Objective: The objectives of this nested study were to (1) assess whether changes in scores between rounds altered the final degree of consensus achieved in three Delphi surveys conducted as part of COS development projects (anal, gastric, and prostate cancer), and (2) explore participants' reasons for changing scores between rounds.
Study Design And Setting: All Delphi surveys were conducted online using DelphiManager software and included healthcare professionals and participating patients. Participants were invited to give a free-text reason whenever they changed their score across an important threshold on a 1-9 Likert scale (1-3 not important, 4-5 important, 7-9 critically important). Reasons for score change were coded by four researchers independently using an inductive-iterative approach.
Results: In all three Delphi surveys, the number of outcomes reaching criteria for consensus was greater in R2 than R1. Twelve themes and 23 subthemes emerged from 2298 discrete reasons given for score change. The most common reasons for the change were "time to reflect" (482 responses, 23%) and vicarious thinking (424, 21%), with 68% (291) of vicarious thinking attributed to seeing other participant's scores.
Conclusion: Our findings support conducting a Delphi survey over the use of a single questionnaire where building consensus is the objective. Time to reflect and vicarious thinking, facilitated by seeing other participant's scores, were important drivers of score change. How results are presented to participants between rounds and the duration of and time between rounds in a Delphi survey may, therefore, influence the results and should be clearly reported.
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http://dx.doi.org/10.1016/j.jclinepi.2020.09.028 | DOI Listing |
Purpose: In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model-Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.
Methods: ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation of experts in PC in sub-Saharan Africa, using standardized curriculum on the basis of PC needs in the region.
Shock
January 2025
Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 599 Taylor Road, Room 209, Piscataway, NJ, USA 08854.
Introduction: Coagulopathy following traumatic injury impairs stable blood clot formation and exacerbates mortality from hemorrhage. Understanding how these alterations impact blood clot stability is critical to improving resuscitation. Furthermore, the incorporation of machine learning algorithms to assess clinical markers, coagulation assays and biochemical assays allows us to define the contributions of these factors to mortality.
View Article and Find Full Text PDFEnviron Health Perspect
January 2025
Centre for Environment, Fisheries and Aquaculture Science (CEFAS), Weymouth, UK.
Background: Environmental change in coastal areas can drive marine bacteria and resulting infections, such as those caused by , with both foodborne and nonfoodborne exposure routes and high mortality. Although ecological drivers of in the environment have been well-characterized, fewer models have been able to apply this to human infection risk due to limited surveillance.
Objectives: The Cholera and Other Illness Surveillance (COVIS) system database has reported infections in the United States since 1988, offering a unique opportunity to both explore the forecasting capabilities machine learning could provide and to characterize complex environmental drivers of infections.
Prehosp Emerg Care
January 2025
Medical College of Wisconsin, Department of Emergency Medicine.
Objectives: Medication for opioid use disorder (MOUD) reduces morbidity and mortality for patients with opioid use disorder (OUD). Recent administrative and legislative changes have made MOUD possible in the prehospital setting. We use an implementation science framework to outline the Reach of a fire department EMS-based Mobile Integrated Health (MIH) prehospital MOUD program.
View Article and Find Full Text PDFBr J Dermatol
January 2025
Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA.
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease, characterized by eczematous skin lesions and pruritus. There is an unmet need for effective first-line systemic therapies with good safety profiles, particularly oral medications. Orismilast is a novel first-in-class oral phosphodiesterase-4 (PDE4) B/D inhibitor under investigation for the treatment of moderate-to-severe AD.
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