What type of evidence is available?
Feeling intrigued, with further investigation, it is interesting to note what type and amount of published evidence was available to inform clinical practice.
A simple PubMed search (using MeSH terms) demonstrated the number of published RCT studies versus opinion/consensus studies in 2021.1. It showed that more opinion-based evidence, such as delphi consensus-derived evidence, was published in 2021 compared to RCTs. Driven in part by the need to address answers to clinical questions to treatment and management of an emerging condition – Covid-19 but spanning a range of conditions and settings.
As recently as 2018, the primacy of randomized trials has been reconsidered because of the weaknesses of RCTs.2 How should opinion in clinical situations be best planned for, obtained and trusted?
It has been cited that stringent application of scientific research techniques, such as the expert Delphi methodology, allows survey of experts in a high quality and scientific manner.2
Delphi is a robust, powerful and applicable medical communications approach, suited to a range of healthcare business situations. Any situation requiring better understanding, better decisions, better relationships and better implementation must be assessed so that the feasibility for Delphi communications can be expertly explored.2
Consensus, without compromise
With its structured method of developing consensus among panel members, the Delphi consensus has gained acceptance in diverse fields of medicine, healthcare, and policy.
The Delphi method in healthcare assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited, ethically/logistically difficult or evidence is conflicting. However, the attempts to assess the quality standard of Delphi studies have reported significant variance, and details of the process followed are usually unclear.3
Triducive recommend systematic quality steps for evaluation of Delphi methodology; identification of problem area of research, selection of panel, anonymity of panellists, controlled feedback, iterative Delphi rounds, consensus criteria, analysis of consensus, closing criteria, and stability of the results.
Variants have been developed from the basic technique and applied across healthcare, now being applied with more heterogeneous expert groups working across healthcare.
The opinion of experts counts
Delphi communication was originally introduced and practiced dealing with technical topics and to seek consensus among homogeneous groups of experts. The RAND Corporation is usually acknowledged as having conducted the earliest Delphi studies in the 1950-60s.4
The types of opportunities for this approach in healthcare are: