Displaying publications 1 - 20 of 84 in total

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  1. Ab Latif R, Mat Nor MZ
    Malays J Med Sci, 2020 Dec;27(6):115-127.
    PMID: 33447139 DOI: 10.21315/mjms2020.27.6.11
    Background: Concept mapping has been established as a learning strategy that encourages critical thinking and creativity among students, leading to the development of a concept mapping guideline designed to guide nurse educators in using this teaching strategy.

    Objectives: This paper illustrates the development of a guideline to build a concept mapping based-learning strategy. Called the Rusnani concept mapping (RCM) protocol guideline, it was adapted from the Mohd Afifi learning model (MoAFF) and the analysis, design, development, implementation and evaluation (ADDIE) model, integrated with the Kemp model.

    Methods: This model uses the five phases of analysis, design, development, implementation and evaluation. The validity of the guideline was determined by using content and face validity and the Delphi technique. Content validity for this RCM guideline was established using expert review. This formula suggested that if the content validity is greater than 70%, it shows good content validity, and if it is less than 70%, the content validity is low and it is advisable to recheck the content according to the objective of the study.

    Results: The reliability of the RCM was 0.816, showing that the RCM guideline has high reliability and validity.

    Conclusion: It is practical and acceptable for nurse educators to apply RCM as an effective and innovative teaching method to enhance the academic performance of their nursing students.

    Matched MeSH terms: Delphi Technique
  2. Abdul Aziz AF, Mohd Nordin NA, Ali MF, Abd Aziz NA, Sulong S, Aljunid SM
    BMC Health Serv Res, 2017 Jan 13;17(1):35.
    PMID: 28086871 DOI: 10.1186/s12913-016-1963-8
    BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking.

    METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres.

    RESULTS: Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems.

    CONCLUSION: Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services.

    TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016).
    Matched MeSH terms: Delphi Technique
  3. Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP, STROCSS Group
    Int J Surg, 2017 Oct;46:198-202.
    PMID: 28890409 DOI: 10.1016/j.ijsu.2017.08.586
    INTRODUCTION: The development of reporting guidelines over the past 20 years represents a major advance in scholarly publishing with recent evidence showing positive impacts. Whilst over 350 reporting guidelines exist, there are few that are specific to surgery. Here we describe the development of the STROCSS guideline (Strengthening the Reporting of Cohort Studies in Surgery).

    METHODS AND ANALYSIS: We published our protocol apriori. Current guidelines for case series (PROCESS), cohort studies (STROBE) and randomised controlled trials (CONSORT) were analysed to compile a list of items which were used as baseline material for developing a suitable checklist for surgical cohort guidelines. These were then put forward in a Delphi consensus exercise to an expert panel of 74 surgeons and academics via Google Forms.

    RESULTS: The Delphi exercise was completed by 62% (46/74) of the participants. All the items were passed in a single round to create a STROCSS guideline consisting of 17 items.

    CONCLUSION: We present the STROCSS guideline for surgical cohort, cross-sectional and case-control studies consisting of a 17-item checklist. We hope its use will increase the transparency and reporting quality of such studies. This guideline is also suitable for cross-sectional and case control studies. We encourage authors, reviewers, journal editors and publishers to adopt these guidelines.

    Matched MeSH terms: Delphi Technique
  4. Agrawal R, Testi I, Mahajan S, Yuen YS, Agarwal A, Rousselot A, et al.
    Ocul Immunol Inflamm, 2020 Apr 06.
    PMID: 32250731 DOI: 10.1080/09273948.2020.1716025
    An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence, and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis, and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.
    Matched MeSH terms: Delphi Technique
  5. Ahmad Basri MAF, Wan Ismail WS, Kamal Nor N, Mohd Tohit N, Ahmad MN, Mohamad Aun NS, et al.
    PLoS One, 2024;19(4):e0301517.
    PMID: 38574084 DOI: 10.1371/journal.pone.0301517
    The use of virtual reality in social skills training for high functioning autism spectrum disorder (HFASD) youth has been found to be engaging and enjoyable. Despite the promising results, previous literature indicates that there has been no consensus on the social skills target in the training content. There is also limited research on how evidence-based strategies like cognitive and behaviour techniques are instantiated into the VR environment to teach social skills. The aim of this study is to determine the key components to design a social skills training content using virtual reality for youths with HFASD. The Fuzzy Delphi method (FDM) was used to obtain expert consensus on social skills difficulties and cognitive behavioral techniques included in the content in three phases. In phase 1, a questionnaire was developed from in-depth interviews and scientific literature review. The in-depth interviews were conducted with 13 HFASD youth, 7 parents and 6 experts. In phase 2, 3 experts rated the relevance of the items in the questionnaire using an item-level content validity index (I-CVI) assessment. In phase 3, the questionnaire was distributed to 10 experts to rate their level of agreement on each component using a 7-point Likert scale. Components that received a value above 75%, threshold value (d) ≤ 0.2, fuzzy score (A) ≥ α - cut value = 0.5 and higher rank based on defuzzification score were prioritized to be included in the content. Items that received higher expert consensus on social skills difficulties included assessing non-verbal responses, initiating, maintaining, and leaving conversations, emotional difficulties and difficulties in perspective taking. Cognitive and behavioral techniques that received higher expert consensus were psychoeducation, modelling, relaxation techniques, reinforcements, and perspective-taking questions. These key components can be used as a framework for the development of virtual learning content for social skills training in future studies.
    Matched MeSH terms: Delphi Technique
  6. Aida Md Saad, Siti Zuraida Maaruf
    ESTEEM Academic Journal, 2020;16(1):15-26.
    MyJurnal
    Recently consumers are facing the issue of health problems such as Non - Communicable Disease (NCD) occurring in the society due to unhealthy lifestyle and behaviours. Consumers have claimed that they have knowledge about nutrition information but with low awareness level to read the
    nutrition information and difficulties to interpret the nutrition information on the food label. The nutrition contained in the food has been presented in numerical data and unattractive design. Plus, the rush when shopping will make the consumers neglect to read the food label. This research attempted to focus on the development of a suitable and usable nutrition pictograph design as a tool to educate the consumers in choosing a healthier selection of packed food. The researchers used the Delphi Technique as a medium in choosing the appropriate nutrition pictograph design, which should be incorporated into the selected food label. Findings from this study revealed positive feedback and reached a consensus, and all expert panels have agreed on the development of the nutrition pictogram design. Therefore, the implication of this study is targeted towards the consumers, Ministry of Health and food manufacturers. It can also contribute to the growth of the Visual Communication field. This nutrition pictograph design is intended to educate and inculcate the consumers and enhance health awareness in selecting the healthier choice of food.
    Matched MeSH terms: Delphi Technique
  7. Alharthi MS, Scott S, Hughes C, Bond C, Hatah E, Bryant L, et al.
    Int J Pharm Pract, 2024 Mar 06;32(2):180-185.
    PMID: 38387608 DOI: 10.1093/ijpp/riae002
    BACKGROUND: Medication review (MR) is the systematic assessment of a patient's medications for safety and effectiveness by a healthcare professional. The language used to describe MR activity, such as stopped medicine and increased dose, should be consistent across studies to assist researchers compare how different services operate and identify their mechanism of impact.

    AIM: To develop an international taxonomy of standardized terms and activity definitions related to medication reviews.

    METHOD: This was a three-stage Delphi-based consensus study with international medication review experts. A systematic review provided MR activity terms for the survey. Experts rated their consensus on each activity term and its definition on a Likert scale and provided written feedback. The consensus was 75% panel agreement. At each stage, consensus elements were retained, and feedback was used to revise definitions.

    RESULTS: Seven experts were recruited for the study (response rate 15.2%) from four countries: the United Kingdom (n = 4), New Zealand (n = 1), Australia (n = 1), and Malaysia (n = 1). The following terms achieved consensus: the term Medication as a descriptor for MR terms; discontinue medication, start medication, dose increase, dose decrease, dosage form change, and medication safety and efficacy monitor to describe MR activity; Educate to describe the delivery of healthcare professionals and patients/carers education.

    CONCLUSION: Standardized medication review activity terms and definitions have been selected for universal adoption in all future MR research to facilitate a meaningful comparison of process evaluations within different settings.

    Matched MeSH terms: Delphi Technique
  8. Appalasamy JR, Joseph JP, Seeta Ramaiah S, Quek KF, Md Zain AZ, Tha KK
    JMIR Aging, 2019 Mar 21;2(1):e11539.
    PMID: 31518260 DOI: 10.2196/11539
    BACKGROUND: The debilitating effects of recurrent stroke among aging patients have urged researchers to explore medication adherence among these patients. Video narratives built upon Health Belief Model (HBM) constructs have displayed potential impact on medication adherence, adding an advantage to patient education efforts. However, its effect on medication understanding and use self-efficacy have not been tested.

    OBJECTIVE: The researchers believed that culturally sensitive video narratives, which catered to a specific niche, would reveal a personalized impact on medication adherence. Therefore, this study aimed to develop and validate video narratives for this purpose.

    METHODS: This study adapted the Delphi method to develop a consensus on the video scripts' contents based on learning outcomes and HBM constructs. The panel of experts comprised 8 members representing professional stroke disease experts and experienced poststroke patients in Malaysia. The Delphi method involved 3 rounds of discussions. Once the consensus among members was achieved, the researchers drafted the initial scripts in English, which were then back translated to the Malay language. A total of 10 bilingual patients, within the study's inclusion criteria, screened the scripts for comprehension. Subsequently, a neurologist and poststroke patient narrated the scripts in both languages as they were filmed, to add to the realism of the narratives. Then, the video narratives underwent a few cycles of editing after some feedback on video engagement by the bilingual patients. Few statistical analyses were applied to confirm the validity and reliability of the video narratives.

    RESULTS: Initially, the researchers proposed 8 learning outcomes and 9 questions based on HBM constructs for the video scripts' content. However, following Delphi rounds 1 to 3, a few statements were omitted and rephrased. The Kendall coefficient of concordance, W, was about 0.7 (PDelphi method was proven to be helpful in conducting discussions systematically and providing precise content for the development of video narratives, whereas the Video Engagement Scale was an appropriate measurement of video realism and emotions, which the researchers believed could positively impact medication understanding and use self-efficacy among patients with stroke. A feasibility and acceptability study in an actual stroke care center is needed.

    TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618000174280; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=373554&isReview=true.

    Matched MeSH terms: Delphi Technique
  9. Ashrafi-Rizi H, Shahrzadi L, Dehghani-Champiri Z
    PMID: 31143819 DOI: 10.4103/jehp.jehp_18_19
    INTRODUCTION: Patients have different rights, one of which is their right to access health information. The aim of this study was to identify patients' rights to benefit from consumer health information services using a qualitative method.

    MATERIALS AND METHODS: The research method was qualitative using a Delphi technique. The statistical population consisted of 12 specialists in the field of medical library and information science and researchers and healthcare professionals. Eight dimensions and 42 items of patients' rights were identified and were approved by Delphi panel.

    RESULTS: Regarding patients' rights to benefit from consumer health information services, eight dimensions including the right to health knowledge, the right to access to health information, the professional behavior of medical librarians with patients, content richness, information seeking skills, awareness of new services and products, the ease of using health information centers, and the professional behavior of healthcare professionals with patients were identified and approved.

    CONCLUSION: Decreasing the gap between the health literacy of healthcare professionals and patients is one of the duties of medical librarians and health information professionals. Establishing of patient rights in the area of utilizing health information services is an important step in improving the quality of services received by patients.

    Matched MeSH terms: Delphi Technique
  10. Atarhim MA, Manap J, Mastor KA, Mokhtar MK, Yusof A, Zabidi AFM
    J Nurs Meas, 2023 Jun 01;31(2):202-218.
    PMID: 37277156 DOI: 10.1891/JNM-2021-0012
    Background & Purpose: This study aims to consolidate expert views and validated 371 items for developing spiritual intelligence instrument for Muslim nurses guided by the Spiritual Intelligence Model for Human Excellence (SIMHE). Methods: A Fuzzy Delphi Method (FDM) was used to validate these items and analyzed with Triangular Fuzzy Numbers and Defuzzification process. Views from 20 experts from three different backgrounds, namely, theology/Sufism, psychology and Islamic counseling, and evaluation and measurement, were also included in the validation process. Results: All items fulfilled the prerequisite of a threshold level of (d) ≤ 0.2, which obtained more than 75% of expert consensus and α-cut value ≥ of 0.5. Conclusion: The FDM analysis results indicated that all items could further validate the instrument using Rasch measurement analysis.
    Matched MeSH terms: Delphi Technique
  11. Ayadurai S, Sunderland VB, Tee LBG, Hattingh HL
    Curr Diabetes Rev, 2018;14(6):565-575.
    PMID: 29243582 DOI: 10.2174/1573399814666171215115239
    BACKGROUND: Studies on a structured method used by pharmacists to provide comprehensive, evidence-based diabetes care are lacking. The aim of this study was to prioritise, rank and construct validate indicators categorised as seven treatment factors utilised in the management of type 2 diabetes namely: Cholesterol, blood pressure and glycaemia control; medication and lifestyle management; cardiovascular risk management and patient education using the Delphi process.

    METHODS: A Delphi questionnaire consisted of 29 Part 1 and nine Part 2 indicators which were incorporated into a tool called Simpler™. The indicators were mainly sourced from American, Australian and Malaysian diabetes management guidelines. Diabetes experts were asked to rank indicators in the order of importance in Part 1. In Part 2, indicators had to be chosen for inclusion into Simpler™ using a fivepoint Likert scale. The consensus level was pre-set at 60%.

    RESULTS: A three round Delphi process was used to validate all 38 indicators by 12 experts from Australia and Malaysia: five pharmacists, four doctors, two endocrinologists and a diabetes nurse. Consensus was reached for 93.1% (27/29) of the Part 1 indicators and all nine Part 2 indicators (100%). Five out of nine indicators in Part 2 questionnaire obtained consensus disagreement for inclusion into the Simpler ™ tool.

    CONCLUSION: The Simpler™ tool is the first structured diabetes multifactorial tool to address all seven evidence-based factors. The tool was refined and validated by multi-disciplinary health professionals from Australia and Malaysia. Pharmacists can use the Simpler™ tool to facilitate evidence-based comprehensive individualised care among type 2 diabetes patients.

    Matched MeSH terms: Delphi Technique
  12. Bhandari P, Subramaniam S, Bourke MJ, Alkandari A, Chiu PWY, Brown JF, et al.
    Gut, 2020 11;69(11):1915-1924.
    PMID: 32816921 DOI: 10.1136/gutjnl-2020-322329
    The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.
    Matched MeSH terms: Delphi Technique
  13. Castro-Calvo J, King DL, Stein DJ, Brand M, Carmi L, Chamberlain SR, et al.
    Addiction, 2021 09;116(9):2463-2475.
    PMID: 33449441 DOI: 10.1111/add.15411
    BACKGROUND AND AIMS: Following the recognition of 'internet gaming disorder' (IGD) as a condition requiring further study by the DSM-5, 'gaming disorder' (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11). However, the proposed diagnostic criteria for gaming disorder remain the subject of debate, and there has been no systematic attempt to integrate the views of different groups of experts. To achieve a more systematic agreement on this new disorder, this study employed the Delphi expert consensus method to obtain expert agreement on the diagnostic validity, clinical utility and prognostic value of the DSM-5 criteria and ICD-11 clinical guidelines for GD.

    METHODS: A total of 29 international experts with clinical and/or research experience in GD completed three iterative rounds of a Delphi survey. Experts rated proposed criteria in progressive rounds until a pre-determined level of agreement was achieved.

    RESULTS: For DSM-5 IGD criteria, there was an agreement both that a subset had high diagnostic validity, clinical utility and prognostic value and that some (e.g. tolerance, deception) had low diagnostic validity, clinical utility and prognostic value. Crucially, some DSM-5 criteria (e.g. escapism/mood regulation, tolerance) were regarded as incapable of distinguishing between problematic and non-problematic gaming. In contrast, ICD-11 diagnostic guidelines for GD (except for the criterion relating to diminished non-gaming interests) were judged as presenting high diagnostic validity, clinical utility and prognostic value.

    CONCLUSIONS: This Delphi survey provides a foundation for identifying the most diagnostically valid and clinically useful criteria for GD. There was expert agreement that some DSM-5 criteria were not clinically relevant and may pathologize non-problematic patterns of gaming, whereas ICD-11 diagnostic guidelines are likely to diagnose GD adequately and avoid pathologizing.

    Matched MeSH terms: Delphi Technique
  14. Chandrashekar BR, Chacko TV, Anand KM, Suvetha K, Jaishankar HP, Suma S
    Indian J Cancer, 2020 8 10;57(3):296-310.
    PMID: 32769291 DOI: 10.4103/ijc.IJC_229_19
    Background: Tobacco use has emerged as a major public health problem. But, most graduates in medical and dental schools receive limited systematic training. The objective of this education innovation project was to enhance dental undergraduate student's ability to identify tobacco users through oral manifestations and improve their counseling skills using a customized Tobacco Counseling Training Module (TCTM).

    Methods: A TCTM for students of dentistry was developed using ADDIE framework as a guide. Content and construct validation of the module was done by six subject experts using Delphi technique for obtaining consensus. Pilot testing was done on 20 students of third year BDS. Pre- and post-intervention assessment of knowledge, attitude, self-confidence was done using learning outcomes questionnaire. Ability to correctly identify oral manifestations was assessed using extended item MCQs and tobacco counseling skills using a modified KEECC. The difference in mean scores were computed and subjected to further statistical analysis using SPSS version 22.

    Results: There was a significant improvement in post intervention scores for mean knowledge (5.5 ± 1.4 to 13.2 ± 1.1), attitude (5.6 ± 0.9 and 8.5 ± 0.5), self-confidence (1.5 ± 0.5 and 3.1 ± 0.2), ability to correctly identify oral manifestations (5.2 ± 1.4 and 9.4 ± 0.8) and tobacco counseling skills.

    Conclusion: It is possible to introduce the module in the existing curriculum and its effectiveness evaluation shows benefit in terms of Kirkpatrick's Level 1, 2, 3 (improvement in knowledge, attitude, self-confidence, ability to identify oral manifestations, and tobacco counseling skills) of training effectiveness.

    Matched MeSH terms: Delphi Technique
  15. Chisholm A, Price DB, Pinnock H, Lee TT, Roa C, Cho SH, et al.
    NPJ Prim Care Respir Med, 2017 Jan 05;27:16089.
    PMID: 28055000 DOI: 10.1038/npjpcrm.2016.89
    REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster's attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal-control clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia.
    Matched MeSH terms: Delphi Technique
  16. Chiu PWY, Uedo N, Singh R, Gotoda T, Ng EKW, Yao K, et al.
    Gut, 2019 02;68(2):186-197.
    PMID: 30420400 DOI: 10.1136/gutjnl-2018-317111
    BACKGROUND: This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers.

    METHOD: The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement.

    RESULTS: Risk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy.

    CONCLUSION: This consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.

    Matched MeSH terms: Delphi Technique
  17. Daud R, Ismail M, Omar Z
    Ind Health, 2010;48(6):824-34.
    PMID: 20616464
    Competencies of occupational safety and health (OSH) professionals have become a concern due to the significance of safety management in the field of safety engineering. The purpose of this article is to identify competencies needed by OSH professionals. These competencies are required by professionals in administrating and enforcing legislations related to OSH in Malaysia. This study used Delphi technique in three rounds of data collection. The benefits of this research approach are the use of experts in gaining opinions without time and geographical restraints. The results show 25 generic competencies with combinations of cognitive, interpersonal and intrapersonal competencies and 33 functional or specific competencies including knowledge and skills needed by OSH professionals. Both generic and functional competencies are also divided into threshold and differentiating competencies that would be used to differentiate average and excellent performance of OSH professionals.
    Matched MeSH terms: Delphi Technique
  18. Ducey J, Lansdale N, Gorst S, Bray L, Teunissen N, Cullis P, et al.
    BMJ Paediatr Open, 2024 Feb 05;8(1).
    PMID: 38316469 DOI: 10.1136/bmjpo-2023-002262
    INTRODUCTION: Heterogeneity in reported outcomes of infants with oesophageal atresia (OA) with or without tracheo-oesophageal fistula (TOF) prevents effective data pooling. Core outcome sets (COS) have been developed for many conditions to standardise outcome reporting, facilitate meta-analysis and improve the relevance of research for patients and families. Our aim is to develop an internationally-agreed, comprehensive COS for OA-TOF, relevant from birth through to transition and adulthood.

    METHODS AND ANALYSIS: A long list of outcomes will be generated using (1) a systematic review of existing studies on OA-TOF and (2) qualitative research with children (patients), adults (patients) and families involving focus groups, semistructured interviews and self-reported outcome activity packs. A two-phase Delphi survey will then be completed by four key stakeholder groups: (1) patients (paediatric and adult); (2) families; (3) healthcare professionals; and (4) researchers. Phase I will include stakeholders individually rating the importance and relevance of each long-listed outcome using a 9-point Likert scale, with the option to suggest additional outcomes not already included. During phase II, stakeholders will review summarised results from phase I relative to their own initial score and then will be asked to rescore the outcome based on this information. Responses from phase II will be summarised using descriptive statistics and a predefined definition of consensus for inclusion or exclusion of outcomes. Following the Delphi process, stakeholder experts will be invited to review data at a consensus meeting and agree on a COS for OA-TOF.

    ETHICS AND DISSEMINATION: Ethical approval was sought through the Health Research Authority via the Integrated Research Application System, registration no. 297026. However, approval was deemed not to be required, so study sponsorship and oversight were provided by Alder Hey Children's NHS Foundation Trust. The study has been prospectively registered with the COMET Initiative. The study will be published in an open access forum.

    Matched MeSH terms: Delphi Technique
  19. Fock KM, Talley N, Goh KL, Sugano K, Katelaris P, Holtmann G, et al.
    Gut, 2016 Sep;65(9):1402-15.
    PMID: 27261337 DOI: 10.1136/gutjnl-2016-311715
    OBJECTIVE: Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus.

    METHODS: A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations.

    RESULTS: A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer.

    CONCLUSIONS: These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region.

    Matched MeSH terms: Delphi Technique
  20. Fox L, Santaolalla A, Handford J, Sullivan R, Torode J, Vanderpuye V, et al.
    JCO Glob Oncol, 2023 Aug;9:e2300111.
    PMID: 37561978 DOI: 10.1200/GO.23.00111
    PURPOSE: The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients.

    METHODS: Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (T-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives.

    RESULTS: The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) (T = 83). Others included cancer registries (T = 62); prevention (T = 52); end-of-life care (T = 53); and value-based and affordable care (T = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly (T = 36). Others included treatment schedule interruption (T = 24); cost-effective reduction of COVID-19 morbidity/mortality (T = 19); and pandemic preparedness (T = 18).

    CONCLUSION: Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access.

    Matched MeSH terms: Delphi Technique
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