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Meta-Analysis
. 2011;6(6):e20476.
doi: 10.1371/journal.pone.0020476. Epub 2011 Jun 9.

Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review

Affiliations
Meta-Analysis

Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review

Rym Boulkedid et al. PLoS One. 2011.

Abstract

Objective: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice.

Methodology and main finding: Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility.

Conclusion: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study selection.

References

    1. Institut of medicine: IOM definition of quality: http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chas....
    1. Kohn LTC, JM, Donaldson MS. To Err is Human, Building a Safer Health System. Washington: 1999. - PubMed
    1. Majeed FA, Voss S. Performance indicators for general practice. Bmj. 1995;311:209–210. - PMC - PubMed
    1. Donabedian A. Explorations in quality assessment and monitoring: the definition of quality and approaches to its assessment. Michigan: Health Administration press; 1980.
    1. Pringle M. Preventing ischaemic heart disease in one general practice: from one patient, through clinical audit, needs assessment, and commissioning into quality improvement. Bmj. 1998;317:1120–1123; discussion 1124. - PMC - PubMed

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