scholarly journals Creation of an Australian Osteotomy Knee Registry Datasheet Instrument using a Modified Delphi Method

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0018 ◽  
Author(s):  
Christopher J. Vertullo
Keyword(s):  
Mechanical Axis ◽  
Consensus Building ◽  
Flexion Deformity ◽  
Delphi Consensus ◽  
Knee Oa ◽  
Modified Delphi ◽  
Group Members ◽  
Final Instrument ◽  
Fixed Flexion Deformity ◽  
Correction Calculation

Background: In 2015, the Australian Knee Society(AKS) agreed to initiate and fund an Australian Knee Osteotomy Registry (AKOR) in 2015 in conjunction with the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). A concise and robust dataset was required to proceed to AKOR preliminary site trialing. Study Design: Modified Delphi consensus building. Methods: Seven participants who were orthopaedic surgeons, AKS members and AKOR working group members performed a four round modified Delphi consensus building electronic non-blinded questionnaires using Google Sheets, a cloud-based spreadsheet. Round 1 involved the attribute rating using 0-10 of surgeon assessed utility of 41 initial datasheet instrument questions with 168 stem options. Surgeons could comment on each question or stem, giving comments on their rating and or proposing new variations or additions. Round 1 questions were based on the Swedish HTO Registry dataset with additional questions from surgeon interview. Questions and or stems with a mean utility rating of less than 2 were excluded. Questions and or stems with a mean utility raking of 8 or greater were accepted. Questions and or stem with a mean utility ranking of between 8 and 2 were included in subsequent rounds. Surgeons comments and votes were non-blinded. New or alternative questions or stems could be proposed by any surgeon during the process and voted on in the next round. This process was repeated until dataset consensus was achieved. Results: A final dataset of 32 questions was created after 4 rounds. Consensus was reached on the following items; patients demographics, hospital, state, surgeon’s code, date, primary or re-operation, diagnosis at primary procedure, diagnosis at re-operation, type of primary osteotomy, type of re-operation, form of fixation, bone graft, coincidental surgery, approach to correction calculation, pre-operative status of ACL, pre-operative status of PCL, previous knee surgery, preoperative mechanical axis, planned post-operative mechanical axis, preoperative fixed flexion deformity, pre-operative Ahlbäck grading of knee OA. Questions that had a final utility rating less than 10 included; coincidental surgery, approach to correction calculation, pre-operative Ahlbäck grading of knee OA, planned post-operative mechanical axis and preoperative fixed flexion deformity. Conclusion: The final AKOR dataset requires pragmatic validation prior to nation-wide implementation. Questions with low final attribute rating may not be included in the final instrument after validatation.

scholarly journals Aromatic L-amino Acid Decarboxylase (AADC) deficiency: results from an Italian modified Delphi consensus

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Carlo Fusco ◽  
◽  
Vincenzo Leuzzi ◽  
Pasquale Striano ◽  
Roberta Battini ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Delay ◽  
Steering Committee ◽  
Outcome Data ◽  
Diagnosis And Treatment ◽  
Acid Decarboxylase ◽  
Delphi Consensus ◽  
Amino Acid Decarboxylase ◽  
Modified Delphi ◽  
Number Of Patients

Abstract Background Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare and underdiagnosed neurometabolic disorder resulting in a complex neurological and non-neurological phenotype, posing diagnostic challenges resulting in diagnostic delay. Due to the low number of patients, gathering high-quality scientific evidence on diagnosis and treatment is difficult. Additionally, based on the estimated prevalence, the number of undiagnosed patients is likely to be high. Methods Italian experts in AADC deficiency formed a steering committee to engage clinicians in a modified Delphi consensus to promote discussion, and support research, dissemination and awareness on this disorder. Five experts in the field elaborated six main topics, each subdivided into 4 statements and invited 13 clinicians to give their anonymous feedback. Results 100% of the statements were answered and a consensus was reached at the first round. This enabled the steering committee to acknowledge high rates of agreement between experts on clinical presentation, phenotypes, diagnostic work-up and treatment strategies. A research gap was identified in the lack of standardized cognitive and motor outcome data. The need for setting up an Italian working group and a patients’ association, together with the dissemination of knowledge inside and outside scientific societies in multiple medical disciplines were recognized as critical lines of intervention. Conclusions The panel expressed consensus with high rates of agreement on a series of statements paving the way to disseminate clear messages concerning disease presentation, diagnosis and treatment and strategic interventions to disseminate knowledge at different levels. Future lines of research were also identified.

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.

ID: 3519259 BEYOND THE RECENT MODIFIED DELPHI CONSENSUS STATEMENTS ON WATER EXCHANGE (WE) - MORE NOVEL BENEFITS OF WE.

2021 ◽  
Vol 93 (6) ◽  
pp. AB35-AB36
Author(s):  
Yu-Hsi Hsieh ◽  
Chih Wei Tseng ◽  
Malcolm Koo ◽  
Felix W. Leung
Keyword(s):  
Water Exchange ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Consensus Statements

scholarly journals Distal rectus femoris surgery in children with cerebral palsy: results of a Delphi consensus project

2021 ◽  
pp. 1-9
Author(s):  
Robert M. Kay ◽  
Kristan Pierz ◽  
James McCarthy ◽  
H. Kerr Graham ◽  
Henry Chambers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Rectus Femoris ◽  
Delphi Consensus ◽  
Level Of Evidence ◽  
Modified Delphi ◽  
International Panel ◽  
Children With Cerebral Palsy ◽  
Stiff Knee ◽  
Paediatric Orthopaedic ◽  
Gmfcs Level

Purpose The purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method. Methods The panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached. Results Consensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade. Conclusion This study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP. Level of evidence V

scholarly journals Tarsal–carpal coalition syndrome: importance of early diagnosis

2019 ◽  
Vol 12 (6) ◽  
pp. e229391
Author(s):  
Gloria Tze Yan Lau ◽  
Gayatri Athalye-Jape ◽  
Natasha Amery
Keyword(s):  
Quality Of Life ◽  
Early Diagnosis ◽  
Range Of Motion ◽  
Carpal Bones ◽  
Flexion Deformity ◽  
Carpal Coalition ◽  
Fixed Flexion Deformity

Tarsal–carpal coalition syndrome is a progressive condition involving synostosis of the wrist, ankle and digits. We describe a mother and her newborn that have this rare inherited condition where the diagnosis was made only after the baby’s birth. The baby’s condition was suspected on antenatal scanning, and he was born with reduced range of motion of his digits, elbows and ankles. The mother’s condition has progressed to involve a fixed flexion deformity of her bilateral elbows, synostoses of her second to fifth digits and extensive coalition of her tarsal and carpal bones. She has required regular osteotomies to improve limb functioning and quality of life.

scholarly journals Management of repository corticotrophin injection therapy for pulmonary sarcoidosis: a Delphi study

2020 ◽  
Vol 29 (155) ◽  
pp. 190147 ◽  
Author(s):  
Franck F. Rahaghi ◽  
Nadera J. Sweiss ◽  
Lesley Ann Saketkoo ◽  
Mary Beth Scholand ◽  
Joseph B. Barney ◽  
...  
Keyword(s):  
Adverse Events ◽  
Delphi Study ◽  
Severe Disease ◽  
Pulmonary Sarcoidosis ◽  
Event Management ◽  
Delphi Consensus ◽  
Consensus Recommendations ◽  
Modified Delphi ◽  
Immunosuppressive Medications ◽  
Starting Dose

In patients treated with repository corticotrophin injection (RCI) for pulmonary sarcoidosis, effective management of adverse events may improve adherence. However, management of adverse events may be challenging due to limitations in real-world clinical experience with RCI and available published guidelines.We surveyed 12 physicians with a modified Delphi process using three questionnaires. Questionnaire 1 consisted of open-ended questions. Panellists' answers were developed into a series of statements for Questionnaires 2 and 3. In these, physicians rated their agreement with the statements using a Likert scale.Key consensus recommendations included a starting dose of 40 units twice a week for patients with less severe disease, continued at a maintenance dose for patients who responded, particularly those with chronic refractory sarcoidosis. Panellists reached consensus that concomitant steroids should be quickly tapered in patients receiving RCI, but that concomitant use of immunosuppressive medications should be continued. Panellists developed consensus recommendations for adverse event management, and reached consensus that RCI should be down-titrated or discontinued if other interventions for the adverse effects fail or if the adverse effect is severe.In the absence of clinical evidence, our Delphi consensus opinions may provide practical guidance to physicians on the management of RCI to treat pulmonary sarcoidosis.

scholarly journals Developing a Preliminary Definition and Domains of Flare in Knee and Hip Osteoarthritis (OA): Consensus Building of the Flare-in-OA OMERACT Group

2019 ◽  
Vol 46 (9) ◽  
pp. 1188-1191 ◽  
Author(s):  
Francis Guillemin ◽  
Camille Ricatte ◽  
Annica Barcenilla-Wong ◽  
Amandine Schoumacker ◽  
Marita Cross ◽  
...  
Keyword(s):  
Content Analysis ◽  
Focus Group ◽  
Health Professionals ◽  
Hip Osteoarthritis ◽  
Consensus Building ◽  
Delphi Consensus ◽  
Focus Group Interviews ◽  
Link Type ◽  
Group Interviews ◽  
Definition Of

Flare in knee and hip osteoarthritis (OA) is more than just an exacerbation of pain. Unstructured, semistructured, and focus group interviews followed by Delphi surveys with patients and health professionals (HP) generated candidate domains of an OA flare. Content analysis of interviews with 29 patients and 16 HP extracted 180 statements, which were grouped into 9 clusters. Delphi consensus with 50 patients (Australia, Canada, and France) and 116 HP (17 countries on 4 continents) identified 5 flare domains: pain, swelling, stiffness, psychological aspects, and effect of symptoms. Elements for a preliminary definition of an OA flare are proposed. Registered at clinicaltrials.govNCT02892058.

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