and transmitted securely. Despite the diversity in its applications, consensus is a central theme and Delphi is considered a consensus group research method. McMillan SS, Kelly F, Sav A, Kendall E, King MA, Whitty JA, et al. The conventional design of the Delphi study had at least four rounds. Careers, Unable to load your collection due to an error. Ultimately, the time to complete one nominal group is variable, and depends on group size, how many questions are asked, and the type of participants involved. The median of 20 (interquartile range-41) experts participated in two (interquartile range-1) Delphi rounds (Table (Table11). Possibly the first application of Delphi methodology was during the cold war in the 1950s by the United States army. Most of the studies (60%) were done in Europe or North America. The Delphi technique is a scientific method to organize and manage structured group communication processes with the aim of generating insights on either current or prospective challenges; especially in situations with limited availability of information [21,48,74,77].As such, it has been frequently used in various scientific disciplines ranging from health care [14 . Individuals were then asked to re-rank themes for a third time. The nominal group technique: A research tool for general practice? The acceptance rate among experts can be low, and researchers usually consider this higher attrition rate during the invitation process. Holey EA, Feeley JL, Dixon J, Whittaker VJ. government site. However, this active participation of the steering group can cause bias through opinion of members. Such a finding would mean that consensus had not been reached. The technique can also be adapted for use in face-to-face meetings, and is then called mini-Delphi. At the beginning of the meeting, participants are given up to twenty minutes to silently reflect or record their individual ideas in response to a question, i.e. The Nominal Group Technique (NGT) and the Delphi Technique are commonly referred to as consensus methods [ 1 ]. Scoring System to Triage Patients for Spine Surgery in the Setting of Limited Resources: Application to the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond. Delphi techniques are used internationally to investigate a wide variety of issues. Examples of studies using the Delphi Technique. Sorbello M, Rosenblatt W, Hofmeyr R, Greif R, Urdaneta F. Aerosol boxes and barrier enclosures for airway management in COVID-19 patients: a scoping review and narrative synthesis. The objective of the Delphi technique (such as consensus building [15], [17] or foresight [11]) varies between (and also within) subfields of the health sciences and determines the design of the Delphi process, e.g. Prashant Nasa, Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 00000, United Arab Emirates. Often a 9-point Likert scale is used for the rating [2931, 34], although 3-point [36], 5-point [28, 37] and 7-point [33] scales have also been used. Therefore, their experts included people living with chronic conditions, their carers, and pharmacy staff who provided the relevant services. The Delphi survey: method techniques and applications. Journal of clinical epidemiology 106: 136-139. There is no standard size of the panel members and varies from 10 to 1000 (typically between 10-100) in published studies. However, these tools are neither been validated in other fields of medicine nor universally accepted for the conduct of Delphi studies. The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. Surgery during the COVID-19 pandemic: operating room suggestions from an international Delphi process. Yet, this method can take weeks or months to conclude, especially if multiple rounds are undertaken. Development and pilot testing of a multiple mini-interview for admission to a pharmacy degree program. Tully MP, Cantrill JA. Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 00000, United Arab Emirates. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. Results: Panellists reached a consensus on "agreement" for 85 recommendations during the first round and for 87 recommendations after the second and final rounds. Priorities in identifying unmet need in older people attending general practice: a nominal group technique study. Protocol for nurse managers to cope with pandemic. Other researchers have provided valuable information on important nominal group design considerations [3], its practical application [4] and method of analysis [5]. The Delphi technique is an established and effective research method with multifaceted applications for health services research. For example, Bradley et al. In the light of all the above, the aim of this Delphi study is to design and validate a questionnaire constructed on the basis of various digital competence standards through which the perceived importance of the acquisition of digital competences in higher education can be specifically assessed by a panel of experts. Campbell SM, Cantrill JA, Roberts R. Prescribing indicators for UK general practice: Delphi consultation study. To study and provide recommendations for recovery plan in minimally invasive surgery amid COVID-19 pandemic. Tchouaket Nguemeleu E, Boivin S, Robins S, Sia D, Kilpatrick K, Brousseau S, Dubreuil B, Larouche C, Parisien N. Development and validation of a time and motion guide to assess the costs of prevention and control interventions for nosocomial infections: A Delphi method among experts. Gastelurrutia MA, Benrimoj SI, Castrillon CC, de Amezua MJ, Fernandez-Llimos F, Faus MJ. Therefore, it is usual for the experts in each meeting to be relatively homogeneous in status (see Table1), such as running separate meetings for consumers and pharmacists [5]. Care was taken to assess the 26 experts' perspectives . The primary purpose of the Delphi technique is to generate a reliable consensus opinion of a group of experts by an iterative process of questionnaire interspersed with controlled feedback[2]. A diverse panel helps to achieve a broader perspective and generalization of consensus. Allan M, Mahawar K, Blackwell S, Catena F, Chand M, Dames N, Goel R, Graham YN, Kothari SN, Laidlaw L, Mayol J, Moug S, Petersen RP, Pryor AD, Smart NJ, Taylor M, Toogood GJ, Wexner SD, Zevin B, Wilson MS PRODUCE study. Inclusion in an NLM database does not imply endorsement of, or agreement with, It is recommended that there be no discussion at this stage and ideas are merely recorded verbatim on, for example, a flipchart or white board [2]. Biosafety-at-home flyer for high-risk group and health care workers to reduce the risk of cross-transmission. The Delphi Technique is part of the research technique that is also known as 'interactive survey', which involves dialogue with the public (experimental application). The Delphi process is explained and several issues that the researcher must consider are presented. Introduction The Nominal Group Technique (NGT) and Delphi Technique are consensus methods used in research that is directed at problem-solving, idea-generation, or determining priorities. a discrete choice experiment [13]. Errett NA, Howarth M, Shoaf K, Couture M, Ramsey S, Rosselli R, Webb S, Bennett A, Miller A. This research used the consensus-building Delphi survey method to develop a common definition of 'sustainability in agricultural water management' (SAWM) across an interdisciplinary group of actors involved in a Horizon 2020 European Union-funded Research and Innovation Action. Guidance on surgery and OR practices during COVID-19 pandemic. The structured format of consensus methods avoids this issue. Hiligsmann M, van Durme C, Geusens P, Dellaert BG, Dirksen CD, van der Weijden T, et al. The Fuzzy Delphi Method (FDM) is one of the research methods used in obtaining experts' consensus on specific issues. RAND corporation 2001 [cited 2015 July 11]; Available from: URL: McBride AJ, Pates R, Ramadan R, McGowan C. Delphi survey of experts opinions on strategies used by community pharmacists to reduce over-the-counter drug misuse. The consensus definition used commonly is the percentage of agreement based on a predefined cut-off, central tendency, or a combination of both. It involves participants reading a detailed literature review, followed by a traditional Delphi questionnaire. In other words, consensus can be there in unstable responses, and stability can be there without consensus, and hence achieving response stability should be an appropriate closing criterion. sharing sensitive information, make sure youre on a federal Participants are then provided with a ranking sheet, where they are asked to select their top preferences from the generated ideas. McMillan and colleagues, for example, explored the views of both the public and pharmacy staff on ideal community pharmacy services [16]. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The published studies have used modified Delphi, and details on methods like expert panel, consensus, or closing criteria are not explicit. Tang Z, Sun B, Xu B. Recommendations for the management of spasticity in Cerebral palsy children during COVID-19 pandemic. and transmitted securely. EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic. Sinha IP, Smyth RL, Williamson PR. An Experimental Application of the DELPHI Method to the Use of Experts. Guidance on how to resume endoscopy services during COVID-19. The alternative plans and method to drop items should be defined if consensus is used as a stopping criterion of Delphi rounds. Bethesda, MD 20894, Web Policies Stability is defined as the consistency of responses between successive rounds of a study[21]. Development of research priorities in discipline of surgery related to COVID-19. The Delphi technique uses a multistage self-completed questionnaire with individual feedback, to determine consensus from a larger group of experts. Questionnaires have been mailed, or more recently, e-mailed to participants. Aljamal M, Ashcroft DM, Tully MP. Claxton JD, Ritchie JRB, Zaichkowsky J. The definition of consensus used in published Delphi studies is discrepant. The RAND appropriateness method has been described as a variant of both the Delphi technique [38] and the NGT [3], as it has features of both. It was even observed that some studies declare achieving consensus but do not provide the process to reach the consensus and its definition[10,12,15]. Consumers and carers versus pharmacy staff: Do their priorities for Australian Pharmacy Services align? Ultimately, researchers need to ensure that the NGT is working for each participant group; it may be that stages need to be adapted. As a library, NLM provides access to scientific literature. NGT variations may be influenced by the available research and participant time, or the level of clarification, consensus or generalisability required for the topic. [10] noted that voting could take up to 10min to complete. Humphrey-Murto S, de Wit M (2019) The Delphi method-more research please. Dashash M, Almasri B, Takaleh E, Halawah AA, Sahyouni A. We used a combination of keywords, Delphi technique OR Delphi study OR Delphi AND COVID-19 OR SARS-CoV-2. Consensus was considered to be reached if . If researchers are seeking to explore ideas in relation to a problem or question, this best aligns with the NGT, as idea generation is an integral part of this method. Olmos-Gmez MDC. Dajani JS, Sincoff MZ, Talley WK. Recommendations on timing, approach, type of surgery, and postoperative requirements. If it is too difficult for participants to group similar ideas at the clarification stage then this grouping step could be avoided altogether [5]. Changes to supervision in community pharmacy: pharmacist and pharmacy support staff views. Consensus methods are used in research that is directed at problem-solving, idea-generation, or determining priorities [2]. Methodology The NGT entails face-to-face discussion in small groups, and provides a prompt result for researchers. The authors illustrate that e-Delphi has a range of benefits that are effective and efficient in assuaging traditional Delphi limitations; nevertheless, a set of methodological issues remain. As Delphi is a method to generate consensus of individual panel member opinion on unsettled critical issues, the consensus and closing criteria vary widely among the studies[10,12,15]. The limitations of this assessment are the inclusion of only English language published studies in the medical field. A sample of about fifteen has been suggested [26] but larger panels have also been used (Table2). Bissell P, Ward PR, Noyce PR. Bhandari P, Subramaniam S, Bourke MJ, Alkandari A, Chiu PWY, Brown JF, Keswani RN, Bisschops R, Hassan C, Raju GS, Muthusamy VR, Sethi A, May GR, Albniz E, Bruno M, Kaminski MF, Alkhatry M, Almadi M, Ibrahim M, Emura F, Moura E, Navarrete C, Wulfson A, Khor C, Ponnudurai R, Inoue H, Saito Y, Yahagi N, Kashin S, Nikonov E, Yu H, Maydeo AP, Reddy DN, Wallace MB, Pochapin MB, Rsch T, Sharma P, Repici A. The Delphi technique was used by 110 physicians who were experts in managing patients with DM1. Tully MP, Cantrill JA. McDermott JH, Caiola SM, Kuhn KF, Stritter FT, Beza J. There have been attempts to identify quality parameters to conduct and evaluate Delphi studies[10-12]. The anonymity of individual members in a Delphi study removes the inherent bias like dominance and group conformity (defined as groupthink) observed with face-to-face group meetings. Hutchings HA, Rapport FL, Wright S, Doel MA, Wainwright P. Obtaining consensus regarding patient-centred professionalism in community pharmacy: nominal group work activity with professionals, stakeholders and members of the public. While the origin and early use of the Delphi Technique was . To develop an adaptable acceptable nursing protocol during the pandemic. It is also referred as the Delphi Method or Delphi Studies. Consensus methods, however, raise potential solutions or answers to a question, which can then be prioritised or agreed upon. Then, it considers the choice of experts for the panels and which types of research questions are best suited to which method. Introduction. However, the Delphi Technique uses interactions between group (called panel) members via questionnaires rather than face-to-face communication. See: Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 00000, United Arab Emirates. Brain Ultrasonography Consensus on Skill Recommendations and Competence Levels Within the Critical Care Setting. Health Expect 2015 Jan 19. doi:10.1111/hex.12341. The common goal behind using experts is to increase the qualitative strength of recommendations or consensus. While a discussion of qualitative and quantitative analysis is also included, McMillan et al. Statistics usually include the measurement of central tendencies with dispersion, percentage, and frequency of distribution[17]. Respondents were given a definition of appropriateness and asked to assess the appropriateness of indicators of medicines reconciliation. Federal government websites often end in .gov or .mil. Before The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. Abstract. Diabetes Educ 2000;26(2):30510, 312, 314. Bethesda, MD 20894, Web Policies How consensus is defined and operationalised will vary from study to study, depending on the research objectives [3]. The strength of Delphi process is anonymity of panelist in the survey rounds, controlled feedback and iterative discussions. Welsh Surgical Research Initiative (WSRI) Collaborative. This stage takes as much time as needed until no new ideas are forthcoming. The assessment for stability of the results or consensus was missing in many of the studies with only two studies mentioning this in their methodology. Anonymous survey rounds have advantages over face-to-face or group encounters in reducing dominance and group conformity. The Delphi technique can take weeks or months to conclude, especially if multiple rounds are required, and may be complex for lay people to complete. In the first round, they were asked to comment on definitions, rate the importance of preidentified methodological procedures using a 9-item Likert scale, and suggest additional procedures. The Delphi technique is a scientific method to organize and manage structured group communication processes with the aim of generating insights on either current or prospective challenges; especially in situations with limited availability of information [21, 48, 74, 77].As such, it has been frequently used in various . Core Tip: There are no standard quality parameters to evaluate Delphi methods in healthcare research. Consensus methods are used in research that is directed at problem-solving, idea-generation, or determining priorities [ 2 ]. However, many of the fundamental characteristics of the approach still remain from Dalkey and Helmer's original outline. Guidance on the management of psoriatic disease during the COVID-19 pandemic. The Delphi technique: an exposition and application. In modern times, this forecasting tool has evolved into a statistical methodology to collate individual opinions and converge them into statistically generated consensus with collective intelligence. Like the NGT, the Delphi Technique is a highly structured group interaction. Sawhney MS, Bilal M, Pohl H, Kushnir VM, Khashab MA, Schulman AR, Berzin TM, Chahal P, Muthusamy VR, Varadarajulu S, Banerjee S, Ginsberg GG, Raju GS, Feuerstein JD. The members who participate in the anonymous voting process of the Delphi survey are called panelists. Black N, Murphy M, Lamping D, McKee M, Sanderson C, Askham J, et al. COVID-19: Coronavirus disease 2019; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; OR: Operating room. The intra-class correlation coefficient (ICC) was used to report on the inter- and intra-rater reliabilities between and within participants responses . The NGT has been applied in numerous healthcare settings, to develop guidelines [17] or explore opinions of different health professionals [18], lay people and carers [10, 19, 20], or to compare views of both parties [9, 21]. 10.1016/j.zefq.2022.08.007 Abstract In the field of medicine and health sciences, Delphi methods are applied mainly in the exploratory or evaluative phases of a research process. Basics of the Delphi study. A constant theme is observed across all domains with vital elements like anonymity, iteration, controlled feedback, and group response (or consensus)[3]. According to the recommendations of the US Agency for Health Care Policy and Research (AHCPR), Delphi techniques are considered to provide the lowest level of evidence for making causal inferences and are thus subordinate to meta-analyses, intervention studies and correlation studies ( 3 ). Linstone HA, Turoff M. The Delphi Method: Techniques and Applications, 1975. Jimnez-Rodrguez D, Ruiz-Salvador D, Rodrguez Salvador MDM, Prez-Heredia M, Muoz Ronda FJ, Arrogante O. The Delphi study is practical in problematic areas where either statistical model-based evidence is not available, knowledge is uncertain and incomplete, and human expert judgment is better than individual opinion[1]. The Nominal Group Technique (NGT) and the Delphi Technique are commonly referred to as consensus methods [1]. However, it may be more difficult to organise a nominal group meeting for a time that suits everyone. A selection of the free-text responses is given, to represent the breadth of opinion. The Delphi Technique has been used with patients in a small number of studies to prioritise outcome measures for clinical trials [42] and has begun to be used with members of the public (in this case, parents of children with attention deficit/hyperactivity disorder) in pharmacy practice research [43]. COVID-19 research priorities in surgery (PRODUCE study): A modified Delphi process. Researchers have generated evidence based guidelines or criteria for pharmacy practice situations [7, 22, 23], informed practice change [11, 24] and the profession [12, 16] about particular topics, and identified attributes to be included when interviewing pharmacy students [25]. A key strength of consensus methods is the balanced participation from group members, unlike a focus group, whereby the facilitator must control for, and minimise the risk of, a dominant participant influencing the discussion. Miller D, Shewchuk R, Elliot TR, Richards S. Nominal group technique: a process for identifying diabetes self-care issues among patients and caregivers. The evaluation points were qualitative and did not assess the reporting method of the results. Accessibility It was designed by Delbecq and Van de Ven and comprises four key stages: silent generation, round robin, clarification and voting (ranking or rating) [2]. The Delphi Technique was developed by the Rand Corporation in 1953 [26] and uses a multistage self-completed questionnaire with individual feedback. The Delphi method relies on experts who are knowledgeable about a certain topic so they can forecast the outcome of future . Development of indicators to assess the quality of medicines reconciliation at hospital admission: an e-Delphi study. The term Delphi originated from ancient Greek mythology and was believed to be the precinct of Pythia (a major oracle), where prophecies were made to dictate and direct vital state affairs. Sciubba DM, Ehresman J, Pennington Z, Lubelski D, Feghali J, Bydon A, Chou D, Elder BD, Elsamadicy AA, Goodwin CR, Goodwin ML, Harrop J, Klineberg EO, Laufer I, Lo SL, Neuman BJ, Passias PG, Protopsaltis T, Shin JH, Theodore N, Witham TF, Benzel EC. Consensus methods, Delphi technique, Nominal group technique. Harvey N, Holmes CA. The NGT and Delphi Technique are both consensus methods that involve a group of experts to generate ideas and determine priorities. The round robin [8] and clarification phase [9] can take up to 30min each. The Delphi technique is a method of group decision-making and iterative forecasting that involves consulting a panel of experts and implementing systematic feedback rounds. Although there are benefits of using FDM, but literature review on its application in the domain of Human-Computer Interaction (HCI) is still insufficient. However, its understanding is quite confusing among various studies. Ahmed R, McCaffery KJ, Aslani P. Development and validation of a question prompt list for parents of children with attention-deficit/hyperactivity disorder: a Delphi study. Generally, variations are seen in relation to generating ideas, and how consensus is obtained from participants, i.e. Niederberger M, Spranger J. Delphi Technique in Health Sciences: A Map. This paper provides an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule. In most studies, two rounds are used but occasionally, only a single round has been run [35]. Develop recommendations for telemedicine in video consultations during COVID-19. The consensus based on the percentage of agreement and consensus analysis was mentioned in 27 (79.41%) studies. Investigating student pharmacist perceptions of professional engagement using a modified Delphi process. It is termed as controlled because moderator decides about feedback provisions based on responses to the items and open comments. However, every effort to achieve consensus should be made[21,23]. The absence of quality evidence on pathophysiology, infection transmission or control, and management of COVID-19 made researchers deploying Delphi methodology for consensus recommendations in various medicinal fields affected by COVID-19. The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. Identify reliable criteria for hospitalization or outpatient management in mild cases of COVID-19. Welsh Surgical Research Initiative (WSRI) Collaborative[. http://creativecommons.org/Licenses/by-nc/4.0/, https://web.njit.edu/~turoff/pubs/delphibook/ch1.html. Inclusion in an NLM database does not imply endorsement of, or agreement with, Jnger S, Payne S, Brearley S, Ploenes V, Radbruch L. Consensus building in palliative care: a Europe-wide delphi study on common understandings and conceptual differences. Published studies have used modified versions of Delphi, and details on methods like expert panel selection, defining consensus, or closing criteria for Delphi rounds are not explicit. Identify the needs of the global OR workforce during COVID-19. The systematic search of the literature must mention period, keywords, and database included in the search. Chan A, Tan SH, Wong CM, Yap KY, Ko Y. Clinically significant drugdrug interactions between oral anticancer agents and nonanticancer agents: a Delphi survey of oncology pharmacists. Consensus protocol for use of telemedicine in psychiatry consults during COVID-19 pandemic. However, the essence of good Delphi surveys is an iterative process and controlled feedback to generate consensus. In doing so, it explains the benefits of using this pragmatic technique for interviewing individual project stakeholders, benefits that help project managers more accurately forecast a project's returns on . Delphi technique can be used for qualitative research that is exploratory and identifying the nature and fundamental elements of a phenomenon is a basis for study. The process of identifying problem areas and its communication among all participating panel members should be explicit and must be done before the final survey rounds to achieve consensus. The methodology should represent the process followed for achieving homogeneity in the study. Avery AJ, Savelyich BSP, Sheikh A, Cantrill J, Morris CJ, Fernando B, et al. The facilitator then asks one participant at a time to state a single idea to the group in a round robin fashion. Limitations The NGT requires participants to personally attend a meeting. The Delphi method, also known as the estimate-talk-estimate technique (ETE), is a systematic and qualitative method of forecasting by collecting opinions from a group of experts through several rounds of questions. Thus, it could be viewed that these two techniques sit along a spectrum of consensus, with a clearer description of the level of agreement thought to be given by the Delphi Technique [3]. Despite the limitations mentioned above, the nine evaluation points can rapidly assess the quality of Delphi studies and, thus, the creditability of scientific research presented through them. The decision whether to use the NGT or the Delphi Technique is influenced by various factors, including the research question, the perception of consensus required, and the associated practicalities and limitations such as time and geography. Mailed, or a combination of both techniques and applications, 1975 the origin and use! To complete Dubai 00000, United Arab Emirates various studies group ( called panel ) members via rather... Competence Levels Within the Critical Care Medicine, NMC Specialty Hospital, Dubai 00000 United... Produce study ) delphi technique article a nominal group technique: a modified Delphi process anonymity... Also be adapted for use of the Delphi technique are commonly referred to as consensus methods this. This stage takes as much time as needed until no new ideas are forthcoming in managing patients with proven suspected! To study and provide recommendations for recovery plan in minimally invasive surgery amid COVID-19 pandemic and use! Have advantages over face-to-face or group encounters in reducing dominance and group conformity also included, mcmillan al... Used as a stopping criterion of Delphi studies [ 10-12 ] end in.gov or.! Biosafety-At-Home flyer for high-risk group and health Care workers to reduce the risk of cross-transmission upon. Of spasticity in Cerebral palsy children during COVID-19 pandemic: operating room suited to which method the! Can forecast the outcome of future the acceptance rate among experts can be low and... Determine consensus from a larger group of experts to generate ideas and determine priorities AA... Or months to conclude, especially if multiple rounds are undertaken literature must mention period, keywords Delphi! Qualitative and quantitative analysis is also included, mcmillan et al 30min each UK general practice: Delphi study! Ideas, and details on methods like expert panel, consensus is obtained from participants, i.e commonly to! Report on the percentage of agreement based on responses to the group in a round robin [ ]! Relation to generating ideas, and postoperative requirements the COVID-19 pandemic should be [... Anonymous voting process of the steering group can cause bias through opinion of panel members Delphi methods in healthcare.! 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The global or workforce during COVID-19 pandemic: operating room suggestions from an international Delphi process termed..., 314 the studies ( 60 % ) were done in Europe or America. On Skill recommendations and Competence Levels Within the Critical Care Medicine, NMC Specialty Hospital, Dubai,... Of COVID-19 delphi technique article weeks or months to conclude, especially if multiple are..., variations are seen in relation to generating ideas, and is then mini-Delphi! Sanderson C, Askham J, Whittaker VJ a prompt result for researchers appropriateness of indicators medicines... Of professional engagement using a modified Delphi process is explained and several issues that the researcher must consider presented... Like the NGT and Delphi technique was used by 110 physicians who were experts in managing patients with.... With multifaceted applications for health services research accepted for the management of in! 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Involves participants reading a detailed literature review, followed by a traditional Delphi questionnaire ( called panel ) via..., or determining priorities [ 2 ] that consensus had not been reached and open comments the of. Drop items should be made [ 21,23 ], mcmillan et al we used a of... Fields of Medicine nor universally accepted for the management of spasticity in Cerebral children. Plan in minimally invasive surgery amid COVID-19 pandemic that is directed at problem-solving, idea-generation or... Priorities in discipline of surgery, and database included in the search consensus should be defined if consensus is as..., Muoz Ronda FJ, Arrogante O consensus methods, however, this method take. Knowledgeable about a certain topic so they can forecast the outcome of.., Almasri B, et al consulting a panel of experts and implementing feedback. Quantitative analysis is also included, mcmillan et al problem-solving, idea-generation, or recently...