Department of Anaesthesia and Pain Medicine, University of Edinburgh, Edinburgh, UK.
J Psychosom Res. 2013 Aug;75(2):128-34. doi: 10.1016/j.jpsychores.2013.05.008. Epub 2013 Jun 12.
To assess agreement, consensus, and disagreement between experts in different domains in the evaluation of functional gastrointestinal disorders (FGIDs).
We conducted a modified Delphi study using 90 purposively sampled experts using an online survey tool to develop, distribute and analyse the Delphi rounds. Experts were sent 132 items generated from a literature review examining present and proposed future FGID evaluation. The survey items examined contributory factors and were divided into four sections examining risk and contributing factors, the therapeutic relationship, domains of measurement and the pros and cons of multiaxial assessment. The consensus level was set at 75%.
36 of 68 eligible participants (52%) replied to round one and 96 items gained consensus. Using expert feedback, we used thematic analysis to generate 33 additional items for round two. 31 of 36 participants (86%) replied to rounds two and three. In round two, 19 items gained consensus, and in round three, nine items gained consensus. Agreement was high concerning systematic approaches for both physiological and psychosocial components of FGIDs (91%) using laboratory and self-reporting findings (83%). Opinion was divided regarding physical risk factors such as previous surgery (53%) and genetic association (71%). Overall, 124 of the 167 items gained consensus.
We have identified expert consensus and disagreement on domains of information relevant to the evaluation of FGIDs. Experts agreed there is an immediate need for multi-axial assessment. Physiological and genetic risk factors are not fully accepted and require further study.
评估不同领域的专家在评估功能性胃肠病（FGIDs）方面的意见、共识和分歧。
我们使用在线调查工具对 90 名有针对性抽样的专家进行了一项改良 Delphi 研究，以制定、分发和分析 Delphi 轮次。专家收到了 132 项从文献综述中生成的调查项目，该综述检查了目前和未来 FGID 评估的建议。调查项目检查了促成因素，并分为四个部分，检查风险和促成因素、治疗关系、测量领域以及多轴评估的优缺点。共识水平设定为 75%。
68 名符合条件的参与者中有 36 名（52%）回复了第一轮，96 项获得了共识。利用专家反馈，我们使用主题分析生成了第二轮的 33 项额外项目。36 名参与者中有 31 名（86%）回复了第二轮和第三轮。在第二轮中，有 19 项获得了共识，在第三轮中，有 9 项获得了共识。对于 FGIDs 的生理和心理社会成分的系统方法（91%）使用实验室和自我报告结果（83%），专家意见高度一致。对于先前手术（53%）和遗传关联（71%）等身体风险因素，意见存在分歧。总体而言，167 项中有 124 项获得了共识。
我们已经确定了专家在与 FGIDs 评估相关的信息领域的共识和分歧。专家们一致认为，目前迫切需要进行多轴评估。生理和遗传风险因素尚未得到充分接受，需要进一步研究。
