Multi-Round versus Real-Time Delphi survey approach for achieving consensus in the COHESION core outcome set: a randomised trial

Trials

Research

Christabell Omukagah Okaronon¹  James R. H. Webbe²  Mandy Daly³  Shireen Meher⁴  Jamie J. Kirkham⁵  Matthew J. Parkes⁶  Farhana Tabassum⁷  Karen Walker⁸  Malcolm R. Battin⁹  Caitlin Bernard^1,10  David M. Haas^1,10  Maira Niaz^1,11  Elaine Finucane^1,12  Elaine Ní Bhraonáin^1,13  Tim Hurley^1,14  Fiona A. Quirke^1,15  Declan Devane^1,16  Eleanor J. Molloy^1,17  Frank H. Bloomfield^1,18  Sarah Koskei^1,19  Patricia Healy^2,20  Linda Biesty^2,21 

[1] AMPATH, Eldoret, Kenya;Academic Neonatal Medicine, Imperial College London, London, UK;Advocacy and Policymaking, Irish Neonatal Health Alliance, Wicklow, Ireland;Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK;Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;Centre for Statistics in Medicine, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxfordshire, UK;Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan;Department of Newborn Care, Royal Prince Alfred Hospital, Sydney, Australia;University of Sydney, Sydney, Australia;The George Institute for Global Health, Sydney, Australia;Council of International Neonatal Nurses, Sydney, Australia;Department of Newborn Services, Auckland District Health Board, Auckland, New Zealand;Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, USA;Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan;Evidence Synthesis Ireland, University of Galway, Galway, Ireland;Family Support Liaison, Irish Neonatal Health Alliance, Wicklow, Ireland;Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland;Department of Paediatric and Child Health, Trinity College Dublin, Tallaght University Hospital (TUH), Dublin, Ireland;Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland;Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland;School of Nursing and Midwifery, University of Galway, Galway, Ireland;Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland;Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland;School of Nursing and Midwifery, University of Galway, Galway, Ireland;Cochrane Ireland, University of Galway, Galway, Ireland;Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland;Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland;Department of Neonatology, Children’s Hospital Ireland at Crumlin and Tallaght, Coombe Women and Infants University Hospital, Dublin, Ireland;Liggins Institute, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand;Moi University, Eldoret, Kenya;School of Nursing and Midwifery, University of Galway, Galway, Ireland;Evidence Synthesis Ireland, University of Galway, Galway, Ireland;School of Nursing and Midwifery, University of Galway, Galway, Ireland;Evidence Synthesis Ireland, University of Galway, Galway, Ireland;Qualitative Research in Trials Centre (QUESTS), University of Galway, Galway, Ireland;

关键词: Real-Time Delphi;    Multi-round Delphi;    Core outcome set;    Randomised trial;    Delphi survey;    Consensus;   

DOI  :  10.1186/s13063-023-07388-9

 received in 2022-09-29, accepted in 2023-05-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDelphi surveys are commonly used to prioritise critical outcomes in core outcome set (COS) development. This trial aims to compare a three-round (Multi-Round) Delphi (MRD) with a Real-Time Delphi (RTD) in the prioritisation of outcomes for inclusion in a COS for neonatal encephalopathy treatments and explore whether ‘feedback’, ‘iteration’, and ‘initial condition’ effects may occur in the two survey methods.MethodsWe recruited 269 participants (parents/caregivers, healthcare providers and researchers/academics) of which 222 were randomised to either the MRD or the RTD. We investigated the outcomes prioritised in each survey and the ‘feedback’, ‘iteration’, and ‘initial condition’ effects to identify differences between the two survey methods.ResultsIn the RTD, n = 92 participants (83%) fully completed the survey. In the MRD, n = 60 participants (54%) completed all three rounds. Of the 92 outcomes presented, 26 (28%) were prioritised differently between the RTD and MRD. Significantly fewer participants amended their scores when shown stakeholder responses in the RTD compared to the MRD (‘feedback effect’). The ‘iteration effect’ analysis found most experts appeared satisfied with their initial ratings in the RTD and did not amend their scores following stakeholder response feedback. Where they did amend their scores, ratings were amended substantially, suggesting greater convergence. Variance in scores reduced with subsequent rounds of the MRD (‘iteration effect’). Whilst most participants did not change their initial scores in the RTD, of those that did, later recruits tended to align their final score more closely to the group mean final score than earlier recruits (an ‘initial condition’ effect).ConclusionThe feedback effect differed between the two Delphi methods but the magnitude of this difference was small and likely due to the large number of observations rather than because of a meaningfully large difference. It did not appear to be advantageous to require participants to engage in three rounds of a survey due to the low change in scores. Larger drop-out through successive rounds in the MRD, together with a lesser convergence of scores and longer time to completion, indicate considerable benefits of the RTD approach.Trial registrationNCT04471103. Registered on 14 July 2020.

【 授权许可】

CC BY   
© The Author(s) 2023

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