ROSE: radiology, obstruction, symptoms and exposure – a Delphi consensus definition of the association of COPD and bronchiectasis by the EMBARC Airways Working Group

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Abstract

Introduction

The coexistence of COPD and bronchiectasis seems to be common and associated with a worse prognosis than for either disease individually. However, no definition of this association exists to guide researchers and clinicians.

Methods

We conducted a Delphi survey involving expert pulmonologists and radiologists from Europe, Turkey and Israel in order to define the “COPD– [bronchiectasis] BE association”.

A panel of 16 experts from EMBARC selected 35 statements for the survey after reviewing scientific literature. Invited participants, selected on the basis of expertise, geographical and sex distribution, were asked to express agreement on the statements. Consensus was defined as a score of ≥6 points (scale 0 to 9) in ≥70% of answers across two scoring rounds.

Results

102 (72.3%) out of 141 invited experts participated in the first round. Their response rate in the second round was 81%. The final consensus definition of “COPD–BE association” was: “The coexistence of (1) specific radiological findings ( abnormal bronchial dilatation, airways visible within 1 cm of pleura and/or lack of tapering sign in ≥1 pulmonary segment and in >1 lobe) with (2) an obstructive pattern on spirometry ([forced expiratory volume in 1 s] FEV ₁/[forced vital capacity] FVC <0.7), (3) at least two characteristic symptoms ( cough, expectoration, dyspnoea, fatigue, frequent infections) and (4) current or past exposure to smoke (≥ 10 pack-years) or other toxic agents (bi omass, etc.)”. These criteria form the acronym “ROSE” (Radiology, Obstruction, Symptoms, Exposure).

Conclusions

The Delphi process formulated a European consensus definition of “COPD–BE association”. We hope this definition will have broad applicability across clinical practice and research in the future.

Abstract

A group of experts from EMBARC has generated a consensus definition of COPD and bronchiectasis association based on the coexistence of radiological findings, bronchial obstruction, compatible symptoms and exposure to smoke or toxic agents (ROSE criteria) https://bit.ly/3g3cdld

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How to use the nominal group and Delphi techniques

Sara S McMillan, Michelle King, Mary P. Tully (2016)

Introduction The Nominal Group Technique (NGT) and Delphi Technique are consensus methods used in research that is directed at problem-solving, idea-generation, or determining priorities. While consensus methods are commonly used in health services literature, few studies in pharmacy practice use these methods. This paper provides an overview of the NGT and Delphi technique, including the steps involved and the types of research questions best suited to each method, with examples from the pharmacy literature. Methodology The NGT entails face-to-face discussion in small groups, and provides a prompt result for researchers. The classic NGT involves four key stages: silent generation, round robin, clarification and voting (ranking). Variations have occurred in relation to generating ideas, and how ‘consensus’ is obtained from participants. The Delphi technique uses a multistage self-completed questionnaire with individual feedback, to determine consensus from a larger group of ‘experts.’ Questionnaires have been mailed, or more recently, e-mailed to participants. When to use The NGT has been used to explore consumer and stakeholder views, while the Delphi technique is commonly used to develop guidelines with health professionals. Method choice is influenced by various factors, including the research question, the perception of consensus required, and associated practicalities such as time and geography. Limitations The NGT requires participants to personally attend a meeting. This may prove difficult to organise and geography may limit attendance. The Delphi technique can take weeks or months to conclude, especially if multiple rounds are required, and may be complex for lay people to complete.

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European Respiratory Society guidelines for the management of adult bronchiectasis.

Eva Polverino, Pieter C. Goeminne, Melissa J. McDonnell … (2017)

Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes.

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Consensus measurement in Delphi studies

Heiko A. von der Gracht (2012)

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Author and article information

Journal

Journal ID (nlm-ta): ERJ Open Res

Journal ID (iso-abbrev): ERJ Open Res

Journal ID (publisher-id): ERJOR

Journal ID (hwp): erjor

Title: ERJ Open Research

Publisher: European Respiratory Society

ISSN (Electronic): 2312-0541

Publication date Collection: October 2021

Publication date (Electronic): 22 November 2021

Volume: 7

Issue: 4

Electronic Location Identifier: 00399-2021

Affiliations

[1 ]Dept of Medicine and Surgery, Respiratory Diseases, Università dell'Insubria, Varese-Como, Italy

[2 ]Pneumology Dept, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Barcelona, Spain

[3 ]CIBER de Enfermedades Respiratorias, Barcelona, Spain

[4 ]Respiratory Dept, La Fe University and Polytechnic Hospital, Valencia, Spain

[5 ]Pulmonology Institute and Cystic Fibrosis Center, Carmel Medical Center, and the Technion – Israel Institute of Technology, the B. Rappaport Faculty of Medicine, Haifa, Israel

[6 ]Dept of Respiratory Medicine and Allergy, Karolinska University Hospital and Dept of Medicine, Karolinska Institutet, Stockholm, Sweden

[7 ]5th Respiratory Department, “SOTIRIA” Hospital for Chest diseases, Athens, Greece

[8 ]Centre for Medical Image Computing, University College London, London, UK

[9 ]UCL Respiratory, University College London, London, UK

[10 ]Dept of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy

[11 ]Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy

[12 ]Dept of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy

[13 ]Institute of Diagnostic and Interventional Radiology, German Center for Lung Research, Breath, Hannover Medical School, Hannover, Germany

[14 ]IRCCS Humanitas Research Hospital, Rozzano, Italy

[15 ]School of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Author notes

Corresponding author: Eva Polverino ( eva.polverino@ 123456vhir.org )

Author information

Marc Miravitlles https://orcid.org/0000-0002-9850-9520

Michal Shteinberg https://orcid.org/0000-0002-0432-3398

John R. Hurst https://orcid.org/0000-0002-7246-6040

Sebastian Ferri https://orcid.org/0000-0002-1831-9672

Stefano Aliberti https://orcid.org/0000-0002-0090-4531

Article

Publisher ID: 00399-2021

DOI: 10.1183/23120541.00399-2021

PMC ID: 8607072

PubMed ID: 34820447

SO-VID: 2e0b993c-b979-4d2d-b35f-12177c1bda5c

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This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org

ROSE: radiology, obstruction, symptoms and exposure – a Delphi consensus definition of the association of COPD and bronchiectasis by the EMBARC Airways Working Group

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Abstract

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Most cited references 60

How to use the nominal group and Delphi techniques

European Respiratory Society guidelines for the management of adult bronchiectasis.

Consensus measurement in Delphi studies

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