MethodsWe employed a systematic review to identify, synthesize and consolidate existing principles of screening, followed by a modified Delphi consensus process with international screening RESEARCH Consolidated principles for screening based on a systematic review and consensus process Jungner published 10 principles of screening that often represent the de facto starting point for screening decisions today; 50 years on, are these principles still the right ones? Our objectives were to review published work that presents principles for population-based screening decisions since Wilson and Jungner's seminal publication, and to conduct a Delphi consensus process to assess the review results. METHODS:We conducted a systematic review and modified Delphi consensus process. We searched multiple databases for articles published in English in 1968 or later that were intended to guide population-based screening decisions, described development and modification of principles, and presented principles as a set or list. Identified sets were compared for basic characteristics (e.g., number, categorization), a citation analysis was conducted, and principles were iteratively synthesized and consolidated into categories to assess evolution. Participants in the consensus process assessed the level of agreement with the importance and interpretability of the consolidated screening principles. RESULTS:We identified 41 sets and 367 unique principles. Each unique principle was coded to 12 consolidated decision principles that were further categorized as disease/condition, test/intervention or program/system principles. Program or system issues were the focus of 3 of Wilson and Jungner's 10 principles, but comprised almost half of all unique principles identified in the review. The 12 consolidated principles were assessed through 2 rounds of the consensus process, leading to specific refinements to improve their relevance and interpretability. No gaps or missing principles were identified. INTERPRETATION:Wilson and Jungner's principles are remarkably enduring, but increasingly reflect a truncated version of contemporary thinking on screening that does not fully capture subsequent focus on program or system principles. Ultimately, this review and consensus process provides a comprehensive and iterative modernization of guidance to inform population-based screening decisions.HEALTH SERVICES
BackgroundThis paper assesses interviewee transcript review (ITR) as a technique for improving the rigour of interview-based, qualitative research. ITR is a process whereby interviewees are provided with verbatim transcripts of their interviews for the purposes of verifying accuracy, correcting errors or inaccuracies and providing clarifications. ITR, in various forms, is widely used among qualitative researchers, however there is limited methodological guidance on how it should be employed and little is known about its actual impact on the transcript, the data, the interviewee or the researcher.MethodsITR was incorporated into a qualitative research study in which 51 key informant interviews were conducted with a range of senior stakeholders within the Canadian health care system. The changes made by interviewees to their transcripts were systematically tracked and categorized using a set of mutually exclusive categories.ResultsThe study found that ITR added little to the accuracy of the transcript and may create complications if the goal of the researcher is to produce a transcript which reflects precisely what was said at the time of the interview. The advantages of ITR are that it allows interviewees the opportunity to edit or clarify information provided in the original interview, with many interviewees providing corrections, clarifications, and in some cases, adding new material to their transcripts. There are also potential disadvantages, such as a bias created by inconsistent data sources or the loss of data when an interviewee chooses to remove valuable material. The impact of ITR on the interviewee may be both positive and negative, depending on the specific circumstances and the nature of the study. The impact of ITR on the researcher was minimal in this study, but is again subject to specific circumstances of the research context.ConclusionWhile ITR is employed by many researchers across numerous fields, the advantages of its use may be relatively small in terms of verifying the accuracy of qualitative interview transcripts. Researchers are advised to carefully consider both the potential advantages and disadvantages of ITR outlined in this paper before deciding to incorporate the practice within their qualitative study designs.
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