Akins Ralitsa B, Tolson Homer, Cole Bryan R
Quality and Patient Safety Initiatives, Rural and Community Health Institute, The Texas A&M University System Health Science Center, College Station, Texas, USA.
BMC Med Res Methodol. 2005 Dec 1;5:37. doi: 10.1186/1471-2288-5-37.
Delphi surveys with panels of experts in a particular area of interest have been widely utilized in the fields of clinical medicine, nursing practice, medical education and healthcare services. Despite this wide applicability of the Delphi methodology, there is no clear identification of what constitutes a sufficient number of Delphi survey participants to ensure stability of results.
The study analyzed the response characteristics from the first round of a Delphi survey conducted with 23 experts in healthcare quality and patient safety. The panel members had similar training and subject matter understanding of the Malcolm Baldrige Criteria for Performance Excellence in Healthcare. The raw data from the first round sampling, which usually contains the largest diversity of responses, were augmented via bootstrap sampling to obtain computer-generated results for two larger samples obtained by sampling with replacement. Response characteristics (mean, trimmed mean, standard deviation and 95% confidence intervals) for 54 survey items were compared for the responses of the 23 actual study participants and two computer-generated samples of 1000 and 2000 resampling iterations.
The results from this study indicate that the response characteristics of a small expert panel in a well-defined knowledge area are stable in light of augmented sampling.
Panels of similarly trained experts (who possess a general understanding in the field of interest) provide effective and reliable utilization of a small sample from a limited number of experts in a field of study to develop reliable criteria that inform judgment and support effective decision-making.
针对特定感兴趣领域的专家小组进行的德尔菲调查已在临床医学、护理实践、医学教育和医疗服务等领域得到广泛应用。尽管德尔菲方法具有广泛的适用性,但对于确保结果稳定性而言,构成足够数量的德尔菲调查参与者的因素尚无明确界定。
本研究分析了对23位医疗质量和患者安全领域专家进行的第一轮德尔菲调查的回复特征。小组成员对《马尔科姆·鲍德里奇医疗卓越绩效标准》有相似的培训和主题理解。通过自抽样对第一轮抽样的原始数据(通常包含最多样化的回复)进行扩充,以获得通过有放回抽样得到的两个更大样本的计算机生成结果。比较了23位实际研究参与者以及两个分别有1000次和2000次重抽样迭代的计算机生成样本对54个调查项目的回复特征(均值、截尾均值、标准差和95%置信区间)。
本研究结果表明,在经过扩充抽样后,定义明确的知识领域中一个小型专家小组的回复特征是稳定的。
经过相似培训的专家小组(对感兴趣领域有总体了解)能够有效地、可靠地利用来自某一研究领域有限数量专家的小样本,以制定可靠的标准,为判断提供依据并支持有效的决策。