Strength in Numbers

What types of methodologies are used to develop a consensus statement? I’m in the midst of helping to write a consensus statement manuscript in education and ran into this great review article. It’s from the British Medical Journal in 1995. 

Basically, there are 2 general types of methodologies:

  • Delphi Process
  • Nominal Group Technique

Delphi Process

An example of a consensus topic might be: How will patient care be affected by the new ACGME Duty Hours rules? The Delphi process takes several rounds of discussions:

  • Round 1: Opinions are expressed on a particular issue and categorized into headings
  • Round 2: Participants rank their agreement with each statement in the summarized opinions.
  • Round 3: Participants view the Round #2 rankings and comments and re-rank their agreement with the opinions.

The final results are analyzed for agreement. If there is no consensus, Round 3 is repeated. The Delphi Process allows a large number of experts to participate in a consensus statement because this entire process can be performed via email.

Nominal Group Technique

In contrast to the Delphi Process, the nominal group technique involves fewer experts (usually 9-12).  Furthermore, this approach requires face-to-face discussion, which adds a more personal element to the methodology.

  • Step 1: Each participant contributes one idea to the facilitator, who records it on a flip chart/projector screen.
  • Step 2: The comments are grouped into different categories.
  • Step 3: Each participant privately ranks each idea.
  • Step 4: The results are tabulated and discussed in a large-group setting.
  • Step 5: Each participant privately re-ranks each idea.
  • Step 6: The results are tabulated to determine consensus.

 

Reference
Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995, 311(7001), 376-80. Download the free PDF.

 

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls https://t.co/7v7cgJqNEn
Michelle Lin, MD