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. 2020 Jul:79:309-316.
doi: 10.1016/j.ijsu.2020.06.015. Epub 2020 Jun 9.

International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study

Beamish Aj  1 , Brown C  2 , Abdelrahman T  2 , Ryan Harper E  2 , Harries Rl  3 , Egan Rj  3 ; Welsh Surgical Research Initiative (WSRI) Collaborative
Collaborators, Affiliations

International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study

Beamish Aj et al. Int J Surg. 2020 Jul.

Abstract

Background: International professional bodies have been quick to disseminate initial guidance documents during the COVID-19 pandemic. In the absence of firm evidence, these have been developed by expert committees, limited in participant number. This study aimed to validate international COVID-19 surgical guidance using a rapid Delphi consensus exercise.

Methods: Delphi statements were directly mapped to guidance from surgical professional bodies in the US and Europe (SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content against international consensus. Agreement from ≥70% participants was determined as consensus agreement.

Results: The Delphi exercise was completed by 339 individuals from 41 countries and 52 statements were mapped to the guidance, 47 (90.4%) reaching consensus agreement. Of these, 27 statements were mapped to SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document. Within the SAGES/EAES document, 92.9% of items reached consensus agreement (median 89.0%, range 60.5-99.2%), 90.4% within the Joint RCS document (87.6%, 63.4-97.9%), and 90.9% within the RACS document (85.5%, 18.7-98.8%). Statements lacking consensus related to the surgical approach (open vs. laparoscopic), dual consultant operating, separate instrument decontamination, and stoma formation rather than anastomosis.

Conclusion: Initial surgical COVID-19 guidance from the US, Europe and Australasia was widely supported by an international expert community, although a small number of contentious areas emerged. These findings should be addressed in future guidance iterations, and should stimulate urgent investigation of non-consensus areas.

Keywords: COVID-19; Delphi consensus; Guidance; Surgery.

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Conflict of interest statement

Declaration of competing interest The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Choropleth of Delphi participation.
See this image and copyright information in PMC

Comment in

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