Suris Joan-Carles, Akre Christina
Research Group on Adolescent Health, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Research Group on Adolescent Health, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
J Adolesc Health. 2015 Jun;56(6):612-8. doi: 10.1016/j.jadohealth.2015.02.007.
The purpose of this study was to reach an international consensus to determine what key elements should be part of a transition program and what indicators could be used to assess its success.
For this purpose, a Delphi study including an international panel of 37 experts was carried out. The study consisted of three rounds, with response rates ranging from 86.5% to 95%. At each round, experts were asked to assess key elements (defined as the most important elements for the task) and indicators (defined as quantifiable characteristics). At each round, panelists were contacted via e-mail explaining them the tasks to be done and giving them the Web link where to complete the questionnaire. At Round 3, each key element and indicator was assessed as essential, very important, important, accessory, or unnecessary. A 70% agreement was used as cutoff.
At Round 3, more than 70% of panelists agreed on six key elements being essential, with one of them (Assuring a good coordination between pediatric and adult professionals) reaching an almost complete consensus (97%). Additionally, 11 more obtained more than 70% agreement when combined with the Very important category. Among indicators, only one (Patient not lost to follow-up) was considered almost unanimously (91%) as essential by the panelists and seven others also reached consensus when the Very important category was included.
Using these results as a framework to develop guidelines at local, national, and international levels would allow better assessing and comparing transition programs.
本研究旨在达成国际共识,以确定过渡计划应包含哪些关键要素,以及可用哪些指标来评估其成功与否。
为此,开展了一项德尔菲研究,其中包括一个由37位专家组成的国际小组。该研究包括三轮,回复率在86.5%至95%之间。在每一轮中,要求专家评估关键要素(定义为任务中最重要的要素)和指标(定义为可量化的特征)。在每一轮中,通过电子邮件联系小组成员,向他们解释要完成的任务,并提供填写问卷链接。在第三轮中,每个关键要素和指标被评估为必不可少、非常重要、重要、附属或不必要。以70%的一致意见作为截止点。
在第三轮中,超过70%的小组成员一致认为六个关键要素是必不可少的,其中一个要素(确保儿科和成人专业人员之间的良好协调)达成了几乎完全的共识(97%)。此外,另外11个要素在与“非常重要”类别合并时也获得了超过70%的一致意见。在指标方面,只有一个指标(患者未失访)被小组成员几乎一致(91%)认为是必不可少的,另外七个指标在纳入“非常重要”类别时也达成了共识。
以这些结果为框架,在地方级、国家级和国际级制定指南,将有助于更好地评估和比较过渡计划。