Noblat L, Oliveira M G G, Santos-Jesus R, Noblat A C B, Badaró R
Federal University of Bahia, Salvador, BA, Brazil.
Braz J Infect Dis. 2006 Jun;10(3):173-8. doi: 10.1590/s1413-86702006000300004.
The Delphi technique has been used since the 1950s to collect the opinions of experts; to gauge their indications, and in some instances, to develop a consensus. This systematic collection and aggregation of informed judgments from a group of experts on specific questions or issues is a highly efficient and cost-effective means to establish guidelines and policies, when compared to other strategies, such as committee meetings or personal interviews.
Examine the content validation process of the proposed criteria of the American Society of Health System Pharmacists (ASHP) for amikacin use in hospital settings.
The Delphi technique was applied using the proposed ASHP criteria questionnaire containing 102 specific questions related to the nosocomial use of amikacin by individual patients. The questionnaire contained six groups of questions: 1) Identification and basic demographic data, 2) Relevant data for the use of amikacin, 3) Justification of its usage, 4) Critical parameters of amikacin use, 5) Complications, 6) Measurement of results. Eight hospital specialist medical doctors were selected, including five in the area of infectious diseases, one surgeon, one nephrologist and one in critical care medicine. The questionnaire was e-mailed to the doctors and they were asked for their opinion about the appropriateness of the questions. They were to say whether the general concept seemed totally or partially adequate to the proposed process, what grade (0 to 10) they would give to each section, and if there were any perceived deficiencies, they could add, omit or modify individual questions. A second questionnaire containing the questions for which there had been no consensus based on the answers to the previous one was re-sent to the participants for consolidation.
Feedback revealed an agreement of 75% concerning the utility and appropriateness of sections 1 and 2. The section about the justification of amikacin usage was agreed on by 50%. There was a total agreement of 62% for the critical parameters of amikacin use, and a partial agreement of 37%. The complication of usage of the questionnaire was agreed upon by 50% of the participants, and positive measurement of the results was totally agreed on by 62%, and partially by 37%. The overall score for the questionnaire was 8.77 +/- 0.25.
The usage criteria for amikacin recommended by ASHP were validated by the Delphi technique for utilization in Brazilian hospital settings. The Delphi technique applied to validate a questionnaire instrument for monitoring the correct use of a specific strategic antibiotic indicated for the treatment and prophylaxis of serious antibiotic-resistant Gram-negative bacteria, proved to be a reliable and simple tool for designing guidelines and a consensus document for hospital use of antibiotics.
自20世纪50年代以来，德尔菲技术一直被用于收集专家意见；评估其适应症，在某些情况下，还用于达成共识。与其他策略（如委员会会议或个人访谈）相比，这种从一组专家那里就特定问题或事项进行系统收集和汇总明智判断的方法，是制定指南和政策的一种高效且具成本效益的手段。
审查美国卫生系统药师协会（ASHP）提出的医院环境中阿米卡星使用标准的内容验证过程。
应用德尔菲技术，使用包含102个与个体患者医院内阿米卡星使用相关的具体问题的ASHP标准问卷。问卷包含六组问题：1）识别与基本人口统计学数据，2）阿米卡星使用的相关数据，3）其使用的理由，4）阿米卡星使用的关键参数，5）并发症，6）结果测量。挑选了八名医院专科医生，包括五名传染病领域的医生、一名外科医生、一名肾病学家和一名重症医学医生。问卷通过电子邮件发送给医生，询问他们对问题适宜性的看法。他们要说明总体概念对提议的过程看起来是完全还是部分合适，给每个部分打多少分（0至10分），如果察觉到有任何不足，他们可以添加、省略或修改个别问题。将一份包含基于前一份问卷答案未达成共识的问题的第二份问卷重新发送给参与者以进行汇总。
反馈显示，关于第1和第2部分的实用性和适宜性，达成一致的比例为75%。关于阿米卡星使用理由的部分，达成一致的比例为50%。关于阿米卡星使用关键参数，总体达成一致的比例为62%，部分达成一致的比例为37%。问卷使用并发症方面，50%的参与者达成一致，结果的积极测量方面，62%的参与者完全达成一致，37%的参与者部分达成一致。问卷的总体评分为8.77±0.25。
ASHP推荐的阿米卡星使用标准通过德尔菲技术进行了验证，可用于巴西医院环境。应用德尔菲技术来验证一份用于监测治疗和预防严重耐抗生素革兰氏阴性菌的特定战略抗生素正确使用情况的问卷工具，被证明是设计医院抗生素使用指南和共识文件的一种可靠且简单的工具。
