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.
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.
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.
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.
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.
ObjectiveTo conduct item analysis on the Pulmonary Nodule Symptom Scale preliminarily developed through Delphi consultation, establish the final version of the scale, and evaluate its reliability and validity. MethodsPatients with pulmonary nodules who visited the outpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May to October 2024 were enrolled according to diagnostic criteria for pulmonary nodules and predefined inclusion/exclusion standards. Demographic data, medical history, and imaging characteristics of pulmonary nodules were collected, and participants completed the preliminary Pulmonary Nodule Symptom Scale developed through Delphi consultation. Four item analysis methods, including discrete trend method, critical ration method, correlation coefficient method, and Cronbach’s α coefficient, were employed for final item screening to determine the definitive version of the scale. Reliability and validity were systematically assessed via Cronbach’s α, split-half reliability, content validity, and construct validity. ResultsA total of 153 patients with pulmonary nodules were included, comprising 56 (36.60%) males and 97 (63.40%) females, with a mean age of (53.77±12.61) years. The median disease duration was 6 (1, 20) months, and mean nodule diameter was (7.64±4.37) mm, including 38 (24.84%) solitary patients and 115 (75.16%) multiple patients, as well as 39 (25.49%) solid nodules and 114 (74.51%) ground-glass nodules. Based on comprehensive results from four item analysis methods and core group discussion, two items ("symptom severity" and "quality of life") in the overall evaluation dimension were removed. The final scale comprised 15 items across three dimensions: respiratory symptoms, systemic manifestations, and psychological state. The Cronbach’s α coefficient was 0.84, with a Spearman-Brown coefficient of 0.912. Item-level content validity indices ranged from 0.824 to 1.000, while the scale-level content validity index reached 0.933. Kaiser-Meyer-Olkin (KMO) measure was 0.803, with Bartlett’s test of sphericity showing statistical significance (P<0.001). Exploratory factor analysis extracted three factors explaining 52.48% of total variance, and the rotated component matrix distribution generally aligned with the predefined three dimensions. ConclusionThe definitive version of the Pulmonary Nodule Symptom Scale contains 15 items across three dimensions (respiratory symptoms, systemic manifestations, and psychological state). Reliability and validity evaluations demonstrate good reliability and satisfactory validity for the scale.
ObjectivesTo provide methodology support for the tracking assessment of specific resolution execution through evidence-based construction of tracking assessment index system for resolution execution of WHO essential medicine accessibility resolution, so as to further promote and improve the establishment of national essential medicine policies, and offer a methodology reference to survey and assess the resolution executions in other public health fields.MethodsA multi-disciplinary team was set up to preliminarily construct the index system by means of earlier system assessment index through index screening based on Delphi method. The weight of each index was determined by analytic hierarchy process.ResultsAfter two rounds of expert consultation, the index system available for resolution execution measures and results of WHO essential medicine accessibility were established, including 9 indexes of resolution execution measures. Meanwhile, the execution results of index contained 4 first class indexes, 13 second class indexes and 36 third class indexes. Each of the indexes obtained its own weight according to degree of importance.ConclusionsIn this study, the assessment index for resolution execution of essential medicine accessibility is established, however, the empirical research is still required to further verify the scientificity as well as feasibility of this index system.
Objective To construct an evaluation index system of the competitiveness of private hospitals, and to provide references for guiding, supervising, and managing the high-quality development of private hospitals. Methods An index pool was constructed by the literature analysis method. Index screening was completed using the modified Delphi method. The analytic hierarchy process, entropy weight method, and combination weight method were used to determine the index weight. Results The competitiveness evaluation index system of private hospitals was constructed, which included 5 primary indexes and 36 secondary indexes. The combination weight methods were resource allocation (0.366 8), service capacity (0.470 8), service efficiency (0.033 7), quality and safety (0.121 3), and financial management (0.007 3). Conclusion The constructed evaluation index system of competitiveness of private hospitals is scientific, targeted, and operable.
As an important auxiliary means of pharmacoeconomics evaluation, budget impact analysis can effectively measure the affordability of medical insurance fund, and plays a significant role in the process of medical insurance access negotiation, adjustment of medical insurance reimbursement directory and establishment of payment price. The quality of budget impact analysis data has a great impact on the analysis results and the scientific decision-making. When the existing data cannot meet the requirements of the paper, relevant software is needed to carry out Delphi method to ensure the data accuracy. Infopoll is a powerful, easy-to-use application that designs consultation questionnaires by providing multiple question choices and multiple forms of answer settings, as well as detailed statistical charts for results analysis. This paper introduces how to obtain the data of budget impact analysis based on Delphi method using Infopoll software, and analyzes the main results in detail.
Objective To construct a nursing sensitive index system for limb blood circulation monitoring, to guide clinical nursing practice, and provide a scientific basis for the evaluation and management of limb blood circulation monitoring nursing quality. Methods The Chinese and English databases such as China National Knowledge Infrastructure, Wanfang, VIP, PubMed, and Web of Science were searched from the establishment of the database to April 1st, 2024. Using the structure-process-outcome three-dimensional quality system model as the theoretical basis, and through semi-structured interviews, an expert letter consultation questionnaire containing 3 first-level indicators, 9 second-level indicators and 30 third-level indicators was developed. The final nursing sensitive index system of limb blood circulation monitoring were determined through two rounds of expert consultation. Results A total of 25 experts participated in the questionnaire survey. The positive coefficients of the two rounds of expert consultation were 96% (24/25) and 100% (24/24), respectively, the expert authority coefficient was 0.906. The final nursing sensitive index system included 3 first-level indicators, 6 second-level indicators and 21 third-level indicators. All the indicators were closely related to limb blood circulation monitoring, and the quality of specialized nursing work of limb blood circulation monitoring was comprehensively improved from the three dimensions of structural indicators, process indicators, and outcome indicators. Conclusion The nursing sensitive index system of limb blood circulation monitoring has strong specialty, it not only clarifies the specific content of limb blood circulation monitoring and nursing work, but also systematically constructs the requirements and standards of the quality management level of blood circulation monitoring, which is scientific and practical.
