Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique

Hohmann, Erik; Angelo, Richard L.; Arciero, Robert A.; Bach, Bernard R.; Cole, Brian J.; Cote, Mark P.; Farr, Jack; Feller, Julian A.; Gelbart, Brad; Gomoll, Andreas H.; Imhoff, Andreas B.; LaPrade, Robert F.; Mandelbaum, Bert R.; Marx, Robert G.; Monllau, Juan Carlos; Noyes, Frank R.; Parker, David; Rodeo, Scott A.; Sgaglione, Nicholas A.; Shea, Kevin P.; Shelbourne, Donald K.; Yoshiya, Shinichi; Glatt, Vaida; Tetsworth, Kevin

doi:10.1016/j.arthro.2019.08.014

Cited by 46 publications

(32 citation statements)

References 53 publications

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“…These existent complicated clinical issues are hardly solvable by RCTs and SRs in a short time, either. A study of expert consensus sets up a structured process to collect information from a series of semi-open questions of interest with controlled feedback, followed by multi-round expert votes to achieve agreement on speci c issues [33]. The Delphi methodology has a speci c advantage that it can even be carried out securely while current research evidence is insu cient or there exists uncertainty in a certain eld [44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Standardizing and Optimizing Acupuncture Therapy for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Wang

Zhang

et al. 2020

Preprint

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Background: Acupuncture has been regarded as a potential physical approach for irritable bowel syndrome (IBS). However, there is still no adequate conclusive evidence on its efficacy and optimal therapeutic strategy of acupuncture for IBS. The purpose of this expert consensus study was to put forward some viable recommendations for clinical acupuncture practitioners in treating IBS.Methods: A panel composed of 74 acupuncturists, was convened to participate in a 2-round clinical issue investigation. Subsequently, systematic reviews on acupuncture for IBS were screened using 3 databases. An initial consensus voting list was generated from the results of clinical issue investigation and literature review. Finally, a multi-round Delphi vote was conducted to develop an expert consensus on these specific issues. 30 authoritative experts were required to respond with agreement, neutrality, or disagreement for the items on the consensus voting list. Consensus achievement was identified as the level of agreement on a given item > 80%.Results: Following a 2-round Delphi vote, there were 19 items achieving consensus; of which 5 items (26.32%) achieved complete consensus, and more than 80% expert agreement was reached for the other 14 items. These items can be roughly categorized into 3 major domains of acupuncture for IBS: (1) therapeutic effects, (2) therapeutic principles and protocols, (3) possible adverse events.Conclusions: Without any ready-made guidelines, this preliminary expert consensus could be helpful for acupuncturists in daily clinical practice and patients with IBS to acquire appropriate and standardized acupuncture treatment. In addition, it also points out the clinical issues which need to be further explored in future studies.

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Section: Discussionmentioning

confidence: 99%

Standardizing and Optimizing Acupuncture Therapy for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Wang

Zhang

et al. 2020

Preprint

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“…According to the previous studies of this type, consensus establishment was defined as that the threshold of agreement amongst respondents should be more than 80% (Ravensbergen et al, 2016;Hohmann et al, 2020). As long as a level of agreement was <80%, it suggested that the item was still lack of agreement and required another round of voting to either reach a higher level of agreement or no consensus achievement.…”

Section: Process Of the Delphi Consensus Surveymentioning

confidence: 99%

Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey

Wang

et al. 2020

Front. Aging Neurosci.

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BackgroundCurrent research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted.MethodsA clinical question investigation among 47 acupuncturists yielded 24 initial items. Subsequently, systematic reviews on acupuncture for CI were searched within three online databases. A panel of 30 authoritative experts were requested to respond with agreement, neutrality, or disagreement for each item. Consensus establishment was defined as the percentage of agreement on a given item >80%.ResultsFollowing a 2-round Delphi survey, there were 21 items reaching consensus and three items resulting in no consensus; of which 10 items reached 90∼100% agreement, and 80∼90% expert agreement was achieved for 11 items. These items could be roughly categorized into six domains: (1) therapeutic effects of acupuncture, (2) therapeutic principles, (3) acupoint selection and combination, (4) acupuncture parameters, (5) considerable combined therapies, and (6) possible adverse events.ConclusionWithout ready-made guidelines, this expert consensus may be conducive to guide acupuncturists in implementing clinical acupuncture practice for CI. Moreover, given the lack of high-quality research evidence and plenty of unresolved clinical issues in this field, it is of necessity to carry out more studies to better clarify the treatment algorithm.

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“…Given the large body of level I RCT evidence addressing the treatment of degenerative meniscal tear and the consistency in findings across these studies, it is somewhat surprising that in their article, "Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique," 10 Hohmann, Angelo, Arciero, Bach, Cole, Cote, Farr, Feller, Gelbhart, Gomoll, Imhoff, LaPrade, Mandelbaum, Marx, Monllau, Noyes, Parker, Rodeo, Sgaglione, Shea, Shelbourne, Yoshiya, Glatt, and Tetsworth turned to the Delphi technique to achieve greater clarity regarding treatment outcomes. Introduced by the Rand Corporation more than 60 years ago as a method for predicting what might happen in the event of nuclear war, the Delphi technique is used to reach consensus among experts when empirical evidence is lacking or contradictory.…”

Section: See Related Article On Page 501mentioning

confidence: 99%

Editorial Commentary: Degenerative Meniscal Tear: Sojourn to the Oracle

Katz

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Degenerative meniscal tears are prevalent and give rise to more than 400,000 arthroscopic partial meniscectomies annually in the United States. These lesions often occur in the setting of knee osteoarthritis and are generally regarded as a component of the tissue damage (to cartilage, meniscus, bone, synovium among others) that comprises osteoarthritis. A wide array of clinicians, ranging from orthopaedic surgeons to general practitioners, regularly encounter symptomatic degenerative meniscal tears, especially among patients with knee osteoarthritis. Clinical evidence suggests that initial treatment for these injuries should be nonoperative, with arthroscopic partial meniscectomy reserved for those whose pain persists despite physical therapy.

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Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique

Cited by 46 publications

References 53 publications

Standardizing and Optimizing Acupuncture Therapy for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Standardizing and Optimizing Acupuncture Therapy for Irritable Bowel Syndrome: A Delphi Expert Consensus Study

Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey

Editorial Commentary: Degenerative Meniscal Tear: Sojourn to the Oracle

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