/cid/ciz362 ◽

2019 ◽

Vol 70 (6) ◽

pp. 1075-1082 ◽

Cited By ~ 2

Author(s):

Marvin A H Berrevoets ◽

Jaap ten Oever ◽

Anke J M Oerlemans ◽

Bart Jan Kullberg ◽

Marlies E Hulscher ◽

...

Keyword(s):

Systematic Review ◽

Quality Indicators ◽

Antimicrobial Therapy ◽

Expert Panel ◽

Outpatient Parenteral Antimicrobial Therapy ◽

Modified Delphi ◽

Delphi Procedure ◽

Antimicrobial Management ◽

Patient Selection Criteria

Abstract Background Our aim in this study was to develop quality indicators (QIs) for outpatient parenteral antimicrobial therapy (OPAT) care that can be used as metrics for quality assessment and improvement. Methods A RAND-modified Delphi procedure was used to develop a set of QIs. Recommendations on appropriate OPAT care in adults were retrieved from the literature using a systematic review and translated into potential QIs. These QIs were appraised and prioritized by a multidisciplinary panel of international OPAT experts in 2 questionnaire rounds combined with a meeting between rounds. Results The procedure resulted in 33 OPAT-specific recommendations. The following QIs that describe recommended OPAT care were prioritized by the expert panel: the presence of a structured OPAT program, a formal OPAT care team, a policy on patient selection criteria, and a treatment and monitoring plan; assessment for OPAT should be performed by the OPAT team; patients and family should be informed about OPAT; there should be a mechanism in place for urgent discussion and review of emergent clinical problems, and a system in place for rapid communication; laboratory results should be delivered to physicians within 24 hours; and the OPAT team should document clinical response to antimicrobial management, document adverse events, and monitor QIs for OPAT care and make these data available. Conclusions We systematically developed a set of 33 QIs for optimal OPAT care, of which 12 were prioritized by the expert panel. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

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Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube

Otolaryngology ◽

10.1177/0194599819848423 ◽

2019 ◽

Vol 161 (1) ◽

pp. 6-17 ◽

Cited By ~ 8

Author(s):

Debara L. Tucci ◽

Edward D. McCoul ◽

Richard M. Rosenfeld ◽

David E. Tunkel ◽

Pete S. Batra ◽

...

Keyword(s):

Eustachian Tube ◽

Delphi Method ◽

Consensus Statement ◽

Expert Panel ◽

Balloon Dilation ◽

Target Population ◽

Functional Health ◽

Modified Delphi ◽

Tube Dysfunction ◽

Definition Of

ObjectiveTo develop a clinical consensus statement on the use of balloon dilation of the eustachian tube (BDET).MethodsAn expert panel of otolaryngologists was assembled with nominated representatives of general otolaryngology and relevant subspecialty societies. The target population was adults 18 years or older who are candidates for BDET because of obstructive eustachian tube dysfunction (OETD) in 1 or both ears for 3 months or longer that significantly affects quality of life or functional health status. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus.ResultsAfter 3 iterative Delphi method surveys, 28 statements met the predefined criteria for consensus, while 28 statements did not. The clinical statements were grouped into 3 categories for the purposes of presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes.ConclusionThis panel reached consensus on several statements that clarify diagnosis and perioperative management of OETD. Lack of consensus on other statements likely reflects knowledge gaps regarding the role of BDET in managing OETD. Expert panel consensus may provide helpful information for the otolaryngologist considering the use of BDET for the management of patients with OETD.

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Clinical Consensus Statement: Ankyloglossia in Children

Otolaryngology ◽

10.1177/0194599820915457 ◽

2020 ◽

Vol 162 (5) ◽

pp. 597-611 ◽

Cited By ~ 5

Author(s):

Anna H. Messner ◽

Jonathan Walsh ◽

Richard M. Rosenfeld ◽

Seth R. Schwartz ◽

Stacey L. Ishman ◽

...

Keyword(s):

American Academy ◽

Head And Neck ◽

Delphi Method ◽

Expert Panel ◽

Target Population ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Older Children ◽

Modified Delphi ◽

Consensus Statements

Objective To identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using established methodology for American Academy of Otolaryngology–Head and Neck Surgery clinical consensus statements. Methods An expert panel of pediatric otolaryngologists was assembled with nominated representatives of otolaryngology organizations. The target population was children aged 0 to 18 years, including breastfeeding infants. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus, per established methodology published by the American Academy of Otolaryngology–Head and Neck Surgery. Results After 3 iterative Delphi method surveys of 89 total statements, 41 met the predefined criteria for consensus, 17 were near consensus, and 28 did not reach consensus. The clinical statements were grouped into several categories for the purposes of presentation and discussion: ankyloglossia (general), buccal tie, ankyloglossia and sleep apnea, ankyloglossia and breastfeeding, frenotomy indications and informed consent, frenotomy procedure, ankyloglossia in older children, and maxillary labial frenulum. Conclusion This expert panel reached consensus on several statements that clarify the diagnosis, management, and treatment of ankyloglossia in children 0 to 18 years of age. Lack of consensus on other statements likely reflects knowledge gaps and lack of evidence regarding the diagnosis, management, and treatment of ankyloglossia. Expert panel consensus may provide helpful information for otolaryngologists treating patients with ankyloglossia.

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Determining electrocardiography training priorities for medical students using a modified Delphi method

10.21203/rs.3.rs-68479/v2 ◽

2020 ◽

Author(s):

Charle Andre Viljoen ◽

Rob Scott Millar ◽

Kathryn Manning ◽

Vanessa Celeste Burch

Keyword(s):

Medical Students ◽

Delphi Method ◽

Delphi Study ◽

Delphi Technique ◽

Expert Panel ◽

Expert Consensus ◽

Modified Delphi ◽

Wide Range ◽

Life Threatening ◽

Curriculum Specialists

Abstract BackgroundAlthough electrocardiography is considered a core learning outcome for medical students, there is currently little curricular guidance for undergraduate ECG training. Owing to the absence of expert consensus on undergraduate ECG teaching, curricular content is subject to individual opinion. The aim of this modified Delphi study was to establish expert consensus amongst content and context experts on an ECG curriculum for medical students.MethodsThe Delphi technique, an established method of obtaining consensus, was used to develop an undergraduate ECG curriculum. Specialists involved in ECG teaching were invited to complete three rounds of online surveys. An undergraduate ECG curriculum was formulated from the topics of ECG instruction for which consensus (i.e. ≥75% agreement) was achieved. ResultsThe panellists (n=131) had a wide range of expertise (42.8% Internal Medicine, 22.9% Cardiology, 16% Family Medicine, 13.7% Emergency Medicine and 4.6% Health Professions Education). Topics that reached consensus to be included in the undergraduate ECG curriculum were classified under technical aspects of performing ECGs, basic ECG analysis, recognition of the normal ECG and abnormal rhythms and waveforms and using electrocardiography as part of a clinical diagnosis. This study emphasises that ECG teaching should be framed within the clinical context. Course conveners should not overload students with complex and voluminous content, but rather focus on commonly encountered and life-threatening conditions, where accurate diagnosis impacts on patient outcome. A list of 23 “must know” ECG diagnoses is therefore proposed.ConclusionA multidisciplinary expert panel reached consensus on the ECG training priorities for medical students.

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Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative

CJEM ◽

10.2310/8000.2012.120686 ◽

2013 ◽

Vol 15 (01) ◽

pp. 24-33 ◽

Cited By ~ 7

Author(s):

Rick Penciner ◽

Robert A. Woods ◽

Jill McEwen ◽

Richard Lee ◽

Trevor Langhan ◽

...

Keyword(s):

Emergency Medicine ◽

Delphi Method ◽

Expert Panel ◽

Core Competencies ◽

Competency Framework ◽

Modified Delphi Method ◽

The Core ◽

Modified Delphi ◽

Physician Competency ◽

Initial List

ABSTRACTObjectives:There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators.Methods:We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada.Results:Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided.Conclusion:This study established a national consensus defining the core competencies for EM clerkship in Canada.

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Establishment of a Unified Quality Indicators System to Increase the Effectiveness of Emergency Departments

International Journal of Information Systems and Social Change ◽

10.4018/ijissc.2019100101 ◽

2019 ◽

Vol 10 (4) ◽

pp. 1-11

Author(s):

Anat Ratnovsky ◽

Shai Rozenes ◽

Pinchas Halpern

Keyword(s):

Emergency Department ◽

Literature Review ◽

Performance Indicators ◽

Expert Panel ◽

High Quality ◽

Medical Treatments ◽

Modified Delphi ◽

Core Set ◽

Key Indicators

The overall quality of an emergency department (ED) can be measured by its ability to provide fast, efficient yet high-quality medical treatments to its patients. The objective of the present study was to derive a common set of key indicators that could be used to assess the quality of the performance of EDs. A modified Delphi process was employed to achieve this. This consisted of a detailed literature review followed by a three-round expert panel interaction, which was used to reduce and refine the list of indicators. The members of the panel comprised ED physicians, ED nurses and hospital and ED administrators drawn from six EDs. This process yielded 47 essential performance indicators and 12 recommended indicators. The performance indicators were classified into 7 main groups according to their characteristics. The chosen indicators comprise a core set that will be used in an ongoing study on a representative sample of EDs.

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