scholarly journals Improving Risk Assessment for Transporting Dangerous Goods through European Road Tunnels: A Delphi Study

Systems ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 80
Author(s):  
Marianna Kalogeraki ◽  
Fani Antoniou

Managing the transportation of dangerous goods (DG) through road tunnels is of great importance since it is associated with a serious risk of accidents. The consequences of an accident involving DG, especially in the closed tunnel environment, might be more significant and even more catastrophic compared to the same accident occurring on an open road. This article presents the Greek experience regarding the application of quantitative risk assessment (QRA) methods for the transportation of DG through Greek road tunnels. The modified Delphi method, with the participation of nine experts, is employed to investigate the obstacles to successfully conforming with the mandatory European Union regulatory framework that applies to transport operations within the Trans-European road network. Recommendations are made to improve the applied QRA approach, to facilitate the cooperation between tunnel managers and emergency services, to communicate lessons learned and to enhance the training of risk assessors.

2021 ◽  
pp. 219256822110126
Author(s):  
Yong Hai ◽  
Jingwei Liu ◽  
Yuzeng Liu ◽  
Tie Liu ◽  
Xinuo Zhang ◽  
...  

Study Design: Modified Delphi study. Objective: The objective of this study was to establish expert consensus on the application of lateral lumbar interbody fusion (LLIF) by using the modified Delphi study. Methods: From June 2019 to March 2020, Members of the Chinese Study Group for Lateral Lumbar Spine Surgery were selected to collect expert feedback using the modified Delphi method where 65 spine surgeons from all over China agreed to participate. Four rounds were performed: 1 face-to-face meeting and 3 subsequent survey rounds. The consensus was achieved with ≥a 70.0% agreement for each question. The recommendation of grade A was defined as ≥90.0% of the agreement for each question. The recommendation of grade B was defined as 80.0-89.9% of the agreement for each question. The recommendation of grade C was defined as 70.0-79.9% of the agreement for each question. Results: A total of 65 experts formed a panelist group, and the number of questionnaires collected was 63, 59, and 62 in the 3 rounds. In total, 5 sections, 71 questions, and 382 items achieved consensus after the Delphi rounds including summary; preoperative evaluation; application at the lumbar spinal stenosis, lumbar disc herniation, lumbar spondylolisthesis, adult degenerative scoliosis, postoperative adjacent segmental degeneration, and revision surgery; complications; and postoperative follow-up evaluation of LLIF. Conclusion: The modified Delphi method was utilized to ascertain an expert consensus from the Chinese Study Group for Lateral Lumbar Spine Surgery to inform clinical decision-making in the application of LLIF. The salient grade A recommendations of the survey are enumerated.


Risk Analysis ◽  
2010 ◽  
Vol 31 (3) ◽  
pp. 382-403 ◽  
Author(s):  
Qiang Meng ◽  
Xiaobo Qu ◽  
Xinchang Wang ◽  
Vivi Yuanita ◽  
Siew Chee Wong

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Qianqian Guo ◽  
Qianjun Chen

Objective. The aim of this study was to establish the standardization of syndrome differentiation of operative breast cancer treated with Traditional Chinese Medicine (TCM) by the modified Delphi method.Method. A literature search for standardization of syndrome differentiation of operative breast cancer was conducted and eligible articles were identified in indexed databases from 1982 to 2013. We carried out two rounds of investigation between March and October 2013 and organized 20 experts who focused on TCM or integrative medicine in breast cancer research. Experts’ judgments were collectedviaposted questionnaires or e-mail. A final evaluation was carried out after the end of both rounds.Result. The response ratio of the 1st round investigation reached 100%, and two experts were excluded due to the uncompleted questionnaire. The 2nd round investigation was completed by 18 experts in the 1st round panel board. In both rounds, the experts agreed that the stage of breast cancer defined by TCM could be divided into the perioperation period, the perichemotherapy period, the periradiotherapy period, and the consolidation period.Conclusion. We identified the feasibility and reasonability to establish the standardization of syndrome differentiation of operative breast cancer. According to the suggestions from experts in our Delphi study, we preliminarily established the TCM standard of syndrome differentiation based on different treatment stages of operative breast cancer.


2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch

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.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S87-S88
Author(s):  
Bongyoung Kim ◽  
Young Kyung Yoon ◽  
Dong-Sook Kim ◽  
Su Jin Jeong ◽  
Song Vogue ahn ◽  
...  

Abstract Background In 2019, the project about developing a system for measure and benchmark antibiotic usage in each hospital was launched. As the basic work for the project, we developed ‘antibiotic classification for measuring antibiotic usage in Korean hospitals’ using a modified Delphi method. Consensual definition of antibiotic components according to the antibiotic classification in Korean hospitals. Methods The study consisted of two series of modified Delphi studies and was performed from July to August 2019. The study ‘antibiotic classification in Korean hospitals’ was performed first and followed by the study ‘antibiotic components according to the antibiotic classification in Korean hospitals’. Each Delphi study included two rounds of surveys in order to gather opinions and refine the information related to each study. We recruited a total of 12 panels including infectious diseases physicians (10), professor of preventive medicine (1), and the researcher of Health Insurance Review & Assessment Service (1). The questions for the Round 1 survey in each study were adopted from the antibiotic classification of the NHSN. Results As for the first study, the response rate of each round was 58.3% (7/12) and 75.0% (9/12), respectively. Most of the subjects of the NHSN’s antibiotic classification for adults were accepted except ‘antibacterial agents posing the highest risk for Clostridioides difficile infection’ (CVR = -1.000). On the contrary, all subjects for children were rejected. Finally, a total of 6 classifications were accepted. They were i) broad-spectrum antibacterial agents predominantly for hospital-onset infections, for adult (CVR = 1.000), ii) broad-spectrum antibacterial agents predominantly used for community-acquired infections, for adult (CVR = 1.000), iii) antibacterial agents predominantly used for resistant gram-positive infections, for adult (CVR =1.000), iv) narrow-spectrum beta-lactam agents, for adult (CVR = 1.000), v) antibacterial agents predominantly used for extensive antibiotic resistant gram-negative bacteria, for adult (CVR = 1.000), and vi) total antibacterial agent (CVR = 1.000). Conclusion this study provides antibiotic classification for measuring antibiotic usage in Korean hospitals. This classification may guide to develop a system for measuring of antibiotic usage in each Korean hospital. Disclosures All Authors: No reported disclosures


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