ObjectiveBy establishing a set of evaluation system for thoracoscopic clinical function and applicability, to evaluate and compare the advantages and disadvantages of different brands of thoracoscopes, and to provide some suggestions for the innovation and upgrade of thoracoscopes, especially for the domestic thoracoscopes.MethodsThe project coordination team initially formulated the evaluation index system for the clinical function and applicability of thoracoscope by querying literature and brainstorming. The Delphi expert consultation method was used to distribute questionnaires to the selected experts. Experts provided scores which were based on the importance of each indicator, and clarified the basis of their judgment and the familiarity with the evaluation indicators. After two rounds of screening by Delphi method, a thoracoscopic clinical function and applicability satisfactory questionnaire was formed. The appropriate sample for pre-investigation was selected, and the reliability and validity were tested. The index composition was adjusted based on the results of the test to form a final evaluation scale.ResultsThe project coordination team initially formulated 24 thoracoscope-related evaluation indicators. After two rounds of experts consultation, the item "brightness adjustment" was deleted without any additional entries. The positive coefficients of the experts in the first round and the second round were 100.0% and 80.0%, respectively. The two rounds of authoritative coefficients were 0.86 and 0.90, and the coordination coefficients were 0.272 (P<0.001) and 0.523 (P<0.001), respectively. A total of 140 questionnaires were issued in this pre-investigation. The recovery rate was 100.0% and the effective rate was 90.0%. The Cronbach's α value of the scale was 0.936, and the Spearman-Brown split-half reliability coefficient was 0.972. The factor analysis finally extracted 3 common factors. The total variance of the cumulative interpretation was 70.9%. The three common factors were named "operation related", "image related" and "device related".ConclusionThe evaluation index system developed in this study has good reliability and validity, and can be used as a tool to evaluate the clinical function and applicability of thoracoscopes.
Objective To construct a sensitive indicator system for the quality of ambulatory chemotherapy nursing, and provide reference basis for the evaluation and scientific management of ambulatory chemotherapy nursing quality. Method Based on Donabedian’s three-dimensional quality structure model of “structure process result”, through literature review, a preliminary quality indicator system for ambulatory chemotherapy nursing was formulated. The Delphi method was used for two rounds of expert inquiry to determine the sensitive treatment indicator system for ambulatory chemotherapy nursing. The weight of the indicators was calculated using the hierarchical analysis method. Result Fifteen expert inquiry questionnaires were distributed through two rounds of inquiry, and the response rates of the two rounds of expert inquiry questionnaires were all 100%, with expert positivity coefficients of 100% and authority coefficients of 0.90 and 0.94, respectively. The second round of expert inquiry questionnaires Kendall’s coefficient of concordance were between 0.573 and 0.769 (P<0.01). The final constructed quality sensitive indicator system for ambulatory chemotherapy nursing included 3 primary indicators, 8 secondary indicators, and 27 tertiary indicators. The overall Cronbach’s α coefficient for the second round of inquiry questionnaires was 0.853, while the Cronbach’s α coefficients for structural indicators, process indicators, and outcome indicators were 0.879, 0.921, and 0.857, respectively. Conclusions The sensitive indicator system for nursing quality in ambulatory chemotherapy wards constructed has high systematicity, sensitivity, and scientificity, and the weight distribution is reasonable. This indicator system can provide a reference basis for objective evaluation and standardized management of nursing quality in ambulatory chemotherapy.
ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
ObjectivesTo construct a symptom assessment system suitable for surgical lung cancer patients, and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.MethodsPostoperative symptom items of lung cancer were formed according to previous researches, literature review, the current lung cancer symptom assessment tools, and expert interviews. The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.ResultsNine first-level symptom items were eventually formed: cough, pain, shortness of breath, fatigue, dizziness, nausea or vomiting, subcutaneous emphysema, insomnia, and constipation. The first round of active coefficient and authority coefficient of experts were 85.0% and 0.88, and the second round were 88.2% and 0.87. The Kendall coordination coefficients of the nine first-level symptom items were 0.47 (P<0.001) and 0.43 (P<0.001), respectively.ConclusionsThe evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.
Objective To scientifically construct a self-management behavior scale for postoperative patients with osteoporotic fractures, in order to assess the self-management behavior level of this patient population. Methods Between November 2022 and February 2023, a scale item pool was constructed using literature analysis and expert panel discussions. A preliminary version of the scale was formed based on feedback from 30 experts and 15 patients. From March 2023 to March 2024, a convenience sampling method was used to survey 230 patients post-osteoporotic fracture surgery from a tertiary hospital in Guangzhou. Cronbach’s α coefficient, split-half reliability, and test-retest reliability were used to assess the reliability of the scale, while content validity and exploratory factor analysis were used to evaluate its validity. Results The developed scale consisted of 5 dimensions and 27 items. The content validity index for each item ranged from 0.933 to 1.000. Exploratory factor analysis extracted 5 common factors, explaining 65.964% of the cumulative variance. The overall Cronbach’s α coefficient, split-half reliability, and test-retest reliability were 0.934, 0.780, and 0.958, respectively. The Cronbach’s α coefficient, split-half reliability, and test-retest reliability for each dimension ranged from 0.849 to 0.897, 0.816 to 0.904, and 0.826 to 0.894, respectively. Conclusions The self-management behavior scale for post-osteoporotic fracture surgery patients demonstrates good reliability and validity. It is a highly authoritative and scientific tool that can be used effectively to assess self-management behaviors in these patients and provide a basis for developing personalized self-management interventions.
ObjectiveTo build core items of database for traumatic brain injury (TBI) in rehabilitation medical database.MethodsRelevant factors in TBI database were summarized through database search in combination of acknowledged relevant items of TBI in rehabilitation medical database. Delphi method was used for experts to determine which items should be included by two rounds of questionnaires.ResultsThe average authority coefficient of experts was 0.94. After two rounds of questionnaires, 73 were included. Its contents include: general conditions, brain damage and disposal, relevant rehabilitation assessment scales, previous rehabilitation treatment, treatment expenses, and contents that require attention during re-evaluation.ConclusionsAfter two rounds of Delphi evaluation, the core items of database for TBI are identified with high recognition and consistency from experts.
Objective To establish an evaluation index system for the quality and safety of day surgery, and provide standard and professional quantitative bases for monitoring and management of day surgery quality. Methods From December 2021 to May 2022, based on the frame work of the three-dimensional “structure-process-outcome” quality model, two rounds of Delphi method interviews were conducted with 15 day surgery-related management experts, and analytic hierarchy process was used to calculate the weight of each index. Results The effective questionnaire recovery rates of the two rounds of surveys were both 100%; the expert authority coefficients were 0.94 and 0.98, respectively; the variation coefficients were 0.00-0.30 and 0.00-0.24, respectively; the Kendall coordination coefficients were 0.382 (P<0.05) and 0.266 (P<0.05), respectively; and the consistency ratios of all levels were less than 0.1. The final day surgery quality and safety evaluation index system included 3 first-level indicators, 10 second-level indicators, and 43 third-level indicators. Conclusions The quality and safety evaluation index system of day surgery is scientific, reasonable and comprehensive. It can provide a reference for the quality and safety evaluation of day surgery and solidly promote the high-quality development of public hospitals.
Objective To construct the expert consensus on comprehensive rehabilitation assessment system for the elderly in the hospital and community. MethodsMedline, Embase, Cochrane Library, China National Knowledge Infrastructure and VIP databases were searched for geriatric rehabilitation assessment materials from June 2016 to June 2021. The primary items were summarized through literature review and research group discussion, and then Delphi method was used among 20 experts in geriatric rehabilitation medicine to develop consensus-based core items for the elderly comprehensive rehabilitation assessment system. Results A total of 158 references were included. Through integration, sorting and screening, the research team initially formulated 41 items and four major sections including cardiopulmonary exercise, sensory perception, cognition and psychology (speech contained), and swallowing, urination and defecation. The effective recovery rates of the two rounds of experts consultation were both 100%, the mean expert authority coefficient was 0.92±0.05, the variation coefficients were 0.174±0.043 and 0.172±0.063, respectively; the Kendall coefficients of concordance were 0.587 and 0.601, with P values<0.05 for both, respectively. Finally, The comprehensive rehabilitation assessment system for the elderly including 16 items would be formed. Conclusion The expert consensus on comprehensive rehabilitation assessment system for the elderly constructed by Delphi method includes motor, sensory perception, cognition, swallowing, speech, cardiopulmonary, defecation, mental and psychological elements, which are identified with high recognition and consistency from experts.