A demonstration of using formal consensus methods within guideline development; a case study

Abstract

Background Recommendations within guidelines are developed by synthesising the best available evidence; when limited evidence is identified recommendations are generally based on informal consensus. However, there are potential biases in group decision making, and formal consensus methods may help reduce these. Methods We conducted a case study using formal consensus, to develop one set of recommendations within the Neonatal Parenteral Nutrition guideline being produced for the National Institute for Health and Care Excellence. Statements were generated through identification of published guidelines on several topics relating to neonatal parenteral nutrition. Ten high quality guidelines were included, and 28 statements were generated; these statements were rated by the committee via two rounds of voting. The statements which resulted in agreement were then used to develop the recommendations. Results The approach was systematic and provided transparency. Additionally, a number of lessons were learnt; including the value of selecting the appropriate topic, giving adequate time to the process, and ensuring methodologies are understood by the committee for their value and relevance. Conclusion Formal consensus is a valuable option for use within guideline development when specific criteria are met. The approach provides transparent methodology, ensuring clarity on how recommendations are developed.

Committee experiences of using formal consensus in healthcare guidelines: a longitudinal qualitative study

“…The post-FCM interviews focused on participant experiences of using FCM within the committee meeting, its effectiveness and relevance within the healthcare guideline setting. The FCM was conducted by NGA technical team members using methods described elsewhere; [ 17 ] interview questions are provided in the Appendix 2 .…”

“…FCM have been suggested for guidelines that have limited evidence because they can provide a transparent way of combining evidence from multiple sources including expert opinion [ 6 , 8 , 16 ]. The current study was based on NGT methods designed for use in healthcare guidelines [ 6 , 17 , 18 ]. Although a major strength of FCM is assumed to be an increased participation of group members [ 19 , 20 ] there has been no qualitative research investigating the perspectives of those using FCM in a healthcare guideline setting.…”

Criteria and Guidelines for Human-Centered Work Design in a Digitally Transformed World of Work: Findings from a Formal Consensus Process

“…Under similar conditions, consensus methods have been successfully used several times in other research areas to develop valid criteria and design recommendations [ 28 , 29 , 30 , 31 ]. By adopting this methodological approach, the present work contributes to answering the question concerning the criteria in a systematic way.…”