Validation of an instrument for injury data collection in rugby union.
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OBJECTIVE: To provide the basis for collecting rugby union injury data using a rigorously validated injury report form. METHODS: Seven stages were used to assess face, content, and criterion validity of the rugby union injury report form. A 22 member panel plus four sporting bodies assessed the form for face validity, and an expert panel assessed it for content and criterion validity. Panel members were consulted until consensus was reached. A yardstick developed by an expert panel using the Delphi technique was used to assess the reliability of the form. An independent panel of 10 viewed a series of five videotaped injuries, three times over a five week period to assess inter-rater and intrarater reliability. The form was then trialed by 40 people in situ during four games. RESULTS: The rugby union injury report form for games and training was developed, and the face, content, and criterion validity successfully assessed. A seven step protocol to create a yardstick was also developed to assist in the validation process. Both inter-rater and intrarater reliability results indicated a 98% agreement. The 40 trialists who completed forms in situ during four games were found to have an inter-rater reliability agreement of 98% for nine injuries. CONCLUSIONS: A measurement instrument for injury data collection in rugby union was successfully developed and validated, providing researchers with a basis for future studies in this area. A procedure to develop future injury data collection instruments in other sports was also developed. (+info)
Comparison of mailed vs. Internet applications of the Delphi technique in clinical informatics research.
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The Delphi technique provides a means of assessing the judgments of groups of experts without the necessity of having these experts meet together. The technique has been used in health care since the mid-1970s, and has just recently become more common in clinical informatics research. As informatics develops as a specialty, it is logical to consider information technology solutions to research as well as clinical practice problems. The overall purpose of this methodology presentation is to compare a mailed vs. Internet application of the Delphi technique for clinical informatics research. Specifically, this presentation will provide: 1) an overview of the Delphi technique, and 2) a methodological comparison of two research applications of the Delphi technique. Results of the studies will be presented elsewhere. (+info)
New Zealand and United Kingdom experiences with the RAND modified Delphi approach to producing angina and heart failure criteria for quality assessment in general practice.
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OBJECTIVES: (1) To describe the development of minimum review criteria for the general practice management in New Zealand (NZ) of two chronic diseases: stable angina and systolic heart failure, and (2) to compare the NZ angina criteria with a set produced in Manchester to assess the extent to which use of the same approach to criteria development yields similar criteria. METHODS: A modified Delphi approach, based on the RAND consensus panel method, was used to produce minimum criteria for reviewing the recorded management of heart failure and angina in NZ general practice. The criteria for angina were compared with those produced in the UK, including assessment of the extent to which each set describes actions that the other panel agrees are necessary to record. RESULTS: For each condition we report minimum criteria describing actions rated as (a) necessary to record and (b) inappropriate to take but, if taken, necessary to record. Although strong scientific evidence underpins approximately one quarter and one third, respectively, of the final sets of NZ and UK angina criteria for actions necessary to record, the NZ criteria agree strongly with the UK criteria (33 of 39 criteria, 85%) but there is less UK agreement with the NZ angina criteria (28 of 40 criteria, 70%). CONCLUSION: Despite the lack of scientific evidence for up to three quarters of angina care in general practice, the RAND based approach to criteria development was used in NZ to reproduce most of the UK angina criteria for actions rated as necessary to record in general practice. It is important to make explicit whether ratings of necessity and appropriateness apply to the recording of actions or to the actions themselves. (+info)
What is a prescribing error?
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OBJECTIVE: To develop a practitioner led definition of a prescribing error for use in quantitative studies of their incidence. DESIGN: Two stage Delphi technique. SUBJECTS: A panel of 34 UK judges, which included physicians, surgeons, pharmacists, nurses and risk managers. MAIN OUTCOME MEASURES: The extent to which judges agreed with a general definition of a prescribing error, and the extent to which they agreed that each of 42 scenarios represented a prescribing error. RESULTS: Responses were obtained from 30 (88%) of 34 judges in the first Delphi round, and from 26 (87%) of 30 in the second round. The general definition of a prescribing error was accepted. The panel reached consensus that 24 of the 42 scenarios should be included as prescribing errors and that five should be excluded. In general, transcription errors, failure to communicate essential information, and the use of drugs or doses inappropriate for the individual patient were considered prescribing errors; deviations from policies or guidelines were not. CONCLUSIONS: Health care professionals are in broad agreement about the types of events that should be included and excluded as prescribing errors. A general definition of a prescribing error has been developed, together with more detailed guidance regarding the types of events that should be included. This definition allows the comparison of prescribing error rates among different prescribing systems and different hospitals, and is suitable for use in both research and clinical governance initiatives. (+info)
Research priorities in occupational health in Italy.
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OBJECTIVE: To find a broad consensus on research priorities and strategies in the field of occupational health and safety in Italy. METHODS: A two phase questionnaire survey was based on the Delphi technique previously described in other reports. 310 Occupational safety and health specialists (from universities and local health units) were given an open questionnaire (to identify three priority research areas). The data obtained from respondents (175, 56.4%) were then used to draw up a list of 27 priority topics grouped together into five macrosectors. Each of these was given a score ranging from 1 (of little importance) to 5 (extremely important). With the mean scores obtained from a total of 203 respondents (65.4%), it was possible to place the 27 topics in rank order according to a scale of priorities. RESULTS: Among the macrosectors, first place was given to the question of methodological approach to research in this field, and for individual topics, occupational carcinogenesis and quality in occupational medicine were ranked first and second, respectively. The question of exposure to low doses of environmental pollutants and multiple exposures ranked third among the priorities; the development of adequate and effective approaches and methods for worker education and participation in prevention was also perceived as being an important issue (fourth place). CONCLUSIONS: This study (the first of its kind in Italy) enabled us to achieve an adequate degree of consensus on research priorities related to the protection of occupational health and safety. Disparities in the mean scores of some of the issues identified overall as being research priorities, seem to be linked both to geographical area and to whether respondents worked in local health units or universities. This finding requires debate and further analysis. (+info)
Occupational health research priorities in Malaysia: a Delphi study.
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OBJECTIVES: As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. METHODS: Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. RESULTS: The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. CONCLUSIONS: The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions. (+info)
Student operator-assistant pairs: an update.
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OBJECTIVE: To seek the opinions of undergraduates using the operator-assistant pairs system. DESIGN: A five-year evaluation of third-, fourth- and fifth-year students using a short, anonymous questionnaire OUTCOME MEASURES: This study set out to evaluate, but does not attempt to formally assess, the system. RESULT: Most students enjoyed working in pairs, citing mutual support and collaborative learning as being the main advantages. However, 67% of responding third- year students, 79% of fourth-year students and 54% of fifth-year students indicated that they did not know why paired working had been introduced. CONCLUSIONS: The majority of students found the pairs system advantageous over teacher-led situations. It encouraged greater efficiency, mutual support and help and collaborative learning. (+info)
A clinical minimum data set for primary dental care.
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OBJECTIVE: To achieve consensus within primary dental care on the contents of a clinical minimum data set to measure oral health status. DESIGN: Using the Delphi process a simple random sample of 30 LDCs and 10 CDS services in England were asked to rank a list of existing clinical indicators in order of their perceived importance as a means of measuring oral health. A nominated panel representing the stakeholder organisations of primary dental care reviewed this ranking and identified a core group of clinical indicators to be included in a clinical minimum data set. RESULTS: An 80 percent response rate to the Delphi process was achieved. Consensus was reached on a core group of 10 indicators, which can provide information on patient's perceptions of pain, function and appearance, and professional measurements of caries, teeth present, periodontal disease, oral sepsis, presence of mucosal pathology and tooth wear. CONCLUSIONS: A representative sample of primary care dentists in England and the key representative organisations of primary dental care achieved consensus on the contents of a clinical minimum data set to record oral health status in primary dental care. This is a first step in standardising the measurement of oral health status across primary care. (+info)