How to Manage Delphi Panels
The Delphi method has become a trusted method in healthcare for gathering expert opinion data to support decision-making in areas like clinical guidelines, policy, or research prioritisation. It offers a systematic way of tapping into the experience of experts by way of iterative surveys to reach consensus.
The credibility of a Delphi study is highly dependent not only on the questions being asked to answer an overarching research question, but also on the participants (especially the expert survey respondents or ‘panel’) and the strength of their engagement with the research project. Managing Delphi panels well is therefore needed to transform a theoretical framework into a practical, credible research outcome.
Getting Started: Defining the Research Purpose & Planning the Delphi Panel
Every effective Delphi process begins with clarity of purpose – what should the study help achieve? Whether the aim is to identify and implement best practices, determine criteria for the use of health innovations, or address changing policy needs, focused objectives will shape the study, from the structure of the questionnaires to the criteria for recruiting panellists. A solid panel could start at 12 people and go up to hundreds, depending on the needs of the project. It should be large enough to ensure variation but remain manageable across multiple rounds.
In Delphi panels, experts should represent the mix of perspectives needed to answer the research question. This can include healthcare professionals with certain specialties, general practitioners, nurses, but also include patients and carers, commissioners, or other ‘on-the-ground’ roles. This is to reflect practical realities, not just theoretical views. The geographical remit of a project should also dictate the inclusion of certain experts, as well as other criteria such as years of experience, for instance.
Recruiting Panellists: Using Strategy & Transparency
Recruiting panellists requires access to the right experts, which could be facilitated through professional networks or research organisations. Where needed, snowball sampling – asking existing panellists for suggestions can help secure more participants and capture underrepresented voices.
Recruiting panellists for Delphi panels requires framing the invitation properly, ensuring it outlines the aim of the project, the level of involvement required, how data will be managed (notably to protect anonymity), and communication plans. Onboarding participants can then include some form of briefing that lays out the study’s goals, methodology, and timelines. It is also helpful to get explicit confirmation from each panellist that they are willing to participate in all planned rounds. Transparency at this stage will foster trust and prevent drop-off between rounds.
Crafting the Questionnaire: Setting Up the Right Questions & Tools
Delphi questionnaires are more than just tools for gathering opinions – they are designed to guide structured, iterative reflection that moves a group toward consensus. These surveys can capture both quantitative and qualitative insights, and their format should align with the specific goals of the project. Question types may range from open-ended prompts in early rounds, designed to surface diverse perspectives, to structured statements rated on a Likert scale in later rounds for testing agreement for instance. It is important to consider how panellists will provide feedback, as comments offer valuable context, highlight areas of uncertainty, and can help inform the refinement of statements in subsequent rounds.
The language used in questionnaires must be clear and precise to avoid any confusion. Questions should tie back to the core research objectives. For this reason, it can be helpful to build or pilot the questionnaire with a small steering group to ensure clarity, balance, and relevance. Finally, a tool to distribute surveys that is practical and easy to use for Delphi panels should be employed, one that also ensures that responses remain anonymous.
Managing Communication with the Panel: Using Consistency & Momentum
Managing Delphi panels well requires consistent communication. When sending out surveys or sharing results, the tone should always remain professional, appreciative, and clear. To keep the Delphi panelists informed, reminders, timeline updates, and thank-you notes can help sustain engagement, especially when projects span several weeks or months.
Attrition is one of the most common pitfalls in Delphi studies. Participants may drop out after the first round. To combat this, after each round, compiling a summary report that highlights key themes, consensus levels, shifts in opinion, as well as comments, can add richness to the feedback and allows participants to understand how their views compare to others without losing the integrity of anonymity. The second round is particularly crucial. This is when panellists begin to reassess their views in light of group feedback, so it is vital that communications underscore the value of continued participation.
Wrapping Up the Study: Reaching Consensus (or Not) & Reporting
The power of Delphi lies in its iterative nature. Most studies involve two or more rounds, with each stage designed to refine thinking and build consensus. Consensus thresholds are typically predefined – often 75% agreement. However, areas of disagreement can be just as important information. The role of the facilitator is then to clarify and understand divergence.
As the final round closes, a concise summary of which items reached consensus and which did not can be shared with the panel, with an invitation to provide feedback and, if appropriate, to contribute recommendations or co-author the final output in the form of a manuscript. The methodology should be clearly outlined, as well as the objectives, panel composition, response rates, and key findings. Aligning reporting with frameworks like the ACCORD guidelines will increase both the credibility and impact of the research, maximising the chances of publication in a peer-reviewed journal.
Conclusion
Managing Delphi panels is as much about human engagement as it is about methodological rigour. While the Delphi method itself provides structure, its effectiveness depends on how well the panel is recruited, supported, and opinions are heard. Approaching the process with clarity, care, and consistency helps ensure that the insights are grounded, inclusive, and ready to support real-world change.
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