LIANG Changhao, YIN Guanxiang, WANG Yaqi, LIU Siqi, GAO Yicheng, LIU Pengwei, SU Xiangfei, FEI Yutong. Application of Delphi Method in the Development and Revision of Clinical Practice Guidelines of Traditional Chinese Medicine: Process and Suggestions[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1084-1090. DOI: 10.12290/xhyxzz.2022-0649
Citation: LIANG Changhao, YIN Guanxiang, WANG Yaqi, LIU Siqi, GAO Yicheng, LIU Pengwei, SU Xiangfei, FEI Yutong. Application of Delphi Method in the Development and Revision of Clinical Practice Guidelines of Traditional Chinese Medicine: Process and Suggestions[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1084-1090. DOI: 10.12290/xhyxzz.2022-0649

Application of Delphi Method in the Development and Revision of Clinical Practice Guidelines of Traditional Chinese Medicine: Process and Suggestions

Funds: 

Xinjiang Uygur Autonomous Region Key Research and Development Program 2022B03011-4

China Association of Traditional Chinese Medicine Research and Evaluation Special Project CACMRE2021-A-04

More Information
  • Corresponding author:

    FEI Yutong, E-mail: yutong_fei@163.com

  • Received Date: November 14, 2022
  • Accepted Date: January 15, 2023
  • Available Online: May 30, 2023
  • Issue Publish Date: September 29, 2023
  • In the process of developing clinical practice guidelines, consensus method is essential to determine clinical problems and recommendations, among which Delphi method and modified Delphi method are the most common. Therefore, scientific and standardized application of Delphi method to reach a consensus (such as expert selection, process design) has become an important topic in urgent need of study. In the process of using Delphi method, it is necessary to refer to mature methodological suggestions to make theconsensus process structured and transparent. This article focuses on the key elements of Delphi method in the development of clinical practice guidelines, and elaborates its basic methods and processes, including the number, composition, standards and selection methods of the "expert group", as well as the key points of patients' participation. In terms of technical points, anonymity, consensus threshold and time control are described. Furthermore, the limitations of Delphi method and the highlights of the report are presented, in order to promote the standardized application of Delphi method in the development of the guidelines.
  • [1]
    Dalkey N. An experimental study of group opinion: The Delphi method[J]. Futures, 1969, 1: 408-426. DOI: 10.1016/S0016-3287(69)80025-X
    [2]
    Black N, Murphy M, Lamping D, et al. Consensus development methods: a review of best practice in creating clinical guidelines[J]. J Health Serv Res Policy, 1999, 4: 236-248. DOI: 10.1177/135581969900400410
    [3]
    Fink A, Kosecoff J, Chassin M, et al. Consensus methods: characteristics and guidelines for use[J]. Am J Public Health, 1984, 74: 979-983. DOI: 10.2105/AJPH.74.9.979
    [4]
    Nair R, Aggarwal R, Khanna D. Methods of formal consensus in classification/diagnostic criteria and guideline development[J]. Semin Arthritis Rheum, 2011, 41: 95-105. DOI: 10.1016/j.semarthrit.2010.12.001
    [5]
    Steurer J. The Delphi method: an efficient procedure to generate knowledge[J]. Skeletal Radiol, 2011, 40: 959-961. DOI: 10.1007/s00256-011-1145-z
    [6]
    梁昌昊, 夏如玉, 黄子玮, 等. 共识法在中医临床实践指南及专家共识中的应用及方法学报告特征分析[J]. 中医杂志, 2022, 63: 26-34. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202201008.htm
    [7]
    Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies[J]. J Clin Epidemiol, 2014, 67: 401-409. DOI: 10.1016/j.jclinepi.2013.12.002
    [8]
    Sandford BA, Hsu CC. The Delphi Technique: Making Sense of Consensus[J]. Pract Assess Res Evaluation, 2007, 26: 289-304.
    [9]
    Keeney S, Hasson F, Mckenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research[J]. J Adv Nurs, 2010, 53: 2.
    [10]
    Gaakeer MI, Veugelers R, Patka P, et al. On behalf of the Dutch ED Study Group. Minimum operational standards for 24/7 available emergency departments in the Nether-lands: a first step taken by emergency physicians using an e-Delphi approach[J]. Eur J Emerg Med, 2019, 26: 86-93. DOI: 10.1097/MEJ.0000000000000494
    [11]
    曾照云, 程晓康. 德尔菲法应用研究中存在的问题分析: 基于38种CSSCI(2014—2015)来源期刊[J]. 图书情报工作, 2016, 60: 116-120. https://www.cnki.com.cn/Article/CJFDTOTAL-TSQB201616020.htm
    [12]
    Mckenna H, Keeney S, Hasson F. The Delphi Technique in Nursing and Health Research[M]. New Jersey: John Wiley & Sons Ltd, 2011: 1-17.
    [13]
    廖星, 谢雁鸣, 张俊华, 等. 中医临床实践指南制修订中专家共识技术规范[J]. 中国中药杂志, 2019, 44: 4354-4359. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY201920034.htm
    [14]
    McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques[J]. Int J Clin Pharm, 2016, 38: 655-662.
    [15]
    McKenna HP. The Delphi technique: a worthwhile research approach for nursing?[J]. J Adv Nurs, 1994, 19: 1221-1225. DOI: 10.1111/j.1365-2648.1994.tb01207.x
    [16]
    Wolf R. The decision Delphi[J]. Technol Forecast Soc Change, 1979, 15: 159-169. DOI: 10.1016/0040-1625(79)90011-8
    [17]
    Crisp J, Pelletier D, Duffield C, et al. The Delphi method?[J]. Nurs Res, 1997, 46: 116-118. DOI: 10.1097/00006199-199703000-00010
    [18]
    Beretta R. A critical review of the Delphi technique[J]. Nurse Res, 1996, 3: 79-89. DOI: 10.7748/nr.3.4.79.s8
    [19]
    Dean P, Schumacher D, Florin TA. Defining Pneumonia Severity in Children: A Delphi Study[J]. Pediatr Emerg Care, 2021, 37: e1482-e1490. DOI: 10.1097/PEC.0000000000002088
    [20]
    Jordans IPM, de Leeuw RA, Stegwee SI, et al. Sono-graphic examination of uterine niche in non-pregnant women: a modified Delphi procedure[J]. Ultrasound Obstet Gynecol, 2019, 53: 107-115. DOI: 10.1002/uog.19049
    [21]
    Gordon T, Pease A. RT Delphi: An efficient, "round-less" almost real time Delphi method[J]. Technol Forecast Soc Change, 2006, 73: 321-333. DOI: 10.1016/j.techfore.2005.09.005
    [22]
    Varndell W, Fry M, Elliott D. Applying real-time Delphi methods: development of a pain management survey in emergency nursing[J]. BMC Nurs, 2021, 20: 149. DOI: 10.1186/s12912-021-00661-9
    [23]
    Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations[J]. BMJ, 2008, 336: 1049-1051. DOI: 10.1136/bmj.39493.646875.AE
    [24]
    Moberg J, Oxman AD, Rosenbaum S, et al. The GRADE Evidence to Decision (EtD) framework for health system and public health decisions[J]. Health Res Policy Syst, 2018, 16: 45. DOI: 10.1186/s12961-018-0320-2
    [25]
    Guyatt G, Oxman AD, Akl EA, et al. GRADE guide-lines: 1. Introduction-GRADE evidence profiles and summary of findings tables[J]. J Clin Epidemiol, 2011, 64: 383-394. DOI: 10.1016/j.jclinepi.2010.04.026
    [26]
    WHO. Handbook for Guideline Development[EB/OL]. (2014-12-08)[2023-05-28]. https://www.who.int/publications/i/item/9789241548960.
    [27]
    胡晶, 张会娜, 康群甫, 等. 共识法在中医临床实践指南制定中的应用[J]. 中医杂志, 2016, 57: 1658-1661. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201619010.htm
    [28]
    Goodman CM. The Delphi technique: a critique[J]. J Adv Nurs, 2010, 12: 729-734.
    [29]
    Ishikawa A, Amagasa M, Shiga T, et al. The max-min Delphi method and fuzzy Delphi method via fuzzy integration[J]. Fuzzy Sets Syst, 1993, 55: 241-253. DOI: 10.1016/0165-0114(93)90251-C
    [30]
    NICE. Developing Nice Guidelines the Manual[EB/OL]. (2014-10-31)[2023-05-28]. https://www.nice.org.uk/process/pmg20/chapter/introduction.
    [31]
    周芬. 患者及公众参与临床实践指南构建及其方法的研究进展[J]. 护理学报, 2020, 27: 14-17. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202005006.htm
    [32]
    Roman BR, Feingold J. Patient-centered Guideline Develop-ment Best Practices Can Improve the Quality and Impact of Guidelines[J]. Otolaryngol Head Neck Surg, 2014, 151: 530-532. DOI: 10.1177/0194599814544878
    [33]
    靳英辉, 王丹琦, 李艳, 等. 临床实践指南制定方法: 国内外临床实践指南制定手册概要[J]. 中国循证心血管医学杂志, 2018, 10: 1-10. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX201801001.htm
    [34]
    解染, 陈耀龙, 陈昊, 等. 循证指南制定中患者价值观和偏好的研究方法[J]. 中国循证医学杂志, 2015, 15: 586-591. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201505015.htm
    [35]
    宁允, 李文姣, 程侣, 等. 患者及公众参与患者指南制定的思考[J]. 中国循证心血管医学杂志, 2020, 12: 908-911. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX202008004.htm
    [36]
    张颖, 季聪华, 李秋爽, 等. 中医临床实践指南制修订中德尔菲法的统计分析方法[J]. 中华中医药杂志, 2018, 33: 249-251. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201801064.htm
    [37]
    付红艳. 关于变异系数、偏度系数和峰度系数的U统计量检验法[D]. 长春: 吉林师范大学, 2014.
    [38]
    Dai F, Wei K, Chen Y, et al. Construction of an index system for qualitative evaluation of undergraduate nursing students innovative ability: A Delphi study[J]. J Clin Nurs, 2019, 28: 4379-4388.
    [39]
    Li Y, Ehiri J, Hu D, et al. Framework of behavioral indicators for outcome evaluation of TB health promotion: a Delphi study of TB suspects and Tb patients[J]. BMC Infect Dis, 2014, 14: 268.
    [40]
    刘弘. 关于痛经辨证分型的专家问卷分析[J]. 中医杂志, 2008, 49: 984-985. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ200811010.htm
    [41]
    Green P. The Outdoor Leadership Handbook. A Manual for Leaders of Land-based Outdoor Pursuits in the Pacific Northwest[M]. Tacoma: Emergency Response Institute, 1982: 7-14.
    [42]
    Chen L, Wu Y, Wang S, et al. Construction of evidence-based practice competencies for nurses in China: A modified Delphi study[J]. Nurse Educ Today, 2021, 102: 104927.
    [43]
    Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique[J]. J Adv Nurs, 2000, 32: 1008-1015.
    [44]
    Martino JP. The Delphi method: Techniques and applica-tions[J]. Technol Forecast Soc Change, 1976, 8: 441-442.
    [45]
    Sandrey MA, Bulger SM. The Delphi Method: An App-roach for Facilitating Evidence Based Practice in Athletic Training[J]. Athl Train Educ J, 2008, 3: 135-142.
    [46]
    李博, 任晨儿, 刘阳. 辨证与厘清: 体育科学研究中"德尔菲法"应用存在的问题及程序规范[J]. 体育科学, 2021, 41: 89-97. https://www.cnki.com.cn/Article/CJFDTOTAL-TYKX202101011.htm
    [47]
    管慧, 戴国华, 高武霖, 等. 中医药临床研究中应用德尔菲法的系统评价[J]. 中国循证医学杂志, 2021, 21: 186-190. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ202102009.htm
    [48]
    Jünger S, Payne SA, Brine J, et al. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological syste-matic review[J]. Palliat Med, 2017, 31: 684-706.
    [49]
    O'Connor N, Clark S. Beware bandwagons! The bandwagon phenomenon in medicine, psychiatry and management[J]. Australas Psychiatry, 2019, 27: 603-606.
  • Related Articles

    [1]LIANG Changhao, YIN Dingran, LIU Meijun, YIN Guanxiang, LI Xun, WANG Yaqi, LIU Siqi, TONG Min, LIU Pengwei, SU Xiangfei, FEI Yutong. Exploring the Essential Factors of Applying the Consensus Methods in the Development of Traditional Chinese Medicine Guidelines: A Qualitative Interview[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 942-952. DOI: 10.12290/xhyxzz.2023-0320
    [2]ZHU Di, LUO Xufei, WANG Zijun, SHI Qianling, LI Haodong, WANG Ye, CHEN Yaolong. The Differences and Connections Among Expert Evidence, Expert Opinion and Expert Consensus in the Development of Guidelines[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 936-941. DOI: 10.12290/xhyxzz.2024-0542
    [3]TIAN Chen, YANG Qiuyu, SUN Mingyao, LIU Jie, TIAN Jinhui, CHEN Yaolong, YANG Kehu, GE Long. Methods for Developing Rapid and Living Evidence-based Guidelines[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(1): 183-191. DOI: 10.12290/xhyxzz.2023-0191
    [4]WANG Ling, WANG Ping, SU Renfeng, ZHAO Junxian, ZHU Di, LI Zhewei, HE Hongfeng, LUO Xufei, LIU Hui, ZHANG Hairong, WANG Xiaohui, CHEN Yaolong. Analysis of Development Method of Clinical Practice Guidelines in Primary Care[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1310-1318. DOI: 10.12290/xhyxzz.2023-0455
    [5]DU Hailin, GU Xiaoyang, LI Jiashan. A Study on the Invention of Folin-Wu Method and Hsien Wu's Contribution in the Process[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 1114-1120. DOI: 10.12290/xhyxzz.2022-0335
    [6]Chinese Medicine Group, Clinical Epidemiology and Evidence-based Medicine Association of Chinese Medical Association. Expert Consensus on Clinical Research Methodology of Traditional Chinese Medicine in the New Era[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 783-788. DOI: 10.12290/xhyxzz.2022-0428
    [7]SHI Lili, WEI Jing, HONG Xia. Reporting System of Patients' Safety Management Established By the Delphi Method about Psychological Evaluation, Intervention and the Psychological Critical Value[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(3): 359-365. DOI: 10.12290/xhyxzz.20190194
    [8]WANG Zi-jun, ZHOU Qi, XING Dan, YANG Nan, LUO Xu-fei, ZHANG Jing-yi, SHI Qian-ling, ZHAO Si-ya, LIU Hui, LIU Xiao, LI Qin-yuan, DU Liang, YANG Ke-hu, CHEN Yao-long. Reporting Quality of Literature Interpreting Clinical Practice Guidelines/Consensus: A Cross-sectional Study[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(2): 260-267. DOI: 10.12290/xhyxzz.20200250
    [9]Yao-long CHEN, Xiao LIU, Yan-ping WANG, Yu-qing ZHANG, Cheng-ping WEN, Dong-yi HE, Yu-tong FEI, Yan-ming XIE, Nan-nan SHI, Bo LI, Hui LI, Hao CHEN, Shu YANG, Yan-fang MA, Hong-cai SHANG, Ke-hu YANG. Western Medical Guidelines and Traditional Chinese Medical Guidelines:Improving Together through Mutual Learning[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 615-620. DOI: 10.3969/j.issn.1674-9081.2020.05.019
    [10]Yao-long CHEN, Xu-fei LUO, Ji-yao WANG, Xiao-qing LIU, Hong-cai SHANG, Ke-hu YANG. How to Distinguish between Clinical Practice Guidelines and Expert Consensus[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 403-408. DOI: 10.3969/j.issn.1674-9081.2019.04.018
  • Cited by

    Periodical cited type(1)

    1. 刘敏,杨金苹,赵金颜,乔建红. 老年共病患者自我感知老化、抑郁情绪与生活质量的相关性研究. 心理月刊. 2024(21): 58-60 .

    Other cited types(0)

Catalog

    Article Metrics

    Article views (886) PDF downloads (92) Cited by(1)
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close