A T2 Translational Science Modified Delphi Study: Spinal Motion Restriction in a Resource-Scarce Environment

Weinstein, Eric S.; Cuthbertson, Joseph; Ragazzoni, Luca; Verde, Manuela

doi:10.1017/s1049023x20000862

Cited by 6 publications

(8 citation statements)

References 40 publications

(52 reference statements)

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“…The smallest study had 15 total ratings, while the largest had 1620. Two of these Delphi studies have been previously published, and several are currently being analyzed for publication (Hung et al, 2022: Weinstein et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

Analysis of Delphi study 7-point linear scale data by parametric methods: Use of the mean and standard deviation

Franc

Hung

Pirisi

et al. 2023

Methodological Innovations

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The Delphi technique is a unique survey method that involves an iterative process to gain consensus when consensus is challenging to establish. Survey participants typically rate a variety of statements using a specified rating scale. The survey is repeated for several rounds, and at each round statements that do not reach a predefined level of consensus are advanced to the next round while giving the participants information about the responses of other participants for their comparison. The final statements are then ranked in order of the average rating. The statistical methods to analyze Delphi studies are not well described. This study investigates the use of a 1–7 linear rating scale along with parametric summary statistics for assessment of consensus and ranking of statements. A study set of 9297 individual ratings on the 1–7 scale were obtained from previously performed Delphi studies and used to create 490,000 simulated Delphi ratings with various numbers of participants. While the overall distribution of ratings was strongly left skewed the sampling distribution was near normally distributed for studies with five or more participants. The average difference between the standard deviation and interquartile range was −0.26/7. The overall risk of falsely concluding consensus using the standard deviation as a summary statistic was 7.3% when compared to using the interquartile range. The average difference between mean and median was −0.20/7. The risk of falsely ranking the statements by a value of 0.5 or more was near zero for all sample sizes when the mean was compared to the median. This study suggests that the use of the 1–7 linear rating scale in combination with the parametric summary statistics of standard deviation and mean is a valid method to analyze ratings from Delphi studies.

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Section: Resultsmentioning

confidence: 99%

Analysis of Delphi study 7-point linear scale data by parametric methods: Use of the mean and standard deviation

Franc

Hung

Pirisi

et al. 2023

Methodological Innovations

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“…15 The modification of this study applied the outcomes of a previously conducted PRISMA-ScR scoping review to capture data related to the research topic in a robust, valid manner. 16 Data retrieved has been analyzed and synthesized into three initial sets of statements, brought to the attention of internal focus groups (IFGs) and external focus groups (EFGs) to produce the final Delphi statements (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Sudden-Onset Disaster Mass-Casualty Incident Response: A Modified Delphi Study on Triage, Prehospital Life Support, and Processes

Cuthbertson,

Weinstein,

Franc

et al. 2023

Prehosp. Disaster med.

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The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken. This resulted in 18 triage, eight life support and damage control interventions, and 23 process consensus statements. These findings will be utilized in the development of evidence-based prehospital mass-casualty incident response tools and guidelines.

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“…This was a cross-sectional survey of a single EMS agency located in central Canada. A draft survey was developed in consultation with local practitioners ( n = 16) using a Delphi process modified to start with candidate questions informed by existing studies [ 32 , 33 ]. This version was tested on a sample of EMS personnel at an international paramedic conference ( n = 39).…”

Section: Methodsmentioning

confidence: 99%

“…Due to the scoring direction of individual questions, its maximum possible score [40] would indicate a high level of skepticism toward the value of treatment (or low level of endorsement), while the minimum [8] would indicate a low level of skepticism (or high level of endorsement). Overall, the median factor score was 26 (IQR: 24-29.75, range [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Internal consistency of each factor was high (Judging MOIs, 0.77 and Treatment Value, 0.76).…”

Section: Exploratory Factor Analysismentioning

confidence: 99%

Paramedic attitudes towards prehospital spinal care: a cross-sectional survey

2022

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Background The optimal application of spinal motion restriction (SMR) in the prehospital setting continues to be debated. Few studies have examined how changing guidelines have been received and interpreted by emergency medical services (EMS) personnel. This study surveys paramedics’ attitudes, observations, and self-reported practices around the treatment of potential spine injuries in the prehospital setting. Methods This was a cross-sectional survey of a North American EMS agency. After development and piloting, the final version of the survey contained four sections covering attitudes towards 1) general practice, 2) specific techniques, 3) assessment protocols, and 4) mechanisms of injury (MOI). Questions used Likert-scale, multiple-choice, yes/no, and free-text responses. Exploratory factor analysis (EFA) was used to identify latent constructs within responses, and factor scores were analyzed by ordinal logistic regression for associations with demographic characteristics (including qualification level, gender, and years of experience). MOI evaluations were assessed for inter-rater reliability (Fleiss’ kappa). Inductive qualitative content analysis, following Elo & Kyngäs (2008), was used to examine free-text responses. Results Two hundred twenty responses were received (36% of staff). Raw results indicated that respondents felt that SMR was seen as less important than in the past, that they were treating fewer patients than previously, and that they follow protocol in most situations. The EFA identified two factors: one (Judging MOIs) captured paramedics’ estimation that the presented MOI could potentially cause a spine injury, and another (Treatment Value) reflected respondents’ composite view of the effectiveness, importance, and applicability of SMR. Respondents with advanced life support (ALS) qualification were more likely to be skeptical of the value of SMR compared to those at the basic life support (BLS) level (OR: 2.40, 95%CI: 1.21–4.76, p = 0.01). Overall, respondents showed fair agreement in the evaluation of MOIs (k = 0.31, 95%CI: 0.09–0.49). Content analysis identified tension expressed by respondents between SMR-as-directed and SMR-as-applied. Conclusion Results of this survey show that EMS personnel are skeptical of many elements of SMR but use various strategies to balance protocol adherence with optimizing patient care. While identifying several areas for future research, these findings argue for incorporating provider feedback and judgement into future guideline revision.

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A T2 Translational Science Modified Delphi Study: Spinal Motion Restriction in a Resource-Scarce Environment

Cited by 6 publications

References 40 publications

Analysis of Delphi study 7-point linear scale data by parametric methods: Use of the mean and standard deviation

Analysis of Delphi study 7-point linear scale data by parametric methods: Use of the mean and standard deviation

Sudden-Onset Disaster Mass-Casualty Incident Response: A Modified Delphi Study on Triage, Prehospital Life Support, and Processes

Paramedic attitudes towards prehospital spinal care: a cross-sectional survey

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