Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, 1280 Main Street W, Room 3N52G, Hamilton, Ontario L8P 0A1, Canada.
Department of Family Medicine (DFM), DBHSC, McMaster University, 5th Floor 100 Main St West, Hamilton, Ontario L8P 1H6, Canada.
J Clin Epidemiol. 2020 Nov;127:105-116. doi: 10.1016/j.jclinepi.2020.04.028. Epub 2020 May 15.
There has been a lack of consensus on which criteria are important when selecting health-related outcome measures (HROM), especially in primary health care A Delphi consensus was undertaken to identify core criteria for selecting among different HROM and contextual factors affecting decision-making.
A Delphi survey using standard methodology (consensus set as 75% agreement) was sent to primary care practitioners, administrators, policymakers, researchers and experts in HROM development. Criteria (n = 35) were selected from a targeted literature search; questions probed contextual factors that may influence selection of core criteria including the following: 1) weighting, 2) clinical contexts, and 3) core areas.
Participants (n = 45) achieved consensus on 17 items in round 1 (plus four new criteria), with one more item in round 2. Unequal weighting of criteria was favored, and the type of clinical scenario did not influence selection of HROM.
Eighteen core criteria from 39 were identified for inclusion in a core set, reflected predominately aspects of feasibility and acceptability. This is the first study providing evidence that contextual factors affect selection of HROM in a core criteria set. Care in primary health care is complex, and therefore, the items not reaching consensus may reflect this heterogeneity.
在选择健康相关结局测量（HROM）时，哪些标准重要，这方面尚未达成共识，尤其是在基层医疗保健中。本研究采用德尔菲共识法，旨在确定选择不同 HROM 的核心标准和影响决策的背景因素。
采用标准方法（共识设定为 75%的同意率）向基层医疗保健从业者、管理人员、政策制定者、研究人员和 HROM 开发专家发送了一份德尔菲调查。从有针对性的文献检索中选择了标准（n=35）；问题探讨了可能影响核心标准选择的背景因素，包括：1）权重、2）临床背景和 3）核心领域。
在第一轮（加了四项新的标准）中，有 45 名参与者对 17 项达成共识，在第二轮中有一项达成共识。赞成标准的权重不等，临床情景的类型并不影响 HROM 的选择。
从 39 项标准中确定了 18 项核心标准，纳入核心标准集，主要反映了可行性和可接受性方面。这是第一项研究表明，背景因素会影响核心标准集中 HROM 的选择。基层医疗保健中的护理是复杂的，因此，未达成共识的项目可能反映了这种异质性。
