International Consensus Recommendations for Safe Use of LAMS for On- and Off-Label Indications Using a Modified Delphi Process.

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The study aimed to develop international consensus recommendations on the safe use of lumen-apposing metal stents (LAMSs) for on- and off-label indications.

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GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

Gordon H Guyatt, Andrew D Oxman, Gunn E Vist … (2008)

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Delphi methodology in healthcare research: How to decide its appropriateness

Prashant Nasa, Ravi Jain, Deven Juneja (2021)

The Delphi technique is a systematic process of forecasting using the collective opinion of panel members. The structured method of developing consensus among panel members using Delphi methodology has gained acceptance in diverse fields of medicine. The Delphi methods assumed a pivotal role in the last few decades to develop best practice guidance using collective intelligence where research is limited, ethically/logistically difficult or evidence is conflicting. However, the attempts to assess the quality standard of Delphi studies have reported significant variance, and details of the process followed are usually unclear. We recommend systematic quality tools for evaluation of Delphi methodology; identification of problem area of research, selection of panel, anonymity of panelists, controlled feedback, iterative Delphi rounds, consensus criteria, analysis of consensus, closing criteria, and stability of the results. Based on these nine qualitative evaluation points, we assessed the quality of Delphi studies in the medical field related to coronavirus disease 2019. There was inconsistency in reporting vital elements of Delphi methods such as identification of panel members, defining consensus, closing criteria for rounds, and presenting the results. We propose our evaluation points for researchers, medical journal editorial boards, and reviewers to evaluate the quality of the Delphi methods in healthcare research.

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A step-up approach or open necrosectomy for necrotizing pancreatitis.

Marja Boermeester, O. Bakker, Vincent B Nieuwenhuijs … (2010)

Necrotizing pancreatitis with infected necrotic tissue is associated with a high rate of complications and death. Standard treatment is open necrosectomy. The outcome may be improved by a minimally invasive step-up approach. In this multicenter study, we randomly assigned 88 patients with necrotizing pancreatitis and suspected or confirmed infected necrotic tissue to undergo primary open necrosectomy or a step-up approach to treatment. The step-up approach consisted of percutaneous drainage followed, if necessary, by minimally invasive retroperitoneal necrosectomy. The primary end point was a composite of major complications (new-onset multiple-organ failure or multiple systemic complications, perforation of a visceral organ or enterocutaneous fistula, or bleeding) or death. The primary end point occurred in 31 of 45 patients (69%) assigned to open necrosectomy and in 17 of 43 patients (40%) assigned to the step-up approach (risk ratio with the step-up approach, 0.57; 95% confidence interval, 0.38 to 0.87; P=0.006). Of the patients assigned to the step-up approach, 35% were treated with percutaneous drainage only. New-onset multiple-organ failure occurred less often in patients assigned to the step-up approach than in those assigned to open necrosectomy (12% vs. 40%, P=0.002). The rate of death did not differ significantly between groups (19% vs. 16%, P=0.70). Patients assigned to the step-up approach had a lower rate of incisional hernias (7% vs. 24%, P=0.03) and new-onset diabetes (16% vs. 38%, P=0.02). A minimally invasive step-up approach, as compared with open necrosectomy, reduced the rate of the composite end point of major complications or death among patients with necrotizing pancreatitis and infected necrotic tissue. (Current Controlled Trials number, ISRCTN13975868.) 2010 Massachusetts Medical Society

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Author and article information

Journal

Journal ID (iso-abbrev): Am J Gastroenterol

Title: The American journal of gastroenterology

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Electronic): 1572-0241

ISSN (Print): 0002-9270

Publication date (Electronic): Apr 01 2024

Volume: 119

Issue: 4

Affiliations

[1 ] Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.

[2 ] Diagnostic Center Bled Group, Bled, Slovenia.

[3 ] Centura Health, Center for Advanced Therapeutic Endoscopy, Colorado, Englewood, USA.

[4 ] Department of Internal Medicine and Gastroenterology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

[5 ] Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.

[6 ] Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, USA.

[7 ] Gastroenterology and Hepatology, Imelda Hospital Bonheiden and University Hospitals Leuven, Belgium.

[8 ] Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands.

[9 ] Nancy Teaching Hospital, Nancy University, Nancy, France.

[10 ] Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy.

[11 ] Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Department of Hepatogastroenterology, Brussels, Belgium.

[12 ] University of Florida, Gainesville, Florida, USA.

[13 ] Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

[14 ] Digestive Endoscopy Unit, Paoli Calmettes Institute, Marseille Cedex 9, France.

[15 ] Gastroenterology Department, Hospital Universitario Río Hortega, Valladolid, Spain.

[16 ] Department of Gastroenterology and Hepatology, Inova Fairfax Hospital, Falls Church, Virginia, USA.

[17 ] Amsterdam University Medical Center, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, Netherlands.

[18 ] Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.

Article

Publisher Item ID: 00000434-990000000-00925

DOI: 10.14309/ajg.0000000000002571

PubMed ID: 37934190

SO-VID: 1daf6814-186e-4fd6-900d-41b98b812434

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International Consensus Recommendations for Safe Use of LAMS for On- and Off-Label Indications Using a Modified Delphi Process.

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Most cited references 82

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

Delphi methodology in healthcare research: How to decide its appropriateness

A step-up approach or open necrosectomy for necrotizing pancreatitis.

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