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. 2013 May-Jun;42(3):332-47.
doi: 10.1111/1552-6909.12032. Epub 2013 Apr 18.

Expert consensus building using e-Delphi for necrotizing enterocolitis risk assessment

Sheila M Gephart  1 , Judith A Effken, Jacqueline M McGrath, Pamela G Reed
Affiliations

Expert consensus building using e-Delphi for necrotizing enterocolitis risk assessment

Sheila M Gephart et al. J Obstet Gynecol Neonatal Nurs. 2013 May-Jun.

Abstract

Objective: To confirm content validity of GutCheck(NEC) , a risk index for necrotizing enterocolitis (NEC) and to determine the level of agreement among experts about NEC risk factors in premature infants.

Design: Electronic Delphi method (e-Delphi).

Setting: Online electronic surveys and e-mail communication supported by an interactive study website.

Participants: Nurses and physicians (N = 35) from four countries and across the United States who rated themselves as at least moderately expert about NEC risk.

Methods: e-Delphi involved three rounds of surveys and qualitative thematic analysis of experts' comments. Surveys continued until criteria for consensus and/or stability were met.

Results: Of 64 initial items, 43 were retained representing 33 risk factors (final GutCheck(NEC) Content Validity Index [CVI] = .77). Two broad themes about NEC risk emerged from 242 comments: the impact of individual physiologic vulnerability and variation in neonatal intensive care unit (NICU) clinicians' practices. Controversy arose over the impact of treatments on NEC, including probiotics, packed red blood cell (PRBC) transfusions, and patent ductus arteriosus (PDA) management using indomethacin.

Conclusion: GutCheck(NEC) achieved borderline content validity for a new scale. The e-Delphi process yielded a broad perspective on areas in which experts share and lack consensus on NEC risk. Future testing is underway to reduce the number of risk items to the most parsimonious set for a clinically useful risk tool and test reliability.

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Conflict of interest statement

Disclosure The authors report no conflict of interest or relevant financial relationships.

Figures

Figure 1
Figure 1
Multi-factorial Etiology of Necrotizing Enterocolitis
Figure 2
Figure 2
Model of Necrotizing Enterocolitis Risk
See this image and copyright information in PMC

References

    1. Bisquera JA, Cooper TR, Berseth CL. Impact of necrotizing enterocolitis on length of stay and hospital charges in very low birth weight infants. Pediatrics. 2002;109(3):423–428. - PubMed
    1. Carmines EG, Zeller RA. Reliability and validity assessment. Thousand Oaks, CA: Sage Publications; 1979.
    1. Catlin A. International Delphi study basis of creation of a neonatal end-of-life palliative care protocol. Journal of Hospice & Palliative Nursing. 2003;5(1):16.
    1. Christensen RD, Wiedmeier SE, Baer VL, Henry E, Gerday E, Lambert DK, Besner GE, et al. Antecedents of Bell Stage III necrotizing enterocolitis. Journal of Perinatology. 2010a;30(1):54–57. - PubMed
    1. Christensen RD, Lambert DK, Henry E, Wiedmeier SE, Snow GL, Baer VL, Pysher TJ, et al. Is “transfusion-associated necrotizing enterocolitis” an authentic pathogenic entity? Transfusion. 2010b;50(5):1106–1112. - PubMed

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