scholarly journals Definitions and Concepts on Keratoconus and Ectatic Corneal Diseases: Panamerican Delphi Consensus — A Pilot for the Global Consensus on Ectasias

2014 ◽  
Vol 3 (3) ◽  
pp. 99-106 ◽  
Author(s):  
Victor L Perez ◽  
Juan Carlos Abad ◽  
José Alvaro P Gomes
Keyword(s):  
Latin American ◽  
Front Surface ◽  
Delphi Panel ◽  
Delphi Consensus ◽  
Web Based ◽  
Global Consensus ◽  
Delphi Approach ◽  
Disease Staging ◽  
Question Survey

ABSTRACT Purpose To establish consensus on definitions and concepts of keratoconus and ectatic corneal diseases by using Delphi approach. Materials and methods Seventeen Latin American experts on keratoconus and ectatic corneal diseases participated in a 3-round Delphi panel approach. A web-based 12 question survey was answered by panelists in two rounds, followed by life discussion meeting. A two-third majority strategy was defined as a consensus. Results Corneal ectatic diseases were defined as progressive thinning conditions without acute stromal inflammation, and were classified as keratoconus, pellucid marginal degeneration (PMD), keratoglobus, and ectasia after trauma or surgery. The pattern of thinning was considered the main aspect for the classification of ectatic diseases, but criteria for staging the disease needs to be improved. Corneal tomography with 3D reconstruction, distinguished from Placido-disk based front surface topography was elected as the diagnostic procedure currently capable of detecting the earliest clinical ectatic changes. Biomechanical alterations were considered to be the first event for ectasia development. Eye rubbing was directly related to the development and progression of ectasia. Inflammation was considered as a possible event on the physiopathology. Keratoconus was considered as a bilateral disease, with often asymmetric presentation, while ectasia may occur unilaterally if there is significant corneal insult, leading to biomechanical failure. No consensus was achieved for the definitions on forme fruste keratoconus (FFKC). Conclusion Consensus was achieved on definitions of corneal ectatic diseases. Disease staging, including criteria for FFKC or subclinical ectasia remains controversial. A larger consensus including experts from different groups around the world is needed. How to cite this article Ambrósio RJr, Belin MW, Perez VL, Abad JC, Gomes JAP. Definitions and Concepts on Keratoconus and Ectatic Corneal Diseases: Panamerican Delphi Consensus — A Pilot for the Global Consensus on Ectasias. Int J Kerat Ect Cor Dis 2014;3(3):99-106.

scholarly journals BoNT-A for Post-Stroke Spasticity: Guidance on Unmet Clinical Needs from a Delphi Panel Approach

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 236
Author(s):  
Alessio Baricich ◽  
Theodore Wein ◽  
Nicoletta Cinone ◽  
Michele Bertoni ◽  
Alessandro Picelli ◽  
...  
Keyword(s):  
Unmet Needs ◽  
Daily Practice ◽  
Delphi Process ◽  
Delphi Panel ◽  
Extensive Literature ◽  
Delphi Consensus ◽  
Patient Centered ◽  
Web Based ◽  
Post Stroke

There is extensive literature supporting the efficacy of botulinum toxin (BoNT-A) for the treatment of post-stroke spasticity, however, there remain gaps in the routine management of patients with post-stroke spasticity. A panel of 21 Italian experts was selected to participate in this web-based survey Delphi process to provide guidance that can support clinicians in the decision-making process. There was a broad consensus among physicians that BoNT-A intervention should be administered as soon as the spasticity interferes with the patients’ clinical condition. Patients monitoring is needed over time, a follow-up of 4–6 weeks is considered necessary. Furthermore, physicians agreed that treatment should be offered irrespective of the duration of the spasticity. The Delphi consensus also stressed the importance of patient-centered goals in order to satisfy the clinical needs of the patient regardless of time of onset or duration of spasticity. The findings arising from this Delphi process provide insights into the unmet needs in managing post-stroke spasticity from the clinician’s perspective and provides guidance for physicians for the utilization of BoNT-A for the treatment of post-stroke spasticity in daily practice.

scholarly journals Place in therapy of innovative drugs in multiple myeloma in 2021 and 2023 according to an expert panel Delphi consensus

2021 ◽  
Vol 8 ◽  
pp. 80-86
Author(s):  
Mario Boccadoro ◽  
Patrizia Berto ◽  
Sara Bringhen ◽  
Elena Zamagni ◽  
Patrizia Tosi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Expert Panel ◽  
New Drugs ◽  
Delphi Panel ◽  
Delphi Consensus ◽  
Web Based ◽  
Combination Treatments ◽  
Italian Market ◽  
New Diagnosis ◽  
Innovative Drugs

Introduction: The objective of this study was to understand the potential use of single agents and drug combinations in multiple myeloma (MM) across treatment lines in the years 2021 and 2023. Methods: The method used was Delphi Panel Method survey, administered to European Myeloma Network (EMN) Italy Working Group centres. Future treatments were identified assessing all available web-based information sources, including therapies (single drugs or combinations) with strong evidence of efficacy, likely to be on the Italian market in 2021 and 2023. Participants were asked to report on the likelihood of prescription for MM therapies, across treatment lines. Results: Across the 15 centres taking part in the survey, about 890 patients per year are forecasted to receive a new diagnosis of MM. In 2021, the Panel forecasted 66% of 1L-TE (transplant eligible) patients will be treated with bortezomib-thalidomide-dexamethasone (VTD) and 32% of patients with daratumumab-bortezomib-thalidomide-dexamethasone (DVTd), with a substantial decrease of VTD (15%) and a marked increase of DVTd (81%) forecasted for 2023. The 2L and 3L R(lenalidomide)-based combination treatments are expected to drop and will likely be substituted by a steep increase in P(pomalidomide)-based regimes (from 7% to 23%). On the contrary, in 3L treatment, all combination therapies (with the exception of IsaPd – isatuximab-pomalidomide-dexamethasone) are expected to lose market share in favour of the most recent new therapies. Conclusions: Expert Panel agrees that many different new drugs and combinations will be used in MM, with different mechanisms of action, both at diagnosis and in subsequent phases of the disease, with a corresponding decline of the drugs currently used.

A Novel Thyroid Ultrasound Proficiency Metric Designed Through a Multidisciplinary Delphi Approach

2021 ◽  
pp. 000313482110111
Author(s):  
Yinin Hu ◽  
Alex D. Michaels ◽  
Rachita Khot ◽  
Worthington G. Schenk ◽  
John B. Hanks ◽  
...  
Keyword(s):  
Learning Curves ◽  
Delphi Panel ◽  
Thyroid Ultrasound ◽  
Point Scale ◽  
Image Capture ◽  
Delphi Approach ◽  
Inflection Points ◽  
Operative Planning ◽  
Positioning Technique ◽  
Formally Trained

Background Thyroid ultrasounds extend surgeons’ outpatient capabilities and are essential for operative planning. However, most residents are not formally trained in thyroid ultrasound. The purpose of this study was to create a novel thyroid ultrasound proficiency metric through a collaborative Delphi approach. Methods Clinical faculty experienced in thyroid ultrasound participated on a Delphi panel to design the thyroid Ultrasound Proficiency Scale (UPS-Thyroid). Participants proposed items under the categories of Positioning, Technique, Image Capture, Measurement, and Interpretation. In subsequent rounds, participants voted to retain, revise, or exclude each item. The process continued until all items had greater than 70% consensus for retention. The UPS-Thyroid was pilot tested across 5 surgery residents with moderate ultrasound experience. Learning curves were assessed with cumulative sum. Results Three surgeons and 4 radiologists participated on the Delphi panel. Following 3 iterative Delphi rounds, the panel arrived at >70% consensus to retain 14 items without further revisions or additions. The metric included the following items on a 3-point scale for a maximum of 42 points: Positioning (1 item), Technique (4 items), Image Capture (2 items), Measurement (2 items), and Interpretation (5 items). A pilot group of 5 residents was scored against a proficiency threshold of 36 points. Learning curve inflection points were noted at between 4 to 7 repetitions. Conclusions A multidisciplinary Delphi approach generated consensus for a thyroid ultrasound proficiency metric (UPS-Thyroid). Among surgery residents with moderate ultrasound experience, basic proficiency at thyroid ultrasound is feasible within 10 repetitions.

Interest on the internet for systemic lupus erythematosus: Analysis of Google Trends in Latin American countries

Lupus ◽  
2021 ◽  
pp. 096120332110103
Author(s):  
Paul J Tejada-Llacsa ◽  
Pamela Villacorta-Landeo ◽  
Eder Aguilar-Buitrón ◽  
Graciela S Alarcón ◽  
Manuel F Ugarte-Gil
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Latin American ◽  
Lupus Erythematosus ◽  
Google Trends ◽  
The Internet ◽  
Systemic Lupus ◽  
Web Based ◽  
Pan American ◽  
Health Institutions ◽  
Latin American Countries

Background/Objective Information available on the internet about Systemic Lupus Erythematosus (SLE) can influence the doctor-patient relationship. Therefore, the aim of this study was to identify the terms used for SLE on the internet. Methods We analyzed the data downloaded from Google Trends, considering the term “Lupus” in a six-year web-based research. The frequency of the terms for each Pan-American country was obtained automatically from Google Trends, which reports relative search volumes or RSV (on a scale from 0 to 100) across regions. Results We obtained a total of 67 registered terms in 18 countries. The terms were distributed into five categories. The categories with interest in all countries were “definition” and “symptoms”. Conclusions Google Trends allows us to find useful information about SLE on the internet; once the accuracy of this information is validated, it can be used by patients, health institutions, rheumatologists and other health professionals.

Surgical treatment of brainstem cavernous malformations: an international Delphi consensus

2021 ◽  
pp. 1-11
Author(s):  
Philipp Dammann ◽  
Adib A. Abla ◽  
Rustam Al-Shahi Salman ◽  
Hugo Andrade-Barazarte ◽  
Vladimir Benes ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Treatment Decision ◽  
Clinical Situation ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Cavernous Malformations ◽  
Clinical Scenarios ◽  
Developmental Venous Anomalies ◽  
Question Survey

OBJECTIVE Indication for surgery in brainstem cavernous malformations (BSCMs) is based on many case series, few comparative studies, and no randomized controlled trials. The objective of this study was to seek consensus about surgical management aspects of BSCM. METHODS A total of 29 experts were invited to participate in a multistep Delphi consensus process on the surgical treatment of BSCM. RESULTS Twenty-two (76%) of 29 experts participated in the consensus. Qualitative analysis (content analysis) of an initial open-ended question survey resulted in 99 statements regarding surgical treatment of BSCM. By using a multistep survey with 100% participation in each round, consensus was reached on 52 (53%) of 99 statements. These were grouped into 4 categories: 1) definitions and reporting standards (7/14, 50%); 2) general and patient-related aspects (11/16, 69%); 3) anatomical-, timing of surgery–, and BSCM-related aspects (22/37, 59%); and 4) clinical situation–based decision-making (12/32, 38%). Among other things, a consensus was reached for surgical timing, handling of associated developmental venous anomalies, handling of postoperative BSCM remnants, assessment of specific anatomical BSCM localizations, and treatment decisions in typical clinical BSCM scenarios. CONCLUSIONS A summary of typical clinical scenarios and a catalog of various BSCM- and patient-related aspects that influence the surgical treatment decision have been defined, rated, and interpreted.

Current practice in treating chronic venous disease by Canadian vascular surgeons

2018 ◽  
Vol 34 (6) ◽  
pp. 414-420
Author(s):  
Gary K Yang ◽  
Jerry C Chen
Keyword(s):  
Full Range ◽  
Perceived Barriers ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Compression Stockings ◽  
Web Based ◽  
Endovenous Ablation ◽  
Training Background ◽  
Current Guidelines ◽  
Question Survey

Objective To evaluate the practice patterns and interests of vascular surgeons in Canada in the treatment of chronic venous disorder. Methods A web-based 19-question survey was sent to 155 active members of the Canadian Society for Vascular Surgery. Questions assessed training background, interest in venous disease, practice site, venous treatments offered, and obstacles to therapy. Results A total of 64 responses (41%) were acquired. Respondents were roughly equal from academic (55%) and community (45%) sites with an even distribution of years in practice. Only 43% offered full range of therapy, which includes compression stockings, sclerotherapy, vein surgery, and endovenous ablation. The main challenges hindering venous practice include lack of time due to overwhelming arterial pathologies (67%), equipment cost/office space limitations (53%), and lack of knowledge or skills in contemporary procedures (28%). The majority of surgeons felt that their residency and fellowship did not prepare them for an active venous practice (69%). Fifty-four percent of the respondents perceived barriers in getting venous ultrasound imaging for their patients. Only 19% of the surgeons find venous disease interesting. Characteristics of these interested surgeons were analyzed and found to be very different from surgeons who did not expressed interest. An overwhelming 92% of all respondents believe that vascular surgeons should be leaders in delivering care for venous disease. Conclusion The treatment of chronic venous disorder has advanced over the last few decades but significant obstacles exist for Canadian surgeons to deliver venous therapy in accordance with current guidelines.

scholarly journals Diagnosis, treatment, and follow-up of heart failure patients by general practitioners: A Delphi consensus statement

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244485
Author(s):  
Caroline Verhestraeten ◽  
Gijs Weijers ◽  
Daphne Debleu ◽  
Agnieszka Ciarka ◽  
Marc Goethals ◽  
...  
Keyword(s):  
Heart Failure ◽  
General Practitioner ◽  
General Practitioners ◽  
Early Stage ◽  
Blood Analysis ◽  
Care Process ◽  
Delphi Panel ◽  
Delphi Consensus ◽  
Heart Failure Patients

Aims Creation of an algorithm that includes the most important parameters (history, clinical parameters, and anamnesis) that can be linked to heart failure, helping general practitioners in recognizing heart failure in an early stage and in a better follow-up of the patients. Methods and results The algorithm was created using a consensus-based Delphi panel technique with fifteen general practitioners and seven cardiologists from Belgium. The method comprises three iterations with general statements on diagnosis, referral and treatment, and follow-up. Consensus was obtained for the majority of statements related to diagnosis, referral, and follow-up, whereas a lack of consensus was seen for treatment statements. Based on the statements with good and perfect consensus, an algorithm for general practitioners was assembled, helping them in diagnoses and follow-up of heart failure patients. The diagnosis should be based on three essential pillars, i.e. medical history, anamnesis and clinical examination. In case of suspected heart failure, blood analysis, including the measurement of NT-proBNP levels, can already be performed by the general practitioner followed by referral to the cardiologist who is then responsible for proper diagnosis and initiation of treatment. Afterwards, a multidisciplinary health care process between the cardiologist and the general practitioner is crucial with an important role for the general practitioner who has a key role in the up-titration of heart failure medication, down-titration of the dose of diuretics and to assure drug compliance. Conclusions Based on the consensus levels of statements in a Delphi panel setting, an algorithm is created to help general practitioners in the diagnosis and follow-up of heart failure patients.

scholarly journals Fostering the employability of business studies graduates

2015 ◽  
Author(s):  
Shairn Hollis-Turner
Keyword(s):  
Higher Education ◽  
Qualitative Data ◽  
Business Administration ◽  
Learning Opportunities ◽  
Delphi Panel ◽  
Corporate Sector ◽  
Business Studies ◽  
Delphi Approach ◽  
Workplace Experience ◽  
Work Integrated Learning

Higher education is under pressure to enhance the employability of graduates by ensuring that they acquire competencies that make them employable in the labour market. This research project investigated the contribution of higher education towards the employability of graduates within a business diploma programme. A Delphi approach was employed with the Delphi panel consisting of three types of professionals – employers within the corporate sector, academics in the field of business studies, and graduates with workplace experience in the corporate sector. Both quantitative and qualitative data were obtained from three rounds of surveys. The findings show that disciplinary knowledge of Information Administration, Business Administration, Communication and Personnel Management, and the simulation of workplace practices as well as work-integrated learning opportunities are significant to enhancing the employability of office administrators and office managers. These findings provided academics with the opportunity to make improvements to the curriculum to foster the employability of the graduates.

scholarly journals A web-based, branching logic questionnaire for the automated classification of migraine

2018 ◽  
Author(s):  
Eric A. Kaiser ◽  
Aleksandra Igdalova ◽  
Geoffrey K. Aguirre ◽  
Brett Cucchiara
Keyword(s):  
Migraine Without Aura ◽  
Large Scale ◽  
Automated Analysis ◽  
Automated Classification ◽  
Online Questionnaire ◽  
Demographic Differences ◽  
Web Based ◽  
Online Evaluation ◽  
Automated Algorithm

AbstractObjectiveTo identify migraineurs and headache-free individuals with an online questionnaire and automated analysis algorithm.MethodsWe created a branching-logic, web-based questionnaire—the Penn Online Evaluation of Migraine (POEM)—to obtain standardized headache history from a previously studied cohort. Responses were analyzed with an automated algorithm to assign subjects to one of several categories based on ICHD-3 (beta) criteria. Following a pre-registered protocol, this result was compared to prior diagnostic classification by a neurologist following a direct interview.ResultsOf 118 subjects contacted, 90 (76%) completed the questionnaire; of these 31 were headache-free, 29 migraine without aura (MwoA), and 30 migraine with aura (MwA). Mean age was 41 ± 6 years and 76% were female. There were no significant demographic differences between groups. The median time to complete the questionnaire was 2.5 minutes. Sensitivity of the POEM tool was 42%, 59%, and 70%, and specificity was 100%, 84%, and 94% for headache-free, MwoA, and MwA, respectively. Sensitivity and specificity of the POEM tool for migraine overall (with or without aura), was 83% and 90%, respectively.ConclusionsThe POEM web-based questionnaire, and associated analysis routines, identifies headache-free and migraine subjects with good specificity. It may be useful for classifying subjects for large-scale research studies.Trial Registration:https://osf.io/sq9ef

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