scholarly journals The ESTMJS (European Society of Temporomandibular Joint Surgeons) Consensus and Evidence-Based Recommendations on Management of Condylar Dislocation

2021 ◽  
Vol 10 (21) ◽  
pp. 5068
Author(s):  
Andreas Neff ◽  
Niall McLeod ◽  
Frederik Spijkervet ◽  
Merle Riechmann ◽  
Ulla Vieth ◽  
...  
Keyword(s):  
European Society ◽  
Mandibular Condyle ◽  
Evidence Based ◽  
Consensus Process ◽  
Consensus Recommendation ◽  
S3 Guideline ◽  
Modified Delphi ◽  
Tmj Dislocation ◽  
Treatment Concepts ◽  
Strong Consensus

Although condylar dislocation is not uncommon, terminology, diagnostics, and treatment concepts vary considerably worldwide. This study aims to present a consensus recommendation based on systematically reviewed literature and approved by the European Society of TMJ Surgeons (ESTMJS). Based on the template of the evidence-based German guideline (register # 007-063) the ESTMJS members voted on 30 draft recommendations regarding terminology, diagnostics, and treatment initially via a blinded modified Delphi procedure. After unblinding, a discussion and voting followed, using a structured consensus process in 2019. An independent moderator documented and evaluated voting results and alterations from the original draft. Although the results of the preliminary voting were very heterogenous and differed significantly from the German S3 guideline (p < 0.0005), a strong consensus was achieved in the final voting on terminology, diagnostics, and treatment. In this voting, multiple alterations, including adding and discarding recommendations, led to 24 final recommendations on assessment and management of TMJ dislocation. To our knowledge, the ESTMJS condylar dislocation recommendations are the first both evidence and consensus-based international recommendations in the field of TMJ surgery. We recommend they form the basis for clinical practice guidelines for the management of dislocations of the mandibular condyle.

scholarly journals Study of Optimal Perimetric Testing In Children (OPTIC): developing consensus and setting research priorities for perimetry in the management of children with glaucoma

Eye ◽  
2021 ◽  
Author(s):  
Dipesh E. Patel ◽  
Phillippa M. Cumberland ◽  
Bronwen C. Walters ◽  
Joseph Abbott ◽  
John Brookes ◽  
...  
Keyword(s):  
Visual Field ◽  
Research Priorities ◽  
Healthcare Setting ◽  
Evidence Based ◽  
Limited Evidence ◽  
Delphi Consensus ◽  
Test Quality ◽  
Consensus Process ◽  
Reliability Indices ◽  
Modified Delphi

Abstract Background Perimetry is important in the management of children with glaucoma, but there is limited evidence-based guidance on its use. We report an expert consensus-based study to update guidance and identify areas requiring further research. Methods Experts were invited to participate in a modified Delphi consensus process. Panel selection was based on clinical experience of managing children with glaucoma and UK-based training to minimise diversity of view due to healthcare setting. Questionnaires were delivered electronically, and analysed to establish ‘agreement’. Divergence of opinions was investigated and resolved where possible through further iterations. Results 7/9 experts invited agreed to participate. Consensus (≥5/7 (71%) in agreement) was achieved for 21/26 (80.8%) items in 2 rounds, generating recommendations to start perimetry from approximately 7 years of age (IQR: 6.75–7.25), and use qualitative methods in conjunction with automated reliability indices to assess test quality. There was a lack of agreement about defining progressive visual field (VF) loss and methods for implementing perimetry longitudinally. Panel members highlighted the importance of informing decisions based upon individual circumstances—from gauging maturity/capability when selecting tests and interpreting outcomes, to accounting for specific clinical features (e.g. poor IOP control and/or suspected progressive VF loss) when making decisions about frequency of testing. Conclusions There is commonality of expert views in relation to implementing perimetry and interpreting test quality in the management of children with glaucoma. However, there remains a lack of agreement about defining progressive VF loss, and utilising perimetry over an individuals’ lifetime, highlighting the need for further research.

scholarly journals Building a neuroinfectious disease consensus curriculum

Neurology ◽  
2019 ◽  
Vol 93 (5) ◽  
pp. 208-216
Author(s):  
Arun Venkatesan ◽  
Felicia C. Chow ◽  
Allen Aksamit ◽  
Russell Bartt ◽  
Thomas P. Bleck ◽  
...  
Keyword(s):  
American Academy ◽  
Delphi Technique ◽  
Fellowship Training ◽  
Consensus Process ◽  
Diverse Range ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Modified Delphi Technique ◽  
Comprehensive Curriculum ◽  
American Academy Of Neurology

ObjectiveTo delineate a comprehensive curriculum for fellowship training in neuroinfectious diseases, we conducted a modified Delphi approach to reach consensus among 11 experts in the field.MethodsThe authors invited a diverse range of experts from the American Academy of Neurology Neuro-Infectious Diseases (AAN Neuro-ID) Section to participate in a consensus process using a modified Delphi technique.ResultsA comprehensive list of topics was generated with 101 initial items. Through 3 rounds of voting and discussion, a curriculum with 83 items reached consensus.ConclusionsThe modified Delphi technique provides an efficient and rigorous means to reach consensus on topics requiring expert opinion. The AAN Neuro-ID section provided the pool of diverse experts, the infrastructure, and the community through which to accomplish the consensus project successfully. This process could be applied to other subspecialties and sections at the AAN.

Vaccinations in patients with multiple sclerosis: A Delphi consensus statement

2020 ◽  
pp. 135245852095231 ◽  
Author(s):  
Agostino Riva ◽  
Valeria Barcella ◽  
Simone V Benatti ◽  
Marco Capobianco ◽  
Ruggero Capra ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Seasonal Influenza ◽  
Careful Consideration ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Disease Modifying Drugs ◽  
Risks And Benefits ◽  
Modified Delphi ◽  
Increased Risk ◽  
Evidence Based Decision Making

Background: Patients with multiple sclerosis (MS) are at increased risk of infection. Vaccination can mitigate these risks but only if safe and effective in MS patients, including those taking disease-modifying drugs. Methods: A modified Delphi consensus process (October 2017–June 2018) was used to develop clinically relevant recommendations for making decisions about vaccinations in patients with MS. A series of statements and recommendations regarding the efficacy, safety and timing of vaccine administration in patients with MS were generated in April 2018 by a panel of experts based on a review of the published literature performed in October 2017. Results: Recommendations include the need for an ‘infectious diseases card’ of each patient’s infectious and immunisation history at diagnosis in order to exclude and eventually treat latent infections. We suggest the implementation of the locally recommended vaccinations, if possible at MS diagnosis, otherwise with vaccination timing tailored to the planned/current MS treatment, and yearly administration of the seasonal influenza vaccine regardless of the treatment received. Conclusion: Patients with MS should be vaccinated with careful consideration of risks and benefits. However, there is an urgent need for more research into vaccinations in patients with MS to guide evidence-based decision making.

scholarly journals A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Veena A. Satyanarayana ◽  
Cath Jackson ◽  
Kamran Siddiqi ◽  
Prabha S. Chandra ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Behaviour Change ◽  
Delphi Survey ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Modified Delphi ◽  
Qualitative Interview Study ◽  
At Home

Abstract Background Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. Methods We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. Results The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. Conclusion A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.

European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium

2017 ◽  
Vol 34 (4) ◽  
pp. 192-214 ◽  
Author(s):  
César Aldecoa ◽  
Gabriella Bettelli ◽  
Federico Bilotta ◽  
Robert D. Sanders ◽  
Riccardo Audisio ◽  
...  
Keyword(s):  
European Society ◽  
Postoperative Delirium ◽  
Evidence Based

scholarly journals Development of an assessment and intervention protocol for postpartum hemorrhage in the mainland of China: an evidence-based method and Delphi consult

2019 ◽  
Vol 6 (4) ◽  
pp. 285-291
Author(s):  
Ying Liu ◽  
Ya-Jing Fan ◽  
Wei Zhuang ◽  
Qun Huang
Keyword(s):  
Best Practices ◽  
Delphi Method ◽  
Postpartum Hemorrhage ◽  
Selection Criteria ◽  
Evidence Based ◽  
Early Assessment ◽  
Modified Delphi ◽  
Intervention Protocol ◽  
The Mainland Of China ◽  
Assessment Questionnaire

Abstract Objective Postpartum hemorrhage (PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses. Methods Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance (M) >3.5, and coefficient of variation (CV) <0.25. Reliability of experts’ opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated. Results A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120. Conclusions The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.

A multisociety organizational consensus process to define guiding principles for acute perioperative pain management

2021 ◽  
pp. rapm-2021-103083
Author(s):  
Edward R Mariano ◽  
David M Dickerson ◽  
Joseph W Szokol ◽  
Michael Harned ◽  
Jeffrey T Mueller ◽  
...  
Keyword(s):  
Pain Management ◽  
Task Force ◽  
Surgical Patient ◽  
Consensus Process ◽  
Perioperative Pain ◽  
Modified Delphi ◽  
The Us ◽  
Perioperative Pain Management ◽  
Guiding Principles ◽  
Evidence Based Guidelines

The US Health and Human Services Pain Management Best Practices Inter-Agency Task Force initiated a public–private partnership which led to the publication of its report in 2019. The report emphasized the need for individualized, multimodal, and multidisciplinary approaches to pain management that decrease the over-reliance on opioids, increase access to care, and promote widespread education on pain and substance use disorders. The Task Force specifically called on specialty organizations to work together to develop evidence-based guidelines. In response to this report’s recommendations, a consortium of 14 professional healthcare societies committed to a 2-year project to advance pain management for the surgical patient and improve opioid safety. The modified Delphi process included two rounds of electronic voting and culminated in a live virtual event in February 2021, during which seven common guiding principles were established for acute perioperative pain management. These principles should help to inform local action and future development of clinical practice recommendations.

Developing a Fracture Risk Clinical Assessment Protocol for Long-Term Care: A Modified Delphi Consensus Process

2020 ◽  
Author(s):  
Caitlin McArthur ◽  
Loretta Hillier ◽  
George Ioannidis ◽  
Jonathan D. Adachi ◽  
Lora Giangregorio ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Clinical Assessment ◽  
Long Term Care ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Term Care ◽  
Assessment Protocol ◽  
Modified Delphi

scholarly journals Primary Therapy of Early Breast Cancer: Evidence, Controversies, Consensus

2019 ◽  
Vol 79 (06) ◽  
pp. 591-604 ◽  
Author(s):  
Michael Untch ◽  
Christoph Thomssen ◽  
Ingo Bauerfeind ◽  
Michael Braun ◽  
Sara Y. Brucker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Clinical Practice ◽  
Consensus Conference ◽  
Evidence Based ◽  
Primary Therapy ◽  
Therapeutic Decision ◽  
Everyday Clinical Practice ◽  
S3 Guideline ◽  
Benefit Risk Assessment

AbstractThe results of the international St. Gallen Consensus Conference for the treatment of patients with primary breast cancer were discussed this year by a working group of leading breast cancer experts in view of the therapy recommendations for everyday clinical practice in Germany. Three of the breast cancer experts are also members of this yearʼs St. Gallen panel. The comparison of the St. Gallen recommendations with the annually updated treatment recommendations of the AGO 2019 as well as the S3 guideline is useful, since the recommendations of the St. Gallen panel represent the opinions of experts from various countries and disciplines. The recommendations of the S3 guideline and AGO are based on evidence-based research of the literature. This yearʼs 16th St. Gallen conference featured the motto “Magnitude of clinical benefit”. In addition to the evidence-based data, each therapeutic decision must also undergo a benefit/risk assessment of the patientʼs individual situation and be discussed with the patient.

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