ADDRESSING UNCERTAINTY IN WOUND MANAGEMENT USING A MODIFIED DELPHI METHODOLOGY
Author(s)
Betts A1, Odeyemi I1, Devlin N2, Yeowell G1, Fatoye F1
1Manchester Metropolitan University, Manchester, UK, 2Office of Health Economics, London, UK
OBJECTIVES: The increasing prevalence and rising costs of Venous Leg Ulcers (VLU), Diabetic Foot Ulcers (DFU) and Pressure Ulcers (PU), means that a consistent level of care and understanding of best practice is needed to improve patient outcomes and maximise value for money This study aimed to achieve consensus on a set of evidence-based statements on these issues from a range of clinical experts. METHODS: A literature search identified 827 articles. Inclusion/exclusion criteria were applied resulting in 145 articles providing 308 quotations in 4 categories: epidemiology, clinical effectiveness, quality of life, and economics. From this, 47 statements were developed. A modified Delphi methodology was used and a consensus threshold of 80% was set. Round I and II: Participants examined and voted yes/no for each statement. If the threshold was not met, comments informed changes. Round III: A meeting to discuss all statements. RESULTS: Round I: 38/47 statements confirmed, none rejected. 9 statements modified using comments and resubmitted. Round II: 5/9 remaining statements confirmed, none rejected, leaving 4. At the meeting, all 47 were confirmed. During examination of confirmed statements, some modifications were made; agreed by all members of the panel. A consensus document is being developed using the statements. CONCLUSIONS: The consensus document developed from this approach can help to address areas of uncertainty in the management of chronic wounds by Healthcare Professionals across a range of disciplines resulting in benefits both for patients and the healthcare system. The panel enjoyed the Delphi methodology, which was an efficient way of arriving at consensus for a large and varied group. Using a Delphi methodology to achieve a consensus on evidence-based statements generated from a literature review is an efficient and robust methodology for resolving uncertainty regarding the management of clinical conditions.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PIN88
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Infectious Disease (non-vaccine), Sensory System Disorders