International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study

INTERNATIONAL JOURNAL OF SURGERY

卷:79

Article

Beamish, A. J.^1,2  Brown, C.²  Abdelrahman, T.²  Harper, Ryan E.²  Harries, Rl^1,2  Egan, R. J.^1,2  Ansell, J.²  Evans, T.²  Hopkins, L.²  James, O.²  Lewis, S.³  Lewis, W. G.²  Luton, O.²  Mellor, K.²  Robinson, D.²  Thomas, R.²  Williams, A.² 

[1] Swansea Univ, Med Sch, Swansea, W Glam, Wales

[2] Hlth Educ & Improvement Wales Sch Surg, Ty Dysgu, Nantgarw, Wales

[3] Hlth Educ South West England, Bristol, Avon, England

关键词: COVID-19;    Delphi consensus;    Guidance;    Surgery;   

DOI  :  10.1016/j.ijsu.2020.06.015

来源: Elsevier

【 摘 要 】

Background: International professional bodies have been quick to disseminate initial guidance documents during the COVID-19 pandemic. In the absence of firm evidence, these have been developed by expert committees, limited in participant number. This study aimed to validate international COVID-19 surgical guidance using a rapid Delphi consensus exercise. Methods: Delphi statements were directly mapped to guidance from surgical professional bodies in the US and Europe (SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content against international consensus. Agreement from 70% participants was determined as consensus agreement. Results: The Delphi exercise was completed by 339 individuals from 41 countries and 52 statements were mapped to the guidance, 47 (90.4%) reaching consensus agreement. Of these, 27 statements were mapped to SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document. Within the SAGES/EAES document, 92.9% of items reached consensus agreement (median 89.0%, range 60.5-99.2%), 90.4% within the Joint RCS document (87.6%, 63.4-97.9%), and 90.9% within the RACS document (85.5%, 18.7-98.8%). Statements lacking consensus related to the surgical approach (open vs. laparoscopic), dual consultant operating, separate instrument decontamination, and stoma formation rather than anastomosis. Conclusion: Initial surgical COVID-19 guidance from the US, Europe and Australasia was widely supported by an international expert community, although a small number of contentious areas emerged. These findings should be addressed in future guidance iterations, and should stimulate urgent investigation of non-consensus areas.

【 授权许可】

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