Consensus-Derived Quality Performance Indicators for Neuroendocrine Tumour Care

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.

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Consensus-based recommendations for the management of juvenile dermatomyositis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-209247 ◽

2016 ◽

Vol 76 (2) ◽

pp. 329-340 ◽

Cited By ~ 83

Author(s):

Felicitas Bellutti Enders ◽

Brigitte Bader-Meunier ◽

Eileen Baildam ◽

Tamas Constantin ◽

Pavla Dolezalova ◽

...

Keyword(s):

Rheumatic Diseases ◽

Online Survey ◽

Juvenile Dermatomyositis ◽

Exercise Physiology ◽

Nominal Group Technique ◽

Standard Of Care ◽

Diagnosis And Treatment ◽

Nominal Group ◽

Consensus Process ◽

Treatment Pathways

BackgroundIn 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile dermatomyositis (JDM) is a rare disease within the group of paediatric rheumatic diseases (PRDs) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment regimens differ throughout Europe.ObjectivesTo provide recommendations for diagnosis and treatment of JDM.MethodsRecommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of 19 experienced paediatric rheumatologists and 2 experts in paediatric exercise physiology and physical therapy, mainly from Europe. Recommendations derived from a validated systematic literature review were evaluated by an online survey and subsequently discussed at two consensus meetings using nominal group technique. Recommendations were accepted if >80% agreement was reached.ResultsIn total, 7 overarching principles, 33 recommendations on diagnosis and 19 recommendations on therapy were accepted with >80% agreement among experts. Topics covered include assessment of skin, muscle and major organ involvement and suggested treatment pathways.ConclusionsThe SHARE initiative aims to identify best practices for treatment of patients suffering from PRD. Within this remit, recommendations for the diagnosis and treatment of JDM have been formulated by an evidence-informed consensus process to produce a standard of care for patients with JDM throughout Europe.

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Consensus-based recommendations for the management of juvenile localised scleroderma

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2018-214697 ◽

2019 ◽

Vol 78 (8) ◽

pp. 1019-1024 ◽

Cited By ~ 20

Author(s):

Francesco Zulian ◽

Roberta Culpo ◽

Francesca Sperotto ◽

Jordi Anton ◽

Tadej Avcin ◽

...

Keyword(s):

Rheumatic Diseases ◽

Online Survey ◽

Nominal Group Technique ◽

Standard Of Care ◽

Access Point ◽

Nominal Group ◽

Consensus Process ◽

Treatment Pathways ◽

Assessment And Treatment ◽

Paediatric Rheumatic Diseases

In 2012, a European initiative called Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile localised scleroderma (JLS) is a rare disease within the group of paediatric rheumatic diseases (PRD) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians’ experience. This study aims to provide recommendations for assessment and treatment of JLS. Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was formed, mainly from Europe, and consisted of 15 experienced paediatric rheumatologists and two young fellows. Recommendations derived from a validated systematic literature review were evaluated by an online survey and subsequently discussed at two consensus meetings using a nominal group technique. Recommendations were accepted if ≥80% agreement was reached. In total, 1 overarching principle, 10 recommendations on assessment and 6 recommendations on therapy were accepted with ≥80% agreement among experts. Topics covered include assessment of skin and extracutaneous involvement and suggested treatment pathways. The SHARE initiative aims to identify best practices for treatment of patients suffering from PRDs. Within this remit, recommendations for the assessment and treatment of JLS have been formulated by an evidence-informed consensus process to produce a standard of care for patients with JLS throughout Europe.

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Photograph Based Evaluation of Consumer Expectation on Healthiness, Fullness, and Acceptance of Sandwiches as Convenience Food

Foods ◽

10.3390/foods10051102 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1102

Author(s):

Purificación García-Segovia ◽

Mª Jesús Pagán-Moreno ◽

Amparo Tárrega ◽

Javier Martínez-Monzó

Keyword(s):

Interaction Effect ◽

Online Survey ◽

Age Groups ◽

Nominal Group Technique ◽

Nominal Group ◽

Visual Appearance ◽

Consumer Expectation ◽

Preference Mapping ◽

Consumer Experiences ◽

And Cluster Analysis

Sandwiches are the most common “casual-food” consumed by all age groups in Spain. Due to the importance of visual appearance to promote unplanned or impulse buying, foodservice and hospitality companies focus on improving the visual impression of their food menus to create an expectation that satisfies both sensory and hedonic consumer experiences. To provide a list of attributes about the visual appearance of sandwiches, 25 students were recruited from a university and were invited to participate in two nominal group technique (NGT) sessions. To understand whether a sandwiches’ appearance can influence the expectation of consumers, 259 participants completed an online survey specially designed from the results of the NGT sessions. Data were analyzed using conjoint, internal preference mapping and cluster analysis; the interaction effect by gender was also studied. The conjoint results indicate that visual perception about the filling (vegetal or pork based) plays the most key role overall in consumer expectation. When consumers choose vegetables as the filling, the consumers’ perceived sandwiches as healthier, but the pork filling was perceived as more attractive and satiating. Interaction effect by gender was observed in filling when females perceived pork filling as less healthy than vegetable. By acceptance, consumers were segmented into three groups. The first cluster (n = 80) selected the pork filling. The smaller group (cluster 3, n = 36) prioritized the vegetal filling, and the most numerous cluster 2 (n = 140) liked sandwiches with multigrain bread. These results may help companies to build tailor-made marketing strategies to satisfy consumer segments.

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Abstract 12173: Out-of-Hospital Cardiac Arrest and Community First Response: Identifying Data Collection and Analysis Priorities via the Nominal Group Technique

Circulation ◽

10.1161/circ.144.suppl_2.12173 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Eithne Heffernan ◽

Dylan Keegan ◽

Jenny Mc Sharry ◽

Tomas Barry ◽

Andrew Murphy ◽

...

Keyword(s):

Cardiac Arrest ◽

Data Collection ◽

Online Survey ◽

Nominal Group Technique ◽

Nominal Group ◽

First Response ◽

Key Stakeholders ◽

Virtual Meeting ◽

Hospital Cardiac Arrest ◽

Group Technique

Introduction: Community First Response (CFR) is an important intervention for out-of-hospital cardiac arrest (OHCA) in many countries. CFR entails the mobilization of volunteers by the Emergency Medical Services (EMS) to respond to OHCAs in their vicinity. These volunteers include lay-people and professionals (e.g. physicians, fire-fighters). CFR can increase rates of cardiopulmonary resuscitation (CPR) or defibrillation performed prior to EMS arrival. However, its impact on additional outcomes (e.g. survival, cognitive function) requires further study. This research aimed to identify the most important CFR data to collect and analyze, as well as the most important uses of CFR data. Methods: This study used the Nominal Group Technique: a structured consensus process where key stakeholders develop a set of prioritized recommendations. There were 16 participants, including CFR volunteers, an OHCA survivor, researchers, clinicians, EMS personnel, and policy-makers. They completed an online survey to generate lists of the most important (1) CFR data to collect and analyze and (2) uses of CFR data. They then attended a virtual meeting where they discussed the survey results in groups before voting for their top ten priorities from each list. They also identified barriers to CFR data collection. Results: The top ten CFR data to collect and analyze included volunteer response time, interventions performed by volunteers, time of emergency, time of CPR initiation, individuals who performed CPR, and the mental and physical effects of being a volunteer. The top ten uses of CFR data included providing feedback to volunteers, increasing bystander participation in resuscitation, improving volunteer training, measuring CFR effectiveness, and encouraging inter-operability with the EMS. Barriers to data collection included time constraints, prioritization of patient care, and limited training. Conclusions: This study established priorities for the collection, analysis, and use of CFR data in consultation with key stakeholders. These findings have important implications for both CFR research and practice. In particular, they can be used to improve the efficiency, consistency, and utility of CFR data collection and to build evidence for this intervention.

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Recommendations for services for people living with chronic breathlessness in advanced disease: Results of a transparent expert consultation

Chronic Respiratory Disease ◽

10.1177/1479973118816448 ◽

2018 ◽

Vol 16 ◽

pp. 147997311881644 ◽

Cited By ~ 4

Author(s):

Lisa Jane Brighton ◽

India Tunnard ◽

Morag Farquhar ◽

Sara Booth ◽

Sophie Miller ◽

...

Keyword(s):

Online Survey ◽

Advanced Disease ◽

Nominal Group Technique ◽

Models Of Care ◽

Nominal Group ◽

Future Research ◽

Expert Consultation ◽

Management Interventions ◽

Stakeholder Workshop ◽

Informal Carers

Chronic breathlessness is highly distressing for people with advanced disease and their informal carers, yet health services for this group remain highly heterogeneous. We aimed to generate evidence-based stakeholder-endorsed recommendations for practice, policy and research concerning services for people with advanced disease and chronic breathlessness. We used transparent expert consultation, comprising modified nominal group technique during a stakeholder workshop, and an online consensus survey. Stakeholders, representing multiple specialities and professions, and patient/carers were invited to participate. Thirty-seven participants attended the stakeholder workshop and generated 34 separate recommendations, rated by 74 online survey respondents. Seven recommendations had strong agreement and high levels of consensus. Stakeholders agreed services should be person-centred and flexible, should cut across multiple disciplines and providers and should prioritize breathlessness management in its own right. They advocated for wide geographical coverage and access to expert care, supported through skills-sharing among professionals. They also recommended recognition of informal carers and their role by clinicians and policymakers. Overall, stakeholders' recommendations reflect the need for improved access to person-centred, multi-professional care and support for carers to provide or access breathlessness management interventions. Future research should test the optimal models of care and educational strategies to meet these recommendations.

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Recommendations for the Management of Uveitis Associated with Juvenile Idiopathic Arthritis: The Czech and Slovak Adaptation of the Share Initiative

Czech and Slovak Ophthalmology ◽

10.31348/2020/7 ◽

2020 ◽

Vol 76 (4) ◽

pp. 182-196

Author(s):

Hana Malcová

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Rheumatic Diseases ◽

Online Survey ◽

Health Care Systems ◽

Treatment Algorithm ◽

Nominal Group Technique ◽

Access Point ◽

Diagnosis And Treatment ◽

Nominal Group ◽

Original Text

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is its most important extra-articular manifestation. Evidence-based recommendations are available only to a limited extent and therefore JIA associated uveitis management is mostly based on physicians’ experience. Consequently, treatment practices differ widely, both nationally and internationally. Therefore, an effort to optimize and publish recommendations for the care of children and young adults with rheumatic diseases was launched in 2012 as part of the international project SHARE (Single Hub and Access Point for Pediatric Rheumatology in Europe) to facilitate clinical practice for paediatricians and (paediatric) rheumatologists. The aim of this work was to translate published international SHARE recommendations for the diagnosis and treatment of JIA associated uveitis and to adapt them for use in the Czech and Slovak Republics. International recommendations were developed according to the standard methodology of the European League against Rheumatism (EULAR) by a group of nine experienced paediatric rheumatologists and three experts in ophthalmology. It was based on a systematic literature review and evaluated in the form of an online survey and subsequently discussed using a nominal group technique. Recommendations were accepted if > 80% agreement was reached (including all three ophthalmologists). A total of 22 SHARE recommendations were accepted: 3 on diagnosis, 5 on disease activity assessment, 12 on treatment and 2 on future recommendations. Translation of the original text was updated and modified with data specific to the czech and slovak health care systems and supplemented with a proposal for a protocol of ophthalmological dispensarization of paediatric JIA patients and a treatment algorithm for JIA associated uveitis. Conclusion: The aim of the SHARE initiative is to improve and standardize care for paediatric patients with rheumatic diseases across Europe. Therefore, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated based on the evidence and agreement of leading European experts in this field.

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Development of performance indicators for systems of urgent and emergency care in the Republic of Ireland. Update of a systematic review and consensus development exercise

HRB Open Research ◽

10.12688/hrbopenres.12805.2 ◽

2019 ◽

Vol 1 ◽

pp. 6 ◽

Cited By ~ 1

Author(s):

Siobhan Boyle ◽

Rebecca Dennehy ◽

Orla Healy ◽

John Browne

Keyword(s):

Systematic Review ◽

Emergency Care ◽

Performance Indicators ◽

Online Survey ◽

Urgent Care ◽

Nominal Group ◽

Consensus Development ◽

Republic Of Ireland ◽

Care Systems ◽

The Republic

Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland. Design: This study comprised of an update of a previously performed systematic review and a formal consensus development exercise. The literature search was conducted in PubMed and covered the period 2008 to 2014. The results of the review were used to inform a consensus group of 17 national experts on urgent and emergency care in Ireland. The consensus development exercise comprised an online survey followed by a face-to-face nominal group technique meeting. During this meeting participants had the opportunity to revise their preferences for different indicators after listening to the views of other group members. A final online survey was then used to confirm the preferences of participants. Results: Initial literature searches yielded 2339 article titles. After further searches, sixty items were identified for full-text review. Following this review, fifty-seven were excluded. Three articles were identified for inclusion in the systematic review. These papers produced 42 unique indicators for consideration during the consensus development exercise. In total, 17 indicators had a median of greater than 7 following the meeting and met our pre-specified criterion for acceptable consensus. Discussion: Using this systematic review and nominal group consensus development exercise, we have identified a set of 17 indicators, which a consensus of different experts regard as potentially good measures of the performance of urgent and emergency care systems in Ireland. Pragmatic implications are discussed with reference to three subsequently performed original studies which used some of the indicators

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Core competencies in neurocritical care training in China: consensus developed by a national Delphi consensus survey combined with nominal group technique

BMJ Open ◽

10.1136/bmjopen-2019-033441 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033441

Author(s):

Zhen Cui ◽

Liang Gao ◽

Qi Bing Huang ◽

Li Hong Li ◽

Bing Hui Qiu ◽

...

Keyword(s):

Critical Care ◽

Online Survey ◽

Neurocritical Care ◽

Neurological Diseases ◽

Core Competencies ◽

Legal Aspects ◽

Nominal Group ◽

Specialist Training ◽

Delphi Consensus ◽

Care Training

ObjectivesTo define the core competencies essential for specialist training in neurocritical care in China.DesignModified Delphi method and nominal group (NG) technique.SettingNational.ParticipantsA total of 1094 respondents from 33 provinces in China participated in the online survey. A NG of 11 members was organised by the Neuro-Critical Care Committee affiliated with the Chinese Association of Critical Care Physicians and the National Center for Healthcare Quality Management in Neurological Diseases.Results1094 respondents from 33 provinces in China participated in the online survey. A formal list containing 329 statements was generated for the rating by a NG. After five rounds of NG meetings and one round of comments and iterative review, 198 core competencies (54 on neurological diseases, 64 on general medical diseases, 42 on monitoring of practical procedures, 20 on professionalism and system management, five on ethical and legal aspects, three on the principles of research and certification and 10 on scoring systems) formed the final list.ConclusionBy using consensus techniques, we have developed a list of core competencies for neurocritical care training, which may serve as a reference for future specialist training programmes in China.

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Preferred Reporting Items for Overviews of Reviews (PRIOR): a protocol for development of a reporting guideline for overviews of reviews of healthcare interventions

Systematic Reviews ◽

10.1186/s13643-019-1252-9 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

Michelle Pollock ◽

Ricardo M. Fernandes ◽

Dawid Pieper ◽

Andrea C. Tricco ◽

Michelle Gates ◽

...

Keyword(s):

Online Survey ◽

Nominal Group Technique ◽

Reporting Guideline ◽

Reporting Guidelines ◽

Nominal Group ◽

Modified Delphi ◽

Relevant Evidence ◽

Delphi Exercise ◽

Healthcare Interventions ◽

High Level

Abstract Background Overviews of reviews (i.e., overviews) compile information from multiple systematic reviews to provide a single synthesis of relevant evidence for healthcare decision-making. Despite their increasing popularity, there are currently no systematically developed reporting guidelines for overviews. This is problematic because the reporting of published overviews varies considerably and is often substandard. Our objective is to use explicit, systematic, and transparent methods to develop an evidence-based and agreement-based reporting guideline for overviews of reviews of healthcare interventions (PRIOR, Preferred Reporting Items for Overviews of Reviews). Methods We will develop the PRIOR reporting guideline in four stages, using established methods for developing reporting guidelines in health research. First, we will establish an international and multidisciplinary expert advisory board that will oversee the conduct of the project and provide methodological support. Second, we will use the results of comprehensive literature reviews to develop a list of prospective checklist items for the reporting guideline. Third, we will use a modified Delphi exercise to achieve a high level of expert agreement on the list of items to be included in the PRIOR reporting guideline. We will identify and recruit a group of up to 100 international experts who will provide input into the guideline in three Delphi rounds: the first two rounds will occur via online survey, and the third round will occur during a smaller (8 to 10 participants) in-person meeting that will use a nominal group technique. Fourth, we will produce and publish the PRIOR reporting guideline. Discussion A systematically developed reporting guideline for overviews could help to improve the accuracy, completeness, and transparency of overviews. This, in turn, could help maximize the value and impact of overviews by allowing more efficient interpretation and use of their research findings.

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

Folia Medica ◽

10.1515/folmed-2015-0031 ◽

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.

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