scholarly journals Expert consensus on the minimum clinical standards of practice for Nigerian physiotherapists working in intensive care units: A modified Delphi study

2021 ◽  
Vol 27 (3) ◽  
pp. 86
Author(s):  
I Idris ◽  
A W Awotidebe ◽  
N B Mukhtar ◽  
R N Ativie ◽  
J M Nuhu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Delphi Study ◽  
Expert Consensus ◽  
Clinical Standards ◽  
Modified Delphi ◽  
Standards Of Practice

scholarly journals Expert Consensus on Clinical Application of Lateral Lumbar Interbody Fusion: Results From a Modified Delphi Study

2021 ◽  
pp. 219256822110126
Author(s):  
Yong Hai ◽  
Jingwei Liu ◽  
Yuzeng Liu ◽  
Tie Liu ◽  
Xinuo Zhang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Delphi Method ◽  
Delphi Study ◽  
Interbody Fusion ◽  
Expert Consensus ◽  
Lumbar Spine Surgery ◽  
Study Group ◽  
Lumbar Interbody Fusion ◽  
Modified Delphi ◽  
Chinese Study

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.

scholarly journals Determining electrocardiography training priorities for medical students using a modified Delphi method

2020 ◽  
Author(s):  
Charle Andre Viljoen ◽  
Rob Scott Millar ◽  
Kathryn Manning ◽  
Vanessa Celeste Burch
Keyword(s):  
Medical Students ◽  
Delphi Method ◽  
Delphi Study ◽  
Delphi Technique ◽  
Expert Panel ◽  
Expert Consensus ◽  
Modified Delphi ◽  
Wide Range ◽  
Life Threatening ◽  
Curriculum Specialists

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.

Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group

2021 ◽  
Vol 23 (2) ◽  
pp. 194-201
Author(s):  
Sainath *Raman ◽  
◽  
Georgia *Brown ◽  
*Equal first authors ◽  
Debbie Long ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Intensive Care ◽  
New Zealand ◽  
Delphi Study ◽  
Face To Face ◽  
Modified Delphi ◽  
Research Questions ◽  
Paediatric Critical Care

OBJECTIVE: Most interventions in paediatric critical care lack high grade evidence. We aimed to identify the key research priorities and key clinical outcome measures pertinent to research in paediatric intensive care patients. DESIGN: Modified three-stage Delphi study combining staged online surveys, followed by a face-to-face discussion and final voting. SETTING: Paediatric intensive care units in Australia and New Zealand. PARTICIPANTS: Medical and nursing staff working in intensive care. MAIN OUTCOME MEASUREMENTS: Self-reported priorities for research. RESULTS: 193 respondents provided a total of 267 research questions and 234 outcomes. In Stage 3, the top 56 research questions and 50 outcomes were discussed face to face, which allowed the identification of the top 20 research questions with the Hanlon prioritisation score and the top 20 outcomes. Topics centred on the use of intravenous fluids (restrictive v liberal fluids, use of fluid resuscitation bolus, early inotrope use, type of intravenous fluid, and assessment of fluid responsiveness), and patient- and family-centred outcomes (health-related quality of life, liberation) emerged as priorities. While mortality, length of stay, and organ support/organ dysfunction were considered important and the most feasible outcomes, long term quality of life and neurodevelopmental measures were rated highly in terms of their importance. CONCLUSIONS: Using a modified Delphi method, this study provides guidance towards prioritisation of research topics in paediatric critical care in Australia and New Zealand, and identifies study outcomes of key relevance to clinicians and experts in the field.

scholarly journals A Delphi study to identify prehospital and emergency department trauma care modifiers for older adults

2021 ◽  
Vol 64 (3) ◽  
pp. E339-E345
Author(s):  
Krishan Yadav ◽  
Valérie Boucher ◽  
Natalie Le Sage ◽  
Christian Malo ◽  
Éric Mercier ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Trauma Care ◽  
Delphi Study ◽  
Older Patients ◽  
Major Trauma ◽  
Trauma Centre ◽  
Expert Consensus ◽  
Consensus Methods ◽  
Modified Delphi

Background: Older patients (age ≥ 65 yr) with trauma have increased morbidity and mortality compared to younger patients; this is partly explained by undertriage of older patients with trauma, resulting in lack of transfer to a trauma centre or failure to activate the trauma team. The objective of this study was to identify modifiers to the prehospital and emergency department phases of major trauma care for older adults based on expert consensus. Methods: We conducted a modified Delphi study between May and September 2019 to identify major trauma care modifiers for older adults based on national expert consensus. The panel consisted of 24 trauma care professionals from across Canada from the prehospital and emergency department phases of care. The survey consisted of 16 trauma care modifiers. Three online survey rounds were distributed. Consensus was defined a priori as a disagreement index score less than 1. Results: There was a 100% response rate for all survey rounds. Three new trauma care modifiers were suggested by panellists. The panel achieved consensus agreement for 17 of the 19 trauma care modifiers. The prehospital modifier with the strongest agreement to transfer to a trauma centre was a respiratory rate less than 10 or greater than 20 breaths/min or need for ventilatory support. The emergency department modifier with the strongest level of agreement was obtaining 12-lead electrocardiography following the primary and secondary survey. Conclusion: Using a modified Delphi process, an expert panel agreed on 17 trauma care modifiers for older adults in the prehospital and emergency department settings. These modifiers may improve the delivery of trauma care for older adults and should be considered when developing local and national trauma guidelines.

scholarly journals Clinically Relevant Interactions with Anti-Infectives on Intensive Care Units—A Multicenter Delphi Study

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1330
Author(s):  
Joachim Andreas Koeck ◽  
Heike Hilgarth ◽  
Andreas von Ameln-Mayerhofer ◽  
Damaris Meyn ◽  
Ruediger Warlich ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Delphi Study ◽  
Patient Management ◽  
Expert Panel ◽  
National Database ◽  
Point Scale ◽  
The Individual ◽  
German Icus ◽  
Infective Agent

Patients in intensive care units (ICUs) are at high risk of drug–drug interactions (DDIs) due to polypharmacy. Little is known about type and frequency of DDIs within German ICUs. Clinical pharmacists’ interventions (PI) recorded in a national database (ADKA-DokuPIK) were filtered for ICU patients. Binary DDIs involving ≥1 anti-infective agent with >1 database entry were selected. A modified two-step Delphi process with a group of senior hospital pharmacists was employed to evaluate selected DDIs for clinical relevance by using a five-point scale and to develop guidance for clinical practice. In total, 16,173 PI were recorded, including 1836 (11%) DDIs in the ICU setting. Of the latter, 41% (756/1836) included ≥1 anti-infective agent, 32% (590/1836) were binary DDIs, and 25% (455/1836) were listed at least twice. This translates into 88 different DDIs, 74% (65/88) of which were rated as being clinically relevant by our expert panel. The majority of DDIs (76% [67/88]) included macrolides, antifungals, or fluoroquinolones. This percentage was even higher in DDIs being rated as clinically relevant by the experts (85% [55/65]). It is noted that an inter-professional discussion and approach is needed in the individual patient management of DDIs. The guidance developed might be a tool for decision support.

scholarly journals Safety, efficacy and delivery of isometric resistance training as an adjunct therapy for blood pressure control: a modified Delphi study

2022 ◽  
Author(s):  
Biggie Baffour-Awuah ◽  
Melissa J. Pearson ◽  
Neil A. Smart ◽  
Gudrun Dieberg
Keyword(s):  
Blood Pressure ◽  
Resistance Training ◽  
Delphi Study ◽  
Consensus Meeting ◽  
Expert Consensus ◽  
Uncontrolled Hypertension ◽  
Delphi Panel ◽  
Modified Delphi ◽  
Study Team ◽  
Final Item

AbstractUncontrolled hypertension remains the major risk factor for cardiovascular disease. Isometric resistance training (IRT) has been shown to be a useful nonpharmacological therapy for reducing blood pressure (BP); however, some exercise physiologists and other health professionals are uncertain of the efficacy and safety of IRT. Experts’ consensus was sought in light of the current variability of IRT use as an adjunct treatment for hypertension. An expert consensus-building analysis (Delphi study) was conducted on items relevant to the safety, efficacy and delivery of IRT. The study consisted of 3 phases: (1) identification of items and expert participants for inclusion; (2) a two-round modified Delphi exercise involving expert panelists to build consensus; and (3) a study team consensus meeting for a final item review. A list of 50 items was generated, and 42 international experts were invited to join the Delphi panel. Thirteen and 10 experts completed Delphi Rounds 1 and 2, respectively, reaching consensus on 26 items in Round 1 and 10 items in Round 2. The study team consensus meeting conducted a final item review and considered the remaining 14 items for the content list. A final list of 43 items regarding IRT reached expert consensus: 7/10 items on safety, 11/11 items on efficacy, 10/12 items on programming, 8/10 items on delivery, and 7/7 on the mechanism of action. This study highlights that while experts reached a consensus that IRT is efficacious as an antihypertensive therapy, some still have safety concerns, and there is also ongoing conjecture regarding optimal delivery.

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