Group Decision Analysis

Dalkey, Norman C.

doi:10.1007/978-3-642-45486-8_3

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…The Delphi technique was originally developed by the RAND Corporation as a method for obtaining consensus regarding international affairs 12 . It has been widely used in orthopaedic surgery to achieve consensus on certain topics on which no agreement had previously existed, by employing an iterative process of feedback from experts in the field [13][14][15][16][17][18][19][20] .…”

Section: Establishing Consensus Using a Classic Delphi Techniquementioning

confidence: 99%

Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees

Medvecky

Kahan

Richter

et al. 2023

Journal of Bone and Joint Surgery

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Background: Multiligament knee injury (MLKI) with associated extensor mechanism (EM) involvement is a rare injury, with limited evidence to guide optimal treatment. The purpose of this study was to identify areas of consensus among a group of international experts regarding the treatment of patients with MLKI and concomitant EM injury.Methods: Utilizing a classic Delphi technique, an international group of 46 surgeons from 6 continents with expertise in MLKI undertook 3 rounds of online surveys. Participants were presented with clinical scenarios involving EM disruption in association with MLKI, classified using the Schenck Knee-Dislocation (KD) Classification. Positive consensus was defined as ‡70% agreement with responses of either "strongly agree" or "agree," and negative consensus was defined as ‡70% agreement with "strongly disagree" or "disagree."Results: There was a 100% response rate for rounds 1 and 2 and a 96% response rate for round 3. There was strong positive consensus (87%) that an EM injury in combination with MLKI significantly alters the treatment algorithm. For an EM injury in conjunction with a KD2, KD3M, or KD3L injury, there was positive consensus to repair the EM injury only and negative consensus regarding performing concurrent ligamentous reconstruction at the time of initial surgery. Conclusions:In the setting of bicruciate MLKI, there was overall agreement on the significant impact of EM injury on the treatment algorithm. We therefore recommend that the Schenck KD Classification be updated with the addition of the modifier suffix "-EM" to highlight this impact. Treatment of the EM injury was judged to have the highest priority, and there was consensus to treat the EM injury only. However, given the lack of clinical outcome data, treatment decisions need to be made on a case-by-case basis with consideration of the numerous clinical factors that are encountered.Clinical Relevance: Little clinical evidence exists to guide the surgeon on the management of EM injury in the setting of a multiligament injured or dislocated knee. This survey highlights the impact that EM injury has on the treatment algorithm and provides some guidance for management until a further large case series or prospective studies are undertaken. *A list of the Knee Fracture-Dislocation Study Group members is included in a note at the end of the article.

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Section: Establishing Consensus Using a Classic Delphi Techniquementioning

confidence: 99%

Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees

Medvecky

Kahan

Richter

et al. 2023

Journal of Bone and Joint Surgery

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“…The golden rule, of course, is maximize expected utility. In some versions, a more general framework, the decision tree is to 8 '!" ^ T?…”

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confidence: 99%

Group Decision Analysis

Dalkey¹

1975

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Delphi, a. a procedure for aggregating judgments under uncertainty, haa suffered fro« the lack of an underlying theoretical fr«neworlc. especially on« that relate« group e.ti-tee to decision processes. Attempts to Introduce group Judgment into exl.tlng theories of decision have run Into difficult!«, exemplified by the Arrow impossibility theorem for group preferences, and an •nalogous theorem by the author demonstrating the non-existence of a general method of aggregating probability estimates. It 1. shown that consistent group preference functions can be formulated by the use of anchored scales, i.e., individual preference scales with fixed reference objects. No general resolution of the aggregation problem for prob-•bllities appears feasible, but a Justification for the use of group probability Judgments can be made, based on a family of theorems to the effect that th-. accuracy of a group Judgment is always greater than (or at worst equal to) the average accuracy of the indi.idual Judgments. Some empirical data, and some analytical reaulta. Indicate that these aggregation rules are more generally applicable, and more powerful than nas been assumed in the paat.

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Bibliography

Hwang¹,

Masud²

1979

Multiple Objective Decision Making — Methods and Applications

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Group Decision Analysis

Cited by 8 publications

References 4 publications

Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees

Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees

Group Decision Analysis

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