Segelov Eva, Chan David, Lawrence Ben, Pavlakis Nick, Kennecke Hagen F, Jackson Christopher, Law Calvin, Singh Simron
, University of New South Wales; and , Royal North Shore Hospital, Sydney, Australia; , University of Auckland, Auckland; , University of Otago, Dunedin, New Zealand; , University of British Columbia, Vancouver; and and , Odette Cancer Centre, Toronto, Canada.
J Glob Oncol. 2016 Oct 12;3(4):380-388. doi: 10.1200/JGO.2016.006916. eCollection 2017 Aug.
Neuroendocrine tumors (NETs) are a diverse group of malignancies that pose challenges common to all rare tumors. The Commonwealth Neuroendocrine Tumor Collaboration (CommNETS) was established in 2015 to enhance outcomes for patients with NETs in Canada, Australia, and New Zealand. A modified Delphi process was undertaken involving patients, clinicians, and researchers to identify gaps in NETs research to produce a comprehensive and defensible research action plan.
A three-round modified Delphi process was undertaken with larger representation than usual for medical consensus processes. Patient/advocate and health care provider/researcher expert panels undertook Round 1, which canvassed 17 research priorities and 42 potential topics; in Round 2, these priorities were ranked. Round 3 comprised a face-to-face meeting to generate final consensus rankings and formulate the research action plan.
The Delphi groups consisted of 203 participants in Round 1 (64% health care providers/researchers, 36% patient/advocates; 52% Canadian, 32% Australian, and 17% New Zealander), of whom 132 participated in Round 2. The top eight priorities were biomarker development; peptide receptor radionuclide therapy optimization; trials of new agents in advanced NETs; functional imaging; sequencing therapies for metastatic NETs, including development of validated surrogate end points for studies; pathologic classification; early diagnosis; interventional therapeutics; and curative surgery. Two major areas were ranked significantly higher by patients/advocates: early diagnosis and curative surgery. Six CommNETS working parties were established.
This modified Delphi process resulted in a well-founded set of research priorities for the newly formed CommNETS collaboration by involving a large, diverse group of stakeholders. This approach to setting a research agenda for a new collaborative group should be adopted to ensure that research plans reflect unmet needs and priorities in the field.
神经内分泌肿瘤（NETs）是一类多样的恶性肿瘤，带来了所有罕见肿瘤共有的挑战。英联邦神经内分泌肿瘤协作组（CommNETS）于2015年成立，旨在改善加拿大、澳大利亚和新西兰NETs患者的治疗结局。采用了改良的德尔菲法，涉及患者、临床医生和研究人员，以确定NETs研究中的差距，从而制定一份全面且合理的研究行动计划。
开展了三轮改良的德尔菲法，其代表性比通常的医学共识流程更大。患者/倡导者和医疗保健提供者/研究人员专家小组进行了第一轮，探讨了17项研究重点和42个潜在主题；在第二轮中，对这些重点进行了排名。第三轮包括一次面对面会议，以产生最终的共识排名并制定研究行动计划。
德尔菲小组在第一轮中有203名参与者（64%为医疗保健提供者/研究人员，36%为患者/倡导者；52%为加拿大人，32%为澳大利亚人，17%为新西兰人），其中132人参与了第二轮。前八项重点是生物标志物开发；肽受体放射性核素治疗优化；晚期NETs新药试验；功能成像；转移性NETs的序贯治疗，包括为研究开发经过验证的替代终点；病理分类；早期诊断；介入治疗；以及根治性手术。患者/倡导者显著更高地排名了两个主要领域：早期诊断和根治性手术。成立了六个CommNETS工作组。
这种改良的德尔菲法通过让大量不同的利益相关者参与，为新成立的CommNETS合作产生了一套有充分依据的研究重点。应采用这种为新合作组设定研究议程的方法，以确保研究计划反映该领域未满足的需求和重点。
