Improving design choices in Delphi studies in medicine: the case of an exemplary physician multi-round panel study with 100% response
Open accessAbstract
BACKGROUND: A proper application of the Delphi technique is essential for obtaining valid research results. Medical researchers regularly use Delphi studies, but reports often lack detailed information on methodology and controlled feedback: in the medical literature, papers focusing on Delphi methodology issues are rare. Since the introduction of electronic surveys, details on response times remain scarce. We aim to bridge a number of gaps by providing a real world example covering methodological choices and response times in detail. METHODS: The objective of our e(lectronic)-Delphi study was to determine minimum standards for emergency departments (EDs) in the Netherlands. We opted for a two-part design with explicit decision rules. Part 1 focused on gathering and defining items; Part 2 addressed the main research question using an online survey tool. A two-person consensus rule was applied throughout: even after consensus on specific items was reached, panellists could reopen the discussion as long as at least two panellists argued similarly. Per round, the number of reminders sent and individual response times were noted. We also recorded the methodological considerations and evaluations made by the research team prior to as well as during the study. RESULTS: The study was performed in eight rounds and an additional confirmation round. Response rates were 100% in all rounds, resulting in 100% consensus in Part 1 and 96% consensus in Part 2. Our decision rules proved to be stable and easily applicable. Items with negative advice required more rounds before consensus was reached. Response delays were mostly due to late starts, but once panellists started, they nearly always finished the questionnaire on the same day. Reminders often yielded rapid responses. Intra-individual differences in response time were large, but quick responders remained quick. CONCLUSIONS: We advise those considering Delphi study to follow the CREDES guideline, consider a two-part design, invest in personal commitment of the panellists, set clear decision rules, use a consistent lay-out and send out your reminders early. Adopting this overall approach may assist researchers in future Delphi studies and may help to improve the quality of Delphi designs in terms of improved rigor and higher response rates.
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The recommended number of panelists to achieve consensus in healthcare is 20.
“Although the Delphi method does not state a predetermined number of panelists, the recommended number to achieve consensus in healthcare is 20 (39).”
From Identifying social media professionalism competencies in Vietnamese medical students: a modified Delphi method (2026) · cites this paper as [39]
In Methods > Selection of experts (page not provided), the paper says there is no fixed ideal panel size, but gives 10–18—not 20—as the recommended number for arriving at consensus. Its separate requirement of 15–25 members applied to this study's panel, not to a general recommendation. (LLM, conf=0.90)
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An Acupuncture Protocol for the Treatment of Erectile Dysfunction: A Delphi Process
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Photobiomodulation on vocal training and rehabilitation: Delphi consensus based on experts
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- Authors
- Veugelers, R., Gaakeer, M. I., Patka, P., & Huijsman, R.
- Affiliations
- Admiraal De Ruyter Ziekenhuis (NL)
- Erasmus MC (NL)
- Erasmus University Rotterdam (NL)
- Corresponding author
- Veugelers, Rebekka
- Venue
- BMC Medical Research Methodology
- Published
- 2020-06-15
- Volume
- 20
- Issue
- 1
- Pages
- 156-156
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC7294633
- OpenAlex
- W3035611753
- Cited by
- 189
- References
- 28
- Citations by year
- 2026: 28 · 2025: 35 · 2024: 38 · 2023: 42 · 2022: 20 · 2021: 23 · 2020: 2
- FWCI
- 29.07
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Stichting Achmea Health (Z634)
- Topics
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Keywords
- Delphi method, electronic surveys, response time, decision rules
- MeSH terms
- Delphi Technique, Humans, Medicine, Netherlands, Physicians, Consensus
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