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.
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.
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.
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.
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.
ObjectiveWe constructed a real-world evidence evaluation system to provide reference for obtaining high-quality evidence in evidence-based medicine.MethodsThrough the investigation and analysis of the key factors influencing the real-world research evidence, combined with domestic and foreign literature and evaluation tools, we preliminarily constructed the indicators of the real-world evidence evaluation system, then consulted experts in related fields by the Delphi method, modified and determined the final evaluation indicators. ResultsThe indicators of the final real-world evidence evaluation system included 40 items. The recovery efficiencies of the two rounds of expert consultation were 88.2% and 100%; The expert coordination coefficients were 0.174 (P<0.001) and 0.189 (P<0.001). After the second round of consultation, the mean of Likert scale in the range of 3.73~4.93, and the coefficient of variation varied in the range of 0.05~0.21. ConclusionThe real-world evidence evaluation system constructed in this study has certain reliability and scientificity, which can provide a basis and help for the transformation of real-world research into high-quality evidence.
ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
Objective To establish an evaluation index system for the quality and safety of day surgery, and provide standard and professional quantitative bases for monitoring and management of day surgery quality. Methods From December 2021 to May 2022, based on the frame work of the three-dimensional “structure-process-outcome” quality model, two rounds of Delphi method interviews were conducted with 15 day surgery-related management experts, and analytic hierarchy process was used to calculate the weight of each index. Results The effective questionnaire recovery rates of the two rounds of surveys were both 100%; the expert authority coefficients were 0.94 and 0.98, respectively; the variation coefficients were 0.00-0.30 and 0.00-0.24, respectively; the Kendall coordination coefficients were 0.382 (P<0.05) and 0.266 (P<0.05), respectively; and the consistency ratios of all levels were less than 0.1. The final day surgery quality and safety evaluation index system included 3 first-level indicators, 10 second-level indicators, and 43 third-level indicators. Conclusions The quality and safety evaluation index system of day surgery is scientific, reasonable and comprehensive. It can provide a reference for the quality and safety evaluation of day surgery and solidly promote the high-quality development of public hospitals.