Delphi Method Consensus on Priority Global Otolaryngology–Head and Neck Surgery Conditions and Procedures

Abstract

Objective The objective of this study was to develop an international expert consensus on priority otolaryngology–head and neck surgery conditions and procedures globally for which national health systems should be capable of caring. Study Design The Delphi method was employed via a multiround online survey administered to attending otolaryngologists in an international research collaborative of >180 otolaryngologists in >40 countries. Setting International online survey. Methods In round 1, participants listed the top 15 otolaryngologic conditions and top 15 otolaryngology procedures for their World Bank regions. In round 2, participants ranked round 1 responses in order of global importance on a 5-point Likert scale. In round 3, participants reranked conditions and procedures that did not achieve consensus, defined as 50% of the round 2 Likert responses being ranked as “important” or “very important.” Descriptive statistics were calculated for each round. Results The survey was distributed to 53 experts globally, with a response rate of 38% (n = 20). Fifty percent (n = 10) of participants were from low- and middle-income countries, with at least 1 participant from each World Bank region. Ten consensus surgical procedures and 10 consensus conditions were identified. Conclusion This study identified a list of priority otolaryngology–head and neck surgery conditions and surgical procedures for which all national health systems around the world should be capable of managing. Acute and infectious conditions with preventative and emergent procedures were highlighted. These findings can direct future research and guide international collaborations.

Essential equipment and services for otolaryngology care: a proposal by the Global Otolaryngology-Head and Neck Surgery Initiative

“…Head and neck cancers account for 5.7% of global cancer- related mortality, with a significantly higher mortality burden and subsequent economic loss in LMICs compared to high-income countries (HICs) [ 33 ▪ ]. Other OHNS conditions with high global burden of disease include upper respiratory infections, cleft lip/palate, head and neck trauma, pediatric foreign body, and deep neck space infections [ 34 ▪ , 35 , 36 ▪▪ ].…”

Letter Response: Design and Implementation of a Global Health and Underserved Care Track

“…In the cited Delphi consensus, a panel of globally diverse experts produced a list of 39 globally important procedures highlighting the breadth and depth of the field. 1 As regional anatomic specialists, otolaryngologists are uniquely positioned to offer medical and surgical care in a global setting to adult and pediatric patients. Despite the opportunity, implementation of formal global health care and health equity educational curriculums is currently limited in otolaryngology residency programs.…”

“…We sincerely appreciate the letter response by Djoutsop and Kanmounye to “Design and Implementation of a Global Health and Underserved Care Track in an Otolaryngology Residency.” The letter introduces the notable work of the Global OHNS initiative and expounds on a number of key points in the original article. In the cited Delphi consensus, a panel of globally diverse experts produced a list of 39 globally important procedures highlighting the breadth and depth of the field 1 . As regional anatomic specialists, otolaryngologists are uniquely positioned to offer medical and surgical care in a global setting to adult and pediatric patients.…”

Letter: Design and Implementation of a Global Health and Underserved Care Track

“…This group has published seminal research on the burden of head and neck cancers 4 and identified priority interventions and diseases within global OHNS. 5 Such a collaboration may help scale the global OHNS track to other ACGME programs and expand the foreign experience to other low- and middle-income countries.…”

“…This initiative is a research collaborative network of more than 180 otolaryngologists in more than 40 countries to understand the challenges to accessing safe, timely, and affordable OHNS care worldwide. This group has published seminal research on the burden of head and neck cancers 4 and identified priority interventions and diseases within global OHNS 5 . Such a collaboration may help scale the global OHNS track to other ACGME programs and expand the foreign experience to other low‐ and middle‐income countries.…”