Cited by 189Delphi Technique in ResearchSurvey Methodology and NonresponseReliability and Agreement in Measurement

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Improving design choices in Delphi studies in medicine: the case of an exemplary physician multi-round panel study with 100% response

Open access
Veugelers, Rebekka, Gaakeer, Menno I., Patka, Peter, Huijsman, Robbert·2020·BMC Medical Research Methodology

Abstract

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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Crossref · 10.1186/s12874-020-01029-4

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Figures

Fig. 1 Components of online survey. The design was identical for each page of the survey and consisted of the following components
Fig. 1 Components of online survey. The design was identical for each page of the survey and consisted of the following componentsCC BY · PubMed Central
Fig. 2 Flowchart for Part 1: gathering and defining items. Preliminary consensus = consensus (agreement 70% or above) but retained based on other decision rule
Fig. 2 Flowchart for Part 1: gathering and defining items. Preliminary consensus = consensus (agreement 70% or above) but retained based on other decision ruleCC BY · PubMed Central
Fig. 3 Flowchart for Part 2. the main research topic: minimum ED standards in three domains (ED facilities, diagnostics and medical specialist availability)
Fig. 3 Flowchart for Part 2. the main research topic: minimum ED standards in three domains (ED facilities, diagnostics and medical specialist availability)CC BY · PubMed Central
Fig. 4 Deemed necessity and influence on number of rounds to reach consensus
Fig. 4 Deemed necessity and influence on number of rounds to reach consensusCC BY · PubMed Central
Fig. 5 Median time to complete survey per round. The vertical axis displays the response time in days; the horizontal axis lists the individual rounds. The figure represents the median, the interquartile range and two outliers in Part 1 Round 4
Fig. 5 Median time to complete survey per round. The vertical axis displays the response time in days; the horizontal axis lists the individual rounds. The figure represents the median, the interquartile range and two outliers in Part 1 Round 4CC BY · PubMed Central
Fig. 6 Response times and reminders. The horizontal axis presents the date; the vertical axis presents the cumulative returned surveys. The dotted lines represent one or more reminders that were sent
Fig. 6 Response times and reminders. The horizontal axis presents the date; the vertical axis presents the cumulative returned surveys. The dotted lines represent one or more reminders that were sentCC BY · PubMed Central
Fig. 7 Number of reminders sent to individual panellists in total and per round
Fig. 7 Number of reminders sent to individual panellists in total and per roundCC BY · PubMed Central

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Research works printed but not linked: 1

  1. Helmer O. Social technology. New York: Basic Books; 1966.

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Metadata

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)
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
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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