ObjectivesTo construct a symptom assessment system suitable for surgical lung cancer patients, and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.MethodsPostoperative symptom items of lung cancer were formed according to previous researches, literature review, the current lung cancer symptom assessment tools, and expert interviews. The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.ResultsNine first-level symptom items were eventually formed: cough, pain, shortness of breath, fatigue, dizziness, nausea or vomiting, subcutaneous emphysema, insomnia, and constipation. The first round of active coefficient and authority coefficient of experts were 85.0% and 0.88, and the second round were 88.2% and 0.87. The Kendall coordination coefficients of the nine first-level symptom items were 0.47 (P<0.001) and 0.43 (P<0.001), respectively.ConclusionsThe evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.
Objective To construct an index system for the rational use of foods for special medical purposes (FSMP) by medical institutions. Methods Based on the literature review and the survey of 300 medical institutions, we developed a questionnaire for expert consultation and conducted two rounds of expert consultation using Delphi method and consensus meeting method to determine the final index system for the rational use of FSMP in medical institutions. Results After two rounds of expert consultation and expert consensus conference meetings, it was finally determined that medical institutions should reasonably use the FSMP comprehensive evaluation index system, including 3 first-level catalog indicators, 17 second-level catalog indicators, and 13 third-level catalog indicators. Conclusion This index system can help promote the rationalization and standardization of FSMP clinical application in medical institutions in China and improve the quality of clinical nutrition care.
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 construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
Objective To construct the expert consensus on comprehensive rehabilitation assessment system for the elderly in the hospital and community. MethodsMedline, Embase, Cochrane Library, China National Knowledge Infrastructure and VIP databases were searched for geriatric rehabilitation assessment materials from June 2016 to June 2021. The primary items were summarized through literature review and research group discussion, and then Delphi method was used among 20 experts in geriatric rehabilitation medicine to develop consensus-based core items for the elderly comprehensive rehabilitation assessment system. Results A total of 158 references were included. Through integration, sorting and screening, the research team initially formulated 41 items and four major sections including cardiopulmonary exercise, sensory perception, cognition and psychology (speech contained), and swallowing, urination and defecation. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.92±0.05, the variation coefficients were 0.174±0.043 and 0.172±0.063, respectively; the Kendall coefficients of concordance were 0.587 and 0.601, with P values<0.05 for both, respectively. Finally, The comprehensive rehabilitation assessment system for the elderly including 16 items would be formed. Conclusion The expert consensus on comprehensive rehabilitation assessment system for the elderly constructed by Delphi method includes motor, sensory perception, cognition, swallowing, speech, cardiopulmonary, defecation, mental and psychological elements, which are identified with high recognition and consistency from experts.
ObjectivesTo use the Delphi method to preliminarily perfect the comprehensive evaluation index system which had been initially constructed by systematic review processes of diabetes food for special medical purposes (FSMP).MethodsThree rounds of expert consultation by Delphi method were compared to define indices held in the evidence-based comprehensive evaluation index system of diabetes FSMP and ways to distinguish effects.ResultsThe preliminary perfect index system after 3 rounds of expert consultation contained 4 primary directory indicators, 15 secondary directory indicators, and 20 tertiary indicators. Among them, the end index which could directly be used for evaluation contained a total of 27 indicators.ConclusionsThe index system is categorized into 4 segments of parameters, which are medical, nutritional, safety and other indices, which has addressed the problem posed by CFDA documents on how to scientifically validate the medical effect and safety of FSMP. It provides great significance to assess and supervise FSMP prior to and after it goes to public, assess characteristics and advantages of MNT, and improves nutrition economy and its social benefits.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.
Objective To scientifically construct a self-management behavior scale for postoperative patients with osteoporotic fractures, in order to assess the self-management behavior level of this patient population. Methods Between November 2022 and February 2023, a scale item pool was constructed using literature analysis and expert panel discussions. A preliminary version of the scale was formed based on feedback from 30 experts and 15 patients. From March 2023 to March 2024, a convenience sampling method was used to survey 230 patients post-osteoporotic fracture surgery from a tertiary hospital in Guangzhou. Cronbach’s α coefficient, split-half reliability, and test-retest reliability were used to assess the reliability of the scale, while content validity and exploratory factor analysis were used to evaluate its validity. Results The developed scale consisted of 5 dimensions and 27 items. The content validity index for each item ranged from 0.933 to 1.000. Exploratory factor analysis extracted 5 common factors, explaining 65.964% of the cumulative variance. The overall Cronbach’s α coefficient, split-half reliability, and test-retest reliability were 0.934, 0.780, and 0.958, respectively. The Cronbach’s α coefficient, split-half reliability, and test-retest reliability for each dimension ranged from 0.849 to 0.897, 0.816 to 0.904, and 0.826 to 0.894, respectively. Conclusions The self-management behavior scale for post-osteoporotic fracture surgery patients demonstrates good reliability and validity. It is a highly authoritative and scientific tool that can be used effectively to assess self-management behaviors in these patients and provide a basis for developing personalized self-management interventions.