scholarly journals Cross-Cultural Validation of the Definition of Multimorbidity in the Bulgarian Language / Культуральная Валидность Определения Полиморбидности В Болгарском Языке

Folia Medica ◽  
2015 ◽  
Vol 57 (2) ◽  
pp. 127-132
Author(s):  
Radost S. Assenova ◽  
Jean Yves Le Reste ◽  
Gergana H. Foreva ◽  
Daniela S. Mileva ◽  
Slawomir Czachowski ◽  
...  
Keyword(s):  
Nominal Group Technique ◽  
Nominal Group ◽  
Multiple Chronic Conditions ◽  
Ageing Population ◽  
Delphi Consensus ◽  
Policy Makers ◽  
Ethnographic Approach ◽  
High Prevalence ◽  
Consensus Procedure ◽  
Definition Of

Abstract INTRODUCTION: Multimorbidity is a health issue with growing importance. During the last few decades the populations of most countries in the world have been ageing rapidly. Bulgaria is affected by the issue because of the high prevalence of ageing population in the country with multiple chronic conditions. The AIM of the present study was to validate the translated definition of multimorbidity from English into the Bulgarian language. MATERIALS AND METHODS: The present study is part of an international project involving 8 national groups. We performed a forward and backward translation of the original English definition of multimorbidity using a Delphi consensus procedure. RESULTS: The physicians involved accepted the definition with a high percentage of agreement in the first round. The backward translation was accepted by the scientific committee using the Nominal group technique. DISCUSSION: Some of the GPs provided comments on the linguistic expressions which arose in order to improve understanding in Bulgarian. The remarks were not relevant to the content. The conclusion of the discussion, using a meta-ethnographic approach, was that the differences were acceptable and no further changes were required. CONCLUSIONS: A native version of the published English multimorbidity definition has been finalized. This definition is a prerequisite for better management of multimorbidity by clinicians, researchers and policy makers.

scholarly journals Prioritization Of Research Under National Aids Control Programme In India Using Nominal Group Technique

1970 ◽  
Vol 8 (1) ◽  
pp. 20-30
Author(s):  
R Sogarwal ◽  
D Bachani
Keyword(s):  
Nominal Group Technique ◽  
Research Priorities ◽  
Control Programme ◽  
Pediatric Hiv ◽  
Nominal Group ◽  
Phase Iii ◽  
Hiv Care ◽  
Policy Makers ◽  
Research Questions ◽  
Group Technique

Introduction: During the fi rst 2 years of the fi ve year plan of India’s National AIDS Control Programme Phase-III (NACP-III; 2007-12), various interactive consultative workshops were organized in collaboration with development partners with the objective of identifying priority areas for operational research and further development of research protocols adopting mentorship approach. Methodology: This article is an attempt to present the Nominal Group Technique (NGT) which was used to identify a set of fundable and practically feasible research priorities under NACP-III specifi cally focusing on Prevention of Parent to Child Transmission (PPTCT) and Pediatric HIV Care in India. The activity was undertaken with support of UNICEF in the year 2010. A total of 110 persons participated in the consultation clustering into 37, 36 and 37 members in Group A, B and C, respectively. The participants refl ected the mix of policy makers / decision makers (8), programme managers (12), implementers (36), subject experts / researchers (28), other stakeholders (16). Results: A total of nine highest priority research questions were identifi ed by all the groups in the assigned themes. The value of Kendall’s W coeffi cient of concordance was 0.68, which shows signifi cant agreement among raters on priority research questions (chi-square=16.35; p=0.03). Conclusion: Based on our experience, we can conclude that NGT was found to be an important tool for setting research priorities that is more democratic and transparent than the traditional methods. By applying various stages of the group sessions, participants can experience the rethinking process with reference information to enhance their judgment. The results of our experience may help programme managers / policy makers to plan similar and more improved method in other element of NACP as well as other health programmes. DOI: http://dx.doi.org/10.3126/saarctb.v8i1.5888 SAARCTB 2011; 8(1): 20-30

scholarly journals Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach

Rheumatology ◽  
2020 ◽  
Author(s):  
Seza Özen ◽  
Erdal Sag ◽  
Eldad Ben-Chetrit ◽  
Marco Gattorno ◽  
Ahmet Gül ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Nominal Group ◽  
Evidence Based ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Health Authorities ◽  
Colchicine Resistance ◽  
Mediterranean Fever ◽  
Definition Of ◽  
The Impact

Abstract Objectives Colchicine is the main treatment for familial Mediterranean fever (FMF). Although a number of individuals with FMF are intolerant/resistant to colchicine, there is no standard definition of colchicine resistance/intolerance. We developed a set of evidence-based core statements defining colchicine resistance/intolerance in patients with FMF that may serve as a guide for clinicians and health authorities. Methods A set of statements was identified using a modified-Delphi consensus-based approach. The process involved development of an initial colchicine resistance/intolerance-related questionnaire derived from a systematic literature review. The questionnaire, which was completed by an international panel of 11 adult and pediatric rheumatologists with expertise in FMF, was analysed anonymously. The results informed draft consensus statements that were discussed by a round-table expert panel, using a nominal group technique to agree on the selection and wording of the final statements. Results Consensus among the panel was achieved on 8 core statements defining colchicine resistance/intolerance in patients with FMF. A definition of resistance was agreed upon that included recurrent clinical attacks (average one or more attacks per month over a 3-month period), or persistent laboratory inflammation in between attacks. Other core statements recognize the importance of assessing treatment adherence, and the impact of active disease and intolerance to colchicine on quality of life. Conclusion Based on expert opinion, a set of evidence-based core statements defining colchicine resistance/intolerance in patients with FMF were identified to help guide clinicians and health authorities in the management of patients with FMF.

Development of Simple Clinical Criteria for the Definition of Inflammatory Arthritis, Enthesitis, Dactylitis, and Spondylitis: A Report from the GRAPPA 2014 Annual Meeting

2015 ◽  
Vol 42 (6) ◽  
pp. 1041-1043 ◽  
Author(s):  
Philip J. Mease ◽  
Jane J. Park ◽  
Amit Garg ◽  
Dafna D. Gladman ◽  
Philip S. Helliwell
Keyword(s):  
Psoriatic Arthritis ◽  
Physical Examination ◽  
Inflammatory Arthritis ◽  
Nominal Group Technique ◽  
Musculoskeletal Disease ◽  
Nominal Group ◽  
Clinical Criteria ◽  
Expert Clinician ◽  
Primary Care Clinicians ◽  
Definition Of

Rheumatologists are trained to determine the presence of musculoskeletal inflammation through history, physical examination, and if needed, laboratory tests and imaging. However, primary care clinicians, dermatologists, surgeons, and others who may initially see patients with musculoskeletal pain are not necessarily able to make the distinction between inflammatory (e.g., rheumatoid arthritis or psoriatic arthritis) and noninflammatory disease (osteoarthritis, traumatic or degenerative tendonitis, back pain, or fibromyalgia). If such clinicians could more readily suspect and identify possible inflammatory musculoskeletal disease, it would lead to more timely diagnosis and triage to rheumatologists for diagnosis and appropriate management. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has been developing evidence-based, practical and reliable criteria that can be used by clinicians to identify inflammatory musculoskeletal disease. The research initiative involves a sequential process of expert clinician nominal group technique, patient focus groups, and Delphi exercises to identify core definitive features of inflammatory disease. The goal is to develop simple clinical criteria (history and physical examination elements) to identify inflammatory arthritis, enthesitis, dactylitis, and spondylitis and distinguish these from degenerative, mechanical, or other forms of these conditions, to achieve more timely and accurate diagnosis and referral of patients with inflammatory arthritis.

Development of Simple Clinical Criteria for the Definition of Inflammatory Arthritis, Enthesitis, Dactylitis, and Spondylitis: A Report from the GRAPPA 2012 Annual Meeting

2013 ◽  
Vol 40 (8) ◽  
pp. 1442-1445 ◽  
Author(s):  
Philip J. Mease ◽  
Amit Garg ◽  
Dafna D. Gladman ◽  
Philip S. Helliwell
Keyword(s):  
Psoriatic Arthritis ◽  
Annual Meeting ◽  
Inflammatory Disease ◽  
Inflammatory Arthritis ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Clinical Criteria ◽  
Expert Clinician ◽  
Primary Care Clinicians ◽  
Definition Of

Dermatologist and primary care clinicians are in an ideal position to identify the emergence of psoriatic arthritis (PsA) in patients with psoriasis. Yet these clinicians are not well trained to distinguish inflammatory musculoskeletal disease from other more common problems such as osteoarthritis, traumatic or degenerative tendonitis and back pain, or fibromyalgia. A simple set of clinical criteria to identify inflammatory disease would aid recognition of PsA. At its 2012 annual meeting, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) discussed development of evidence-based, practical, and reliable definitions of inflammatory arthritis, enthesitis, dactylitis, and spondylitis. This project will be a sequential process of expert clinician nominal-group technique, patient surveys and focus groups, and Delphi exercises to identify core features of inflammatory disease, testing these in a small group of patients with and without inflammatory disease, and finally validating these criteria in larger groups of patients.

scholarly journals Consensus-Derived Quality Performance Indicators for Neuroendocrine Tumour Care

2019 ◽  
Vol 8 (9) ◽  
pp. 1455
Author(s):  
Woodhouse ◽  
Pattison ◽  
Segelov ◽  
Singh ◽  
Parker ◽  
...  
Keyword(s):  
Performance Indicators ◽  
Online Survey ◽  
Neuroendocrine Tumour ◽  
Nominal Group Technique ◽  
Neuroendocrine Cells ◽  
Nominal Group ◽  
Pathology Report ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Quality Performance

Quality performance indicators (QPIs) are used to monitor the delivery of cancer care. Neuroendocrine tumours (NETs) are a family of individually uncommon cancers that derive from neuroendocrine cells or their precursors, and can occur in most organs. There are currently no QPIs available for NETs and their heterogeneity makes QPI development difficult. CommNETs is a collaboration between NET clinicians, researchers and advocates in Canada, Australia and New Zealand. We created QPIs for NETs using a three-step consensus process. First, a multidisciplinary team used the nominal group technique to create candidates (n = 133) which were then curated into appropriateness statements (62 statements, 44 sub-statements). A two-stage modified RAND/UCLA Delphi consensus process was conducted: an online survey rated the statement appropriateness then the top-ranked statements (n = 20) were assessed in a face-to-face meeting. Finally, 10 QPIs met consensus criteria; documentation of primary site, proliferative index, differentiation, tumour board review, use of a structured pathology report, presence of distant metastasis, 5- and 10-year disease-free and overall survival. These NET QPIs will be trialed as a method to monitor and improve care for people with NETs and to facilitate international comparison.

scholarly journals THE ECONOMY OF THE BELGIAN REGIONS TESTED WITH MULTIMOORA

2010 ◽  
Vol 11 (2) ◽  
pp. 173-209 ◽  
Author(s):  
Willem Karel M. Brauers ◽  
Romualdas Ginevičius
Keyword(s):  
Delphi Method ◽  
Nominal Group Technique ◽  
Optimization Method ◽  
Nominal Group ◽  
Ratio Analysis ◽  
Common Language ◽  
Multi Objective Optimization ◽  
Multi Objective ◽  
Starting Point ◽  
Definition Of

The definition of robustness in econometrics, the error term in a linear equation, was not only broadened, but in addition moved to the meaning of common language: from a cardinal to a qualitative one. At that moment the most robust Multi‐Objective Optimization Method has to fulfill seven essential conditions. In addition, considering all stakeholders involved, the choice of the objectives is non‐subjective with the assistance of the Ameliorated Nominal Group Technique and the Delphi method. Outside Normalization is not necessary by the use of a Full Multiplicative Form or of MOORA (Multi‐Objective Optimization by Ratio Analysis). This last one is composed of ratio analysis “senso stricto” and of the Reference Point Method with the previously obtained ratios as a starting point. Combining the three methods in MULTIMOORA a full guarantee for robustness in Multiple Objectives Optimization is offered. This interpretation is tested by an application to the Economy of the Belgian Regions. Santrauka Stiprumo apibrežimas ekonometrijoje, klaidos terminas linijineje lygtyje buvo ne tik išplestas, jo reikš‐me buvo perkelta i paprasta kalba, t. y. nuo kiekybines iki kokybines reikšmes. Šiuo metu stipriausi daugiatiksliai optimizavimo metodai turi atitikti septynias pagrindines salygas. Be to, turint omenyje visas suinteresuotas grupes, tikslu pasirinkimas yra objektyvus taikant patobulinta nominaliu grupiu ir Delphi metodus. Normalizavimas privalo būti taip pat objektyvus, tai imanoma padaryti naudojant dauginamaja MOORA (daugiatikslis optimizavimas remiantis santykio analize) metodo forma. Ji su‐sideda iš santykio analizes "senso strigto” ir atskaitos taško metodo su anksčiau gautu santykiu kaip pradžios tašku. Taigi sujungus tris metodus, kaip stiprumo garantas buvo pasiūlytas MULTIMOORA. Šis metodas yra išbandytas tiriant Belgijos regionu ekonomika.

scholarly journals Stakeholder engagement in economic evaluation: Protocol for using the nominal group technique to elicit patient, healthcare provider, and health system stakeholder input in the development of an early economic evaluation model of chimeric antigen receptor T-cell therapy

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046707
Author(s):  
Mackenzie Wilson ◽  
Kednapa Thavorn ◽  
Terry Hawrysh ◽  
Ian D Graham ◽  
Harold Atkins ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Stakeholder Engagement ◽  
Evaluation Model ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Economic Evaluations ◽  
Policy Makers ◽  
Car T ◽  
Economic Evaluation Model ◽  
Insight Into

IntroductionChimeric antigen receptor T-cell (CAR-T) therapy is a class of immunotherapy. An economic evaluation conducted at an early stage of development of CAR-T therapy for treatment of adult relapsed or refractory acute lymphoblastic leukaemia could provide insight into factors contributing to the cost of treatment, the potential clinical benefits, and what the health system can afford. Traditionally, stakeholders are engaged in certain parts of health technology assessment processes, such as in the identification and selection of technologies, formulation of recommendations, and implementation of recommendations; however, little is known about processes for stakeholder engagement during the conduct of the assessment. This is especially the case for economic evaluations. Stakeholders, such as clinicians, policy-makers, patients, and their support networks, have insight into factors that can enhance the validity of an economic evaluation model. This research outlines a specific methodology for stakeholder engagement and represents an avenue to enhance health economic evaluations and support the use of these models to inform decision making for resource allocation. This protocol may inform a tailored framework for stakeholder engagement processes in future economic evaluation model development.Methods and analysisWe will involve clinicians, healthcare researchers, payers, and policy-makers, as well as patients and their support networks in the conduct and verification of an early economic evaluation of a novel health technology to incorporate stakeholder-generated knowledge. Three stakeholder-specific focus groups will be conducted using an online adaptation of the nominal group technique to elicit considerations from each. This study will use CAR-T therapy for adults with relapsed or refractory B-cell acute lymphoblastic leukaemia as a basis for investigating broader stakeholder engagement processes.Ethics and disseminationThis study received ethics approval from the Ottawa Hospital Research Institute Research Ethics Board (REB 20200320-01HT) and the results will be shared via conference presentations, peer-reviewed publications, and ongoing stakeholder engagement.

scholarly journals Where Do We Start? Building Consensus on Drivers of Health Sector Corruption in Nigeria and Ways to Address It

2019 ◽  
Author(s):  
Obinna Onwujekwe ◽  
Charles T. Orjiakor ◽  
Eleanor Hutchinson ◽  
Martin McKee ◽  
Prince Agwu ◽  
...  
Keyword(s):  
Literature Review ◽  
Health System ◽  
Health Workers ◽  
Health Sector ◽  
Nominal Group Technique ◽  
Health Financing ◽  
Nominal Group ◽  
Consensus Building ◽  
Policy Makers ◽  
Frontline Workers

Background: Corruption is widespread in Nigeria’s health sector but the reasons why it exists and persists are poorly understood and it is often seen as intractable. We describe a consensus building exercise in which we asked health workers and policy-makers to identify and prioritise feasible responses to corruption in the Nigerian health sector. Methods: We employed three sequential activities. First, a narrative literature review identified which types of corruption are reported in the Nigerian health system. Second, we asked 21 frontline health workers to add to what was found in the review (based on their own experiences) and prioritise them, based on their significance and the feasibility of assessing them, by means of a consensus building exercise using a Nominal Group Technique (NGT). Third, we presented their assessments in a meeting of 25 policy-makers to offer their views on the practicality of implementing appropriate measures. Results: Participants identified 49 corrupt practices from the literature review and their own experience as most important in the Nigerian health system. The NGT prioritised: absenteeism, procurement-related corruption, underthe-counter payments, health financing-related corruption, and employment-related corruption. This largely reflected findings from the literature review, except for the greater emphasis on employment-related corruption from the NGT. Absenteeism, Informal payments and employment-related corruption were seen as most feasible to tackle. Frontline workers and policy-makers agreed that tackling corrupt practices requires a range of approaches. Conclusion: Corruption is recognized in Nigeria as widespread but often seems insurmountable. We show how a structured approach can achieve consensus among multiple stakeholders, a crucial first step in mobilizing action to address corruption.

KEBIJAKAN POLITIK KERUKUNAN ANTARAGAMA DI INDONESIA ERA REFORMASI

2017 ◽  
Vol 9 (2) ◽  
pp. 407-424
Author(s):  
Jamaluddin Jamaluddin
Keyword(s):  
Transition Period ◽  
Religious Life ◽  
New Order ◽  
Reform Era ◽  
Policy Makers ◽  
Accommodation Space ◽  
Nation States ◽  
The Government ◽  
Definition Of ◽  
Cultural Reality

Indonesian reformation era begins with the fall of President Suharto. Political transition and democratic transition impact in the religious life. Therefore, understandably, when the politic transition is not yet fully reflects the idealized conditions. In addition to the old paradigm that is still attached to the brain of policy makers, various policies to mirror the complexity of stuttering ruler to answer the challenges of religious life. This challenge cannot be separated from the hegemonic legacy of the past, including the politicization of SARA. Hegemony that took place during the New Order period, adversely affected the subsequent transition period. It seems among other things, with airings various conflicts nuances SARA previously muted, forced repressive. SARA issues arise as a result of the narrowing of the accommodation space of the nation state during the New Order regime. The New Order regime has reduced the definition of nation-states is only part of a group of people loyal to the government to deny the diversity of socio-cultural reality in it. To handle the inheritance, every regime in the reform era responds with a pattern and a different approach. It must be realized, that the post-reform era, Indonesia has had four changes of government. The leaders of every regime in the reform era have a different background and thus also have a vision that is different in treating the problem of racial intolerance, particularly against religious aspect. This treatment causes the accomplishment difference each different regimes of dealing with the diversity of race, religion and class that has become the hallmark of Indonesian society.

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