Local treatment improves the outcomes for oligometastatic disease, an intermediate state between locoregional and widespread disease. However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The first edition "Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe" was published on February 15, 2023 by 65 European medical specialists. In this article, the consensus will be interpreted to provide new idea for the diagnosis and treatment of oligometastatic oesophagogastric cancer for Chinese clinicians.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.
Objective To develop a preliminary "pulmonary nodule symptom scale" based on the Delphi method, providing a tailored, standardized, normalized, and promotable symptomatic evaluation tool for the efficacy assessment of pulmonary nodule patients treated with traditional Chinese medicine or integrated traditional Chinese and Western medicine interventions. Methods A preliminary pool of scale items was formed through literature review, interviews with doctors and patients, and reference to guidelines and consensus on pulmonary nodules and patient-reported outcome (PRO) scales related to lung cancer. Two rounds of expert consultation were conducted using the Delphi method. Based on the concentration and variation indicators of expert evaluations, and considering experts’ suggestions for specific item deletions and modifications, a core group meeting was held to screen and refine the scale items. Results Invitations were sent to 54 experts, with 51 accepting the consultation. The active coefficient for the first round of consultation was 94.4%, and for the second round, it was 100%. The average authority coefficient for the 51 experts was 0.896. The Kendall’s coefficient of concordance and the average coefficient of variation for the first and second rounds of consultation were 0.215 (P<0.001) and (0.34±0.07), 0.162 (P<0.001) and (0.24±0.05), respectively. Through two rounds of Delphi expert consultation, a preliminary “pulmonary nodule symptom scale” covering 17 items across four dimensions - respiratory symptoms, systemic manifestations, psychological state, and overall assessment - was formed. Conclusion The experts participating in this Delphi consultation had high authority and enthusiasm, and they have a good level of acceptance and consistency for the preliminary “pulmonary nodule symptom scale”. Subsequent empirical research will be conducted on a large sample cohort of pulmonary nodule patients to verify the scale’s stability and effectiveness.
As the incidence of lung cancer continues to rise, segmentectomy has emerged as a favored surgical technique for treating selective early-stage non-small cell lung cancer patients, gaining increasing support from thoracic surgery specialists. However, there remains a deficiency in clinical guidance concerning indications and other related aspects for segmentectomy. In April 2023, a collaborative effort among 15 Asia thoracic surgery experts led to the publication of the "Asian expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study". This study presents a total of 36 expert consensus agreements across three aspects: patient indications, surgical approaches, lymph node assessment, outlining key principles of them. This paper intends to provide a brief interpretation of these consensuses for the reference of colleagues in clinical practice.
Objective To set up healthcare device-technology deployment assessment model and procedures through establishing the assessment parameter system between the functions of the clinical technical requirements and devices. Methods The bidirectional assessment parameter system developed by the literature review and Delphi, then combination weighting calculated by the combination weighting method, and the proposals for function deployment performed on the cluster analysis. Results The positive coefficients of twice Delphi were 75.56% and 87.50%, respectively. The effective recovery rates of the questionnaire were higher. The structure of the bidirectional assessment parameter system acquired according to the data mining and review, Delphi and integrated analysis. We calculated the weighting for the required functions and the deployed functions of the ventilator in the ICU, ER and RR. We listed the absolute importance and rank. The proposals for the function deployment of the ventilator which met different needs in fields of the critical care medicine were produced by the cluster analysis, ranking absolute importance and the calibration of weighting based on the investigation for actual function utilized rate. Conclusion It studies healthcare device-technology deployment assessment model by sequential integrated methods and sets up bidirectional assessment parameter system based on clinical technical function requirement, and the result is effective.
ObjectiveBy establishing a set of evaluation system for thoracoscopic clinical function and applicability, to evaluate and compare the advantages and disadvantages of different brands of thoracoscopes, and to provide some suggestions for the innovation and upgrade of thoracoscopes, especially for the domestic thoracoscopes.MethodsThe project coordination team initially formulated the evaluation index system for the clinical function and applicability of thoracoscope by querying literature and brainstorming. The Delphi expert consultation method was used to distribute questionnaires to the selected experts. Experts provided scores which were based on the importance of each indicator, and clarified the basis of their judgment and the familiarity with the evaluation indicators. After two rounds of screening by Delphi method, a thoracoscopic clinical function and applicability satisfactory questionnaire was formed. The appropriate sample for pre-investigation was selected, and the reliability and validity were tested. The index composition was adjusted based on the results of the test to form a final evaluation scale.ResultsThe project coordination team initially formulated 24 thoracoscope-related evaluation indicators. After two rounds of experts consultation, the item "brightness adjustment" was deleted without any additional entries. The positive coefficients of the experts in the first round and the second round were 100.0% and 80.0%, respectively. The two rounds of authoritative coefficients were 0.86 and 0.90, and the coordination coefficients were 0.272 (P<0.001) and 0.523 (P<0.001), respectively. A total of 140 questionnaires were issued in this pre-investigation. The recovery rate was 100.0% and the effective rate was 90.0%. The Cronbach's α value of the scale was 0.936, and the Spearman-Brown split-half reliability coefficient was 0.972. The factor analysis finally extracted 3 common factors. The total variance of the cumulative interpretation was 70.9%. The three common factors were named "operation related", "image related" and "device related".ConclusionThe evaluation index system developed in this study has good reliability and validity, and can be used as a tool to evaluate the clinical function and applicability of thoracoscopes.
As a tool for building consensus among groups, Delphi technique has been widely used in healthcare research which is appropriate for clinical questions where quantitative methods are unlikely to yield results that can be successfully implemented in practice. Researchers in palliative care developed standards for conducting and reporting Delphi studies (CREDES). This paper introduces and interprets the specific content of CREDES standards, with a view to providing reference for the evaluation of Delphi research design quality and report transparency.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.
ObjectiveTo construct the occupational therapy core items oriented by life return for stroke patients, and provide a reliable tool to promote the comprehensive rehabilitation and successful return for stroke patients.MethodsFrom January to February 2020, the primary items were summarized through literature analysis and research group discussion, and then Delphi method was used to determine which items should be included by two rounds of experts consultation.ResultsA total of 22 experts were selected. After two rounds of experts consultation, 60 items in 6 domains were included. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.87±0.54. In the two rounds of experts consultation, the importance scores of consulted items were 7.60±0.97 and 8.06±0.35, respectively; the variation coefficients were 0.14±0.05 and 0.11±0.03, respectively; the Kendall coefficients of concordance were 0.522 (P<0.001) and 0.578 (P<0.001), respectively.ConclusionThrough the Delphi method, the core items oriented by life return are identified with high recognition and consistency from experts, which can be used as a guideline tool for stroke patients in in-hospital occupational therapy, discharge guidance, and community/home rehabilitation.