Reporting guidelines for Delphi techniques in health sciences: A methodological review

BACKGROUND

Delphi techniques are conducted across different subfields in the health sciences. The reporting practices of studies using Delphi techniques vary, and current reporting guidelines for Delphi techniques focus on individual subfields of the health sciences or on different aspects of research and are therefore of limited applicability. The aim of this article was to identify similarities, differences, and possible shortcomings of existing Delphi reporting guidelines and to draft an initial proposal for a comprehensively applicable reporting guideline.

METHODS

A systematic literature search for reporting guidelines on Delphi studies was performed in existing data resources based on databases in the health sciences (Scopus, MEDLINE, CINAHL, Epistemonikos) including publications from 2016 to 2021. In June 2021, we conducted an additional search in PubMed and included further studies by contacting experts of the scientific Delphi expert network (DeWiss). Title and abstract screening of articles was performed, followed by a full-text screening of the articles included. We qualitatively and quantitatively evaluated, compared and contrasted the reporting guidelines identified using content analysis and discussed the results among the members of the Delphi expert network.

RESULTS

We retrieved ten health science articles with reporting guidelines for Delphi studies. In analyzing them, we identified nine main categories (Justification, Expert panel, Questionnaire, Survey design, Process regulation, Analyses, Results, Discussion, Methods reflection & Ethics). The current reporting guidelines vary significantly, with only the aspect of consensus appearing in all of them. Frequency distributions show that most of the subcategories are only addressed in individual articles (e.g., meeting of participants, proceeding with the survey method, transfer of the results, validation, prevention of bias) and that epistemological foundations of the Delphi technique are rarely mentioned or reflected on. We drafted an initial proposal for Delphi reporting guidelines for the health science sector.

DISCUSSION

A well-justified position concerning epistemological foundations of Delphi studies is necessary to make the quality of the process assessable and, along with the reporting of the process, to classify and compare study results. This will increase the acceptance of both the method in the health science sector and the results in medical practice. A Delphi reporting guideline must, above all, take into account the diversity of variants, subfield-related objectives and application areas, and their modifications of the Delphi technique in order to be comprehensively applicable in the health sciences.

CONCLUSION

The results of our methodological review do not provide a final reporting guideline. The newly developed proposal is intended to encourage discussion and agreement in further analyses.

[Development of items for the assessment of paediatric incontinence-associated dermatitis in German: Delphi study]

Development of items for the assessment of paediatric incontinence-associated dermatitis in German: Delphi study Abstract: Background: Paediatric incontinence-associated dermatitis (PIAD) is a common problem in premature infants, neonates, infants and young children. Standardized instruments for the assessment of PIAD can support clinical decision-making, but no standardized instrument is yet available for German-speaking countries. Aim: Selection, development and agreement of appropriate items for the assessment of PIAD in newborns, infants and young children in German (aIADchild Delphi). Method: Using a Delphi technique, international items were formulated in German by a steering committee, the items were assessed by panellists using an online survey, and a consensus (I-CVI > = 75%, comments) was formed by the steering committee and panellists. Results: 54 experts from four German-speaking countries were recruited. 44 (1st round) and 33 (2nd round) completed the questionnaire in full. Twelve items for the assessment of PIAD were rated as relevant, comprehensive and comprehensibility: erythema, skin change without and with damage to the skin surface, exudation, bleeding, oedema, overheating, signs of mycotic/bacterial superinfection, pain, itching, localization/extension and duration. Conclusion: The items aIADchild Delphi for the assessment of PIAD in German should be tested for their measurement properties prior to clinical use and the construction of an instrument.

Prioritäten der Pflegeforschung für das Themenfeld "Dementia Care" im deutschsprachigen Raum - Eine Delphi-Studie

Priorities of nursing research in dementia care in German-speaking countries - A Delphi study Abstract. Background and objective: To meet the central needs of people with dementia, their relatives and their caregivers in complex living conditions and care situations, a substantive examination of research priorities is required. The aim of this work was the identification and prioritisation of nursing research topics concerning dementia care in German-speaking countries.

METHODS

To identify existing research agendas in dementia care, we conducted a systematic literature research. As part of a Delphi process, systematically identified dementia care experts from German-speaking countries supplemented research priorities extracted from existing research agendas and assessed their importance. Subsequently, they prioritized topics of particular importance for nursing research.

RESULTS

Fifteen experts supplemented 61 topics previously identified in existing research agendas. They assessed 107 topics in terms of their importance and prioritized 79 topics.

CONCLUSIONS

The research priorities developed are a potential framework for nursing science, health policy and research funding in order to structure research activities. To ensure currency, priorities should be regularly updated and re-opened for discussion.

[E-Learning in bachelor-level nursing education in Germany and the role of the nurse educator - a Delphi survey]

E-Learning in bachelor-level nursing education in Germany and the role of the nurse educator - a Delphi survey Abstract.

BACKGROUND

In addition to conventional face-to-face classes, e-learning is becoming more prevalent in tertiary-level nurse education. Its asynchronous, decentralized nature influences teaching and learning.

AIM

This study examines current expert opinion on how e-learning is affecting tertiary-level nurse education and the role of the nurse educator.

METHODS

In a 3-wave Delphi survey, nurse educators, nursing students / alumni, information and communications technology (ICT-) specialists and members of the scientific community were recruited as experts and asked to give their opinions regarding e-Learning and its effects on nurse education and the nurse educator's role. The null-round (R0) instrument comprised open questions. The R0-data were analyzed utilizing qualitative content analysis and then used in conjunction with the results of an earlier literature review to generate items for standardized follow up rounds (R1&2). The R1&2-instrument consists of 14 statements pertaining to e-learning and 13 statements pertaining to the nurse educator's role. Participants were asked to indicate the degree to which they agree with each statement. R1&2-data were analyzed using statistical methods. The means and medians for R1&2 were compared with each other. In addition, the response behavior of each individual participant was analyzed and assessed as assimilating, divergent, stable or inexplicable.

RESULTS

The size of the expert panel was: R0 = 8, R1&2 = 15; total panel mortality was n = 2. The analysis of standardized data provides the following representation of expert opinion: Participants viewed the effectiveness of e-learning as being not only dependent upon the domain of the learning objective (i. e. cognitive, affective), but also upon the complexity of the subject matter. According to the experts, face-to-face interaction is paramount to successful learning. The experts also recognized e-learning's potential for facilitating cooperation between clinical and classroom settings, the continuity of teaching and learning, a better work-study-life balance, as well as knowledge transfer. Furthermore, the participants took the view that e-learning changes the nurse educator's role, requiring new / expanded didactical, pedagogical, administrative and technical competencies compared to traditional face-to-face teaching and learning.

CONCLUSIONS

Nurse educators will need specific training to prepare them for their altered role. Blended learning offers more added value than pure online learning.

An Acupuncture Protocol for the Treatment of Erectile Dysfunction: A Delphi Process

INTRODUCTION

Erectile dysfunction (ED) is a widespread disorder, and the worldwide incidence is rapidly increasing. Acupuncture, an intervention out of the spectrum of traditional Chinese medicine (TCM), has a long tradition as treatment for ED. Nonetheless, a best-practice treatment protocol is currently missing. A recent systematic review and meta-analysis confirmed a huge diversity of acupuncture treatments for ED and concluded that there is an urgent need to standardise acupuncture treatment for ED. Consequently, the authors conducted a Delphi process with the aim to achieve an expert consensus as a basis for the development of a best-practice protocol.

METHODS

The Delphi process consisted of four rounds of questionnaires with closed and open-ended questions. Eleven acupuncture experts participated. The therapeutic aim was defined as "to achieve an erection sufficient for sexual satisfaction."

RESULTS

Consensus was achieved on 24 acupoints corresponding to 12 TCM syndromes. The syndromes were KI Yang xu, KI Yin xu, KI Qi xu, Ki and HT not harmonised, LR Qi Stagnation, LR Qi stagnation and Heat, Liver Blood xu, Liver Blood xu and Liver Qi stagnation, Damp-heat sinking to the lower Jiao5, HT and GB Qi xu, SP xu and HT Blood xu, Yin xu. The suggested optimal dose was between 11 and 15 treatments given once or twice a week.

CONCLUSION

An expert consensus-based, semi-standardised best-practice treatment protocol for the treatment of ED was developed. Moreover, the Delphi process also revealed inconsistencies as to which signs and symptoms constitute a TCM syndrome. Further Delphi studies including a broader range of experts from various acupuncture traditions are needed to establish further agreement. Nonetheless, the best-practice protocol introduced in this study provides a first point of departure for the implementation of a more standardised treatment approach. Moreover, since a recent meta-analysis concluded that more high-quality clinical studies on the topic are needed, this study provides a first standardised acupuncture treatment protocol for ED.