SEARCH · PubMed Health

Results for “Delphi”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

PubMed2000

Comparison of mailed vs. Internet applications of the Delphi technique in clinical informatics research.

The Delphi technique provides a means of assessing the judgments of groups of experts without the necessity of having these experts meet together. The technique has been used in health care since the mid-1970s, and has just recently become more common in clinical informatics research. As informatics develops as a specialty, it is logical to consider information technology solutions to research as well as clinical practice problems. The overall purpose of this methodology presentation is to compare a mailed vs. Internet application of the Delphi technique for clinical informatics research. Specifically, this presentation will provide: 1) an overview of the Delphi technique, and 2) a methodological comparison of two research applications of the Delphi technique. Results of the studies will be presented elsewhere.

Computer Communication Networks↗

PubMed2000

An accessible analytical approach for investigating what happens between the rounds of a Delphi study.

The Delphi method is used to investigate consensus amongst a panel of experts using repeated rounds of a questionnaire, often in healthcare settings. However, many Delphi studies do not report any investigation into what happens to the stability of consensus or the convergence of agreement between the rounds in the study, which may be of importance. In this paper an accessible analytical approach is outlined using graphical presentations of means and standard deviations to identify what happens between rounds. For Delphi studies where the scale upon which experts are expressing their opinions can be considered to be interval, the mean will represent the group opinion whilst the standard deviation will represent the level of agreement. An example Delphi study from a healthcare setting is used to illustrate the methodology.

Attitude of Health Personnel↗

PubMed2003

[Personality diagnosis in elderly psychiatric patients using a Delphi technique].

A Delphi-technique was used as part of the development of a screening instrument to diagnose personality disorders in the elderly. Several statements regarding this subject were tested. Fifty-three Delphi-members, with expertise in the field of mental health services for the elderly and knowledge about the concept 'personality disorder', gave their opinion on the statements. In three successive rounds we aimed to get consensus as well as agreement on the contents of the statements. In the first round the Delphi-panel confirmed the importance of diagnosing personality disorders, with regard to individual therapy in older adults and psycho-educational activities. The DSM-IV Axis II criteria and related assessment-instruments do not take into account the emotional and social context of the elderly people. In the second round the Delphi-panel endorsed the importance of several information sources namely biographical information, informant information, behavioural observations and the reactions of the therapist himself. In the third round, 44 items considering diagnostics on personality were pro-pounded to the panel. There was agreement as well as consensus on 25 out of the 44 items. In conclusion, adjusting the DSM-IV Axis II criteria to the elderly will improve the quality of the diagnostics. Developments of a specific screening instrument for older adults probably will also increase the quality of the diagnostics.

Aged↗

PubMed2003

The setting of standards for agricultural nitrogen emissions: a case study of the Delphi technique.

The Delphi technique is a means of aggregating the judgement of a panel of experts in order to improve the quality of decision-making. This paper provides a case study of the technique by undertaking a three-round Delphi study to determine a package of best available techniques to reduce nitrogen emissions from a poultry unit under the Integrated Pollution Prevention and Control Directive (IPPC). Forms of nitrogen addressed included ammonia (NH3), nitrous oxide (N2O) nitrogen oxides (NOx), dusts and nitrate (NO3-), with the study providing a means to prioritise the pollution concerns on different spatial scales. The priority pollutant issues were the contribution of NH3 to eutrophication, the global cooling effect of NH4+ aerosol, the role of NH4+ as a vector for atmospheric transport of NOx and SO2, the contribution of N2O to global warming, and NO3- leaching. Reduced nitrogen (NHx) was rated as a priority on all scales, while N2O and NO3- were rated as priorities only on global and local scales, respectively. The study indicated the need for abatement techniques at each stage of poultry rearing and waste management, with particular attention to reduce NH3 emissions, reflecting the priority pollutant concerns. Measures identified by the panel include maintenance of dry litter, low emission removal of litter from housing and storage of litter under cover. Once the litter has left the farm, this should either be used as a biofuel for electricity generation or rapidly incorporated into agricultural soils. The amounts and timing of manure application should be tuned to crop needs. Uncertainties in the Delphi technique limit its suitability as a stand-alone decision making tool. However, the Delphi technique proved useful in identifying priority pollutant issues, areas of agreement, disagreement and where information is lacking. This demonstrates its use when dealing with the complex issues of prioritising pollution issues and abatement approaches.

Air Pollutants↗

PubMed2000

Establishing nursing research priorities on a paediatric haematology, oncology, immunology and infectious diseases unit: a Delphi survey.

For research to be successfully integrated and applied to practice, ownership and identification must come from those who are most likely to implement research into practice. This was one of the reasons for undertaking a Delphi survey to identify and rank the research priorities for clinical nursing research in a paediatric haematology, oncology, immunology and infectious diseases unit. The 'Nurses' Research Group' initiated the survey as a first step towards developing a strategy for evidence-based nursing. Four members of the research group volunteered to establish a working party to undertake the survey. This paper describes a four-round Delphi survey. The survey questionnaire was sent to all nursing staff on the unit. The initial process identified 151 research topics/themes. Through a process of refinement the priority list was reduced to 89. Repeat rounds were completed, culminating in the identification of four top priority areas of: symptom management, negotiation of care between the child and family, quality-of-life issues and retention of staff. The findings indicate directions for future clinical nursing research that will benefit specialist nurses, children and young people and their families. This paper provides a detailed account of the method, procedure and outcomes of the Delphi survey. The limitations of the Delphi survey method are also addressed and in this survey these included time (the length of time it took to complete the survey and time needed to complete each questionnaire), maintaining motivation of respondents, and the influence of researchers working in the research setting.

Journal Article↗

PubMed2005

Development and assessment of indicators of rheumatoid arthritis severity: results of a Delphi panel.

OBJECTIVE: To develop a set of indicators for assessing the severity of rheumatoid arthritis (RA) through medical records. METHODS: A list of 47 potential indicators of RA was reviewed by an expert Delphi panel of 6 rheumatologists. The Delphi method is a formal approach for gathering expert opinion. The 47 potential indicators included items from the following 5 categories: radiologic and laboratory findings, clinical and functional status measures, extraarticular manifestations, prior surgical history, and medications. The panelists rated the potential indicators' relationship to RA disease severity. Each panelist rated each indicator on a scale of 0-6, in which 0 indicated no relationship at all with severe RA and 6 indicated a perfect relationship with severe RA. After a baseline set of ratings, a literature review was distributed to the panelists along with the panel's initial mean ratings and the ranges. The panelists then met to discuss the literature and rerate all indicators. RESULTS: After repeat ratings and review of relevant literature, the panel rated 28 of 47 (60%) potential indicators as having a strong or very strong relationship to severe RA. These 28 indicators were drawn from all 5 categories of potential indicators. There was agreement among the panelists on ratings for 41 of 47 indicators. Agreement was defined as a range of scores among the panelists </=3. CONCLUSION: A Delphi panel of rheumatologists agreed that data generally available in medical records may serve as potential indicators of severe RA.

Antirheumatic Agents↗

PubMed2006

Defining the Bobath concept using the Delphi technique.

BACKGROUND AND PURPOSE: The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept. METHOD: A four-round Delphi study design was used. The sample included all members of the British Bobath Tutor's Association, who are considered experts in the field. Initial statements were identified from the literature, with respondents generating additional statements during the study. The level of agreement was determined using a five-point Likert scale. The respondents were then provided with feedback on group opinions and given an opportunity to re-rate each statement. The level of group consensus was set at 80%. RESULTS: Fifteen experts took part. The response rate was 85% in the first round, and 93% in each subsequent round. Ten statements from the literature were rated with a further 12 generated by the experts. Thirteen statements achieved consensus for agreement and seven for disagreement. CONCLUSIONS: The Delphi study was an effective research tool, maintaining anonymity of responses and exploring expert opinions on the Bobath concept. The experts stated that Bobath's work has been misunderstood if it is considered as the inhibition of spasticity and the facilitation of normal movement, as described in some literature. They agreed that the Bobath concept was developed by the Bobaths as a living concept, understanding that as therapists' knowledge base grows their view of treatment broadens.

Central Nervous System Diseases↗

PubMed1993

The Delphi technique: a comparison of results obtained using two expert panels.

The Delphi technique is a useful method of obtaining group consensus. However, "consensus" is not usually defined when this technique is used. This paper describes a study in which two panels of experts (registered nurses who were nurse managers or involved in management education) were asked to identify the competencies expected of first-line nurse managers using the Delphi technique. The results from both panels are compared. Prior to the commencement of the Delphi rounds a baseline mean of 3.00 ("agree" on the Likert scale used) was set for the inclusion of items. The level at which consensus was achieved was defined as the point at which 10% or less of the 168 competencies provided to the panel moved above or below this point of inclusion. A total of 156 of the 168 competencies (93%) presented to the two panels were either retained or rejected by both.

Delphi Technique↗

PubMed2005

Metadata-driven Delphi rating on the Internet.

Paper-based data collection and analysis for consensus development is inefficient and error-prone. Computerized techniques that could improve efficiency, however, have been criticized as costly, inconvenient and difficult to use. We designed and implemented a metadata-driven Web-based Delphi rating and analysis tool, employing the flexible entity-attribute-value schema to create generic, reusable software. The software can be applied to various domains by altering the metadata; the programming code remains intact. This approach greatly reduces the marginal cost of re-using the software. We implemented our software to prepare for the Conference on Guidelines Standardization. Twenty-three invited experts completed the first round of the Delphi rating on the Web. For each participant, the software generated individualized reports that described the median rating and the disagreement index (calculated from the Interpercentile Range Adjusted for Symmetry) as defined by the RAND/UCLA Appropriateness Method. We evaluated the software with a satisfaction survey using a five-level Likert scale. The panelists felt that Web data entry was convenient (median 4, interquartile range [IQR] 4.0-5.0), acceptable (median 4.5, IQR 4.0-5.0) and easily accessible (median 5, IQR 4.0-5.0). We conclude that Web-based Delphi rating for consensus development is a convenient and acceptable alternative to the traditional paper-based method.

Delphi Technique↗

PubMed2005

Subjective and objective descriptors of clinical lumbar spine instability: a Delphi study.

Accurate ability to diagnose lumbar spine clinical instability is controversial for numerous reasons, including inaccuracy and limitations in capabilities of radiographic findings, poor reliability and validity of clinical special tests, and poor correlation between spinal motion and severity of symptoms. It has been suggested that common subjective and objective identifiers are specific to lumbar spine clinical instability. The purpose of this study was to determine if consensual, specific identifiers for subjective and objective lumbar spine clinical instability exist as determined by a Delphi survey instrument. One hundred and sixty eight physical therapists identified as Orthopaedic Clinical Specialists (OCS) or Fellows of the American Academy of Orthopaedic Manual Physical Therapists participated in three Delphi rounds designed to select specific identifiers for lumbar spine clinical instability. Round I consisted of open-ended questions designed to provide any relevant issues. Round II allowed the participants to rank the organized findings of Round I. Round III provided an opportunity to rescore the ranked variables after viewing other participant's results. The results suggest that those identifiers selected by the Delphi experts are synonymous with those represented in related spine instability literature and may be beneficial for use during clinical differential diagnosis.

Adult↗

PubMed1997

Estimating the incidence of food-borne Salmonella and the effectiveness of alternative control measures using the Delphi method.

The paper describes the use of the Delphi method to estimate the incidence of food-borne Salmonella in the UK and the effectiveness of alternative control measures. A panel of experts of food-borne Salmonella participated in the Delphi survey, which involved five rounds of questioning taking place in the period July 1993 to January 1994. Participants were asked to give initial estimates for a number of parameters and invited to revise these estimates through progressive rounds of the survey at which the group responses were reported back. This process resulted in a reduction in the variation between the estimates given by individual experts. The final estimated annual incidence of food-borne Salmonella in the UK was 537,000, although significant variation remained between, individual estimates. The foods judged to be the most important modes of transmission were poultry and poultry products (50% of cases) and eggs and egg products (26% of cases). The panel was also requested to estimate the effectiveness of strategies available to reduce the incidence of food-borne Salmonella from all sources. The most effective methods were judged to be food irradiation and mandatory application of HACCP, although there were significant differences in the judged effectiveness of these technologies for individual respondents. The paper demonstrates the efficacy of the Delphi method as a mechanism for reconciling differences between expert judgements of the incidence of food-borne disease and the effectiveness of alternative control strategies.

Animals↗

PubMed2003

Delphi as a method to establish consensus for diagnostic criteria.

BACKGROUND/OBJECTIVES: To achieve a consensus, among a panel of experts, on the best clinical criteria for the clinical diagnosis of carpal tunnel syndrome (CTS). METHODS: Experts rated the diagnostic importance of items from the clinical history and physical examination for CTS. The ratings were expressed on a 10-cm visual analog scale. The average and standard deviation of the scores for each item were returned to the panelists. The panel members evaluated the items a second time with knowledge of the group responses from the first round. The scores were standardized to minimize scaling variations and, after the second round, the items were ranked in order of importance assigned by the group. Cronbach's alpha was used as a measure of homogeneity for the rankings. Increasing homogeneity was considered to be an indication of consensus among the panelists. RESULTS: Cronbach's alpha increased from 0.86 after the first round to 0.91 after the second iteration. Panelists who were relative outliers on the first round demonstrated a much higher correlation with the entire group after the second round. CONCLUSIONS: Delphi is an effective method of establishing consensus for certain clinical questions. Cronbach's alpha was a useful statistic for measuring the extent of consensus among the panel members. Delphi was chosen from the possible methods of group process because of its inherent feasibility. The absence of a need by the panelists to meet in person removed any constraint on the geographic location of the panel members. In addition, the anonymous nature of Delphi was thought to be a key factor in avoiding a result that might be skewed by one or more persuasive panelists. Both of these characteristics were felt to be particularly important to the topic on which consensus was sought, the clinical diagnostic criteria for CTS. This movement in the opinions of some of the panelists appeared to result from the feedback of information describing the group opinion.

Carpal Tunnel Syndrome↗

PubMedDate not supplied

Identifying HIV/AIDS research priorities for the next millennium: a Delphi study with nurses in AIDS care.

The purpose of this study was to identify HIV/AIDS research priorities for the next millennium from the perspective of nurses in AIDS care. The study used a three-round Delphi technique, with study participants (the panel of experts) selected from the membership of the Association of Nurses in AIDS Care. In the first round of the Delphi study, 317 nurses identified more than 2,000 topics they viewed as important for overall HIV/AIDS research and for HIV/AIDS nursing research. Using qualitative analysis, 12 priority topics were generated in the overall research category and 12 priority topics in the nursing research category. In Round II of the Delphi survey, study participants ranked the 12 topics in categories (overall and nursing research priorities) identified in Round I. Finally, in Round III, the top five priority topics from Round II were prioritized in each category. The overall HIV/AIDS research topics identified were (a) HIV community-level education and prevention; (b) development of more tolerable drugs; (c) HIV prevention focusing on individual or specific group behavior; (d) vaccine development; and (e) development of new and more effective drugs. The HIV/AIDS nursing research priorities identified were (a) symptom management; (b) community-level HIV education and prevention; (c) quality of life issues in chronic HIV disease; (d) HIV prevention focusing on individual or specific group behavior; and (e) research related to adherence to drug therapy.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Core characteristics of the competent general practice trainer, a Delphi study.

INTRODUCTION: The specific skills, attitude, knowledge, and personality characteristics, which should define the competent GP-trainer have been subject of research for many years. What are the most important of these characteristics have yet to be delineated. AIM: The aim of this study is to identify which characteristics are prerequisite for a competent GP-trainer. METHOD: A modified Delphi procedure was used to answer the research question. Earlier qualitative research using focus groups identified 43 characteristics defining the competent GP-trainer. These characteristics were the subject of the Delphi procedure in which 48 experts chosen from the entire field of Dutch General Practice Training participated. RESULTS: After two rounds of the Delphi procedure, 37 characteristics were identified as being important for a competent GP-trainer. The characteristics which were ranked as the most important were 1. a competent GP-trainer is good at giving feedback, 2. dares to give feedback, 3. is critical of the GP-trainee and the learning process, 4. is good at communicating with the GP-trainee, and 5. has respect for the trainee. An important new characteristic has been identified: "being able to inspire reflection in the trainee". CONCLUSION: The core characteristics of the GP-trainer as identified in this research project, form a profile for the ideal GP-trainer to be used as a blueprint for objectives of schooling and for the assessment of GP-trainers.

Delphi Technique↗

PubMed1999

Go the extra mile--use the Delphi Technique.

AIM: The Delphi Technique is reviewed and its potential contribution to the management of change assessed. BACKGROUND: Change management is an essential skill required, not just by managers, but by all staff working in health care. Modern theories advocate participation and free communication to engender commitment and ensure successful change. Data collection methods associated with surveys--interviews and questionnaires--are regularly used to obtain information for service development. Indications of likely resistance are more difficult to obtain. KEY ISSUES: The Delphi Technique is critiqued and found to incorporate many attributes that can produce information which would be otherwise difficult or impossible to obtain. A recently published study performed by the author illustrates this potentiality. An indication of the impact of the findings on the subsequent implementation of change by service managers is provided. CONCLUSION: The Delphi Technique is a useful management tool that can provide data that are difficult to obtain by other means.

Attitude of Health Personnel↗

PubMed2002

Staffing requirements for infection control programs in US health care facilities: Delphi project.

BACKGROUND: The guideline for staffing infection control programs of 1 infection control professional (ICP) for every 250 occupied acute care beds has been used in many health care facilities in the United States since 1985. Since that time, the health care system, patient populations, and expectations about the work of infection prevention and control programs have changed substantially. METHODS: The Delphi method was used; data were obtained from a group of ICPs through a series of 10 surveys. Through this iterative process, participant responses were progressively synthesized and areas of agreement and disagreement identified. These surveys were conducted by electronic and paper mail to identify the personal ICP characteristics and structural variables associated with performance of activities required for contemporary infection prevention and control programs in a variety of health care settings. RESULTS: Delphi panel members (n = 32) from 20 states and who represented acute care, long-term care, and community care settings reported tasks in addition to those identified in earlier task analyses as well as expanded responsibilities. Competing responsibilities and lack of adequate resources were the most frequently cited reasons for nonperformance of essential infection control tasks. A ratio of 0.8 to 1.0 ICP for every 100 occupied acute care beds was suggested as adequate staffing by the Delphi panel. CONCLUSIONS: Infection control responsibilities have expanded beyond the traditional acute care setting. Recommendations for staffing must not only consider the number of occupied beds (average daily census) but also include the scope of the program, the complexity of the health care facility or system, the characteristics of the patient population, and the unique or urgent needs of the facility and community.

Bed Occupancy↗

PubMedDate not supplied

The DELPHI method as a consensus and knowledge acquisition tool for the evaluation of the DIABETES system for insulin administration.

DIABETES is a decision-support system in the field of insulin administration. System performance evaluation is particularly difficult because of the absence of a uniform decision-making model followed by the specialists. The DELPHI method has been selected since it is appropriate for those domains where there is divergence among experts' opinions. The DELPHI approach helps a number of diabetologists arrive at a consensus and thus it facilitates performance evaluation and further knowledge acquisition. Insulin administration regimes, for 100 diabetic subjects, were proposed by DIABETES and five diabetologists (round 1). These suggestions were compiled and forwarded back to the specialists who proposed a second management approach (round 2). In each case, the experts were asked to justify their decision and comment on the suggestions of their colleagues and DIABETES. A novel scoring system for quantification of agreement was adopted. The DELPHI procedure significantly increased the agreement among the diabetologists from 67% to 84% (X2, p = 0.0001). The agreement between experts' and DIABETES recommendations was to a level of 54%. A total of 3500 comments were acquired by the experts.

Adult↗

PubMed2004

GPs' needs for practice-oriented nutrition education; a Delphi study among Dutch GPs.

BACKGROUND: Published guidelines and lists of topics in nutrition education for GPs are affected by practical drawbacks, which prevent them from being easily implemented in vocational training curricula. OBJECTIVE: Our aim was to draw up a concise priority list of disease-related nutrition topics reflecting the needs among Dutch GPs for nutrition education geared to everyday practice, which can be used to decide on the main topics and educational content of computer-based instruction. METHODS: This was a two-round Delphi study, using pilot-tested questionnaires carried out among 41 GPs who attended a national CME meeting on nutrition in The Netherlands. Sum scores of, and summarized comments on nutrition topics and their frequencies in top-10 lists drawn up by respondents were the main outcome measures. RESULTS: The response in both Delphi rounds was high (93 and 95%). Analysis of questionnaires in both rounds yielded a priority list of disease-related nutrition topics, with the 14 highest ranking topics identical in both rounds. A fifteenth topic, only found in the second questionnaire, completed the priority list. A group of experts assessed this list as fully acceptable. CONCLUSION: It was possible to compile a priority list of disease-related nutrition topics reflecting the needs of GPs for nutrition education. Based on the results of the Delphi study, we generated the following list of five priority topics: weight problems; diabetes mellitus; hypercholesterolaemia; intestinal complaints; and hypertension. This list of five and the summarized comments of respondents will determine the main topics and educational content of a computer-based instruction we are currently developing.

Delphi Technique↗