Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Wilmslow Road, Manchester M20 4BX, UK; Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, UK.
Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester M20 4BX, UK.
J Clin Epidemiol. 2020 Dec;128:118-129. doi: 10.1016/j.jclinepi.2020.09.028. Epub 2020 Oct 1.
The objectives of this nested study were to (1) assess whether changes in scores between rounds altered the final degree of consensus achieved in three Delphi surveys conducted as part of COS development projects (anal, gastric, and prostate cancer), and (2) explore participants' reasons for changing scores between rounds.
All Delphi surveys were conducted online using DelphiManager software and included healthcare professionals and participating patients. Participants were invited to give a free-text reason whenever they changed their score across an important threshold on a 1-9 Likert scale (1-3 not important, 4-5 important, 7-9 critically important). Reasons for score change were coded by four researchers independently using an inductive-iterative approach.
In all three Delphi surveys, the number of outcomes reaching criteria for consensus was greater in R2 than R1. Twelve themes and 23 subthemes emerged from 2298 discrete reasons given for score change. The most common reasons for the change were "time to reflect" (482 responses, 23%) and vicarious thinking (424, 21%), with 68% (291) of vicarious thinking attributed to seeing other participant's scores.
Our findings support conducting a Delphi survey over the use of a single questionnaire where building consensus is the objective. Time to reflect and vicarious thinking, facilitated by seeing other participant's scores, were important drivers of score change. How results are presented to participants between rounds and the duration of and time between rounds in a Delphi survey may, therefore, influence the results and should be clearly reported.
本嵌套研究的目的是：（1）评估在作为 COS 开发项目一部分而进行的三轮 Delphi 调查中，两轮间评分的变化是否改变了最终达成的共识程度（分析、胃和前列腺癌）；（2）探讨参与者在两轮间改变评分的原因。
所有 Delphi 调查均在线使用 DelphiManager 软件进行，参与者包括医疗保健专业人员和参与患者。每当参与者在 1-9 级 Likert 量表（1-3 不重要，4-5 重要，7-9 非常重要）上的重要阈值间改变评分时，他们都会被邀请提供自由文本原因。评分变化的原因由四位研究人员使用归纳迭代方法独立编码。
在所有三轮 Delphi 调查中，第二轮比第一轮达到共识标准的结果数量更多。2298 个离散评分变化原因中出现了 12 个主题和 23 个子主题。评分变化最常见的原因是“反思时间”（482 次回应，23%）和替代思维（424 次，21%），其中 68%（291 次）的替代思维归因于看到其他参与者的评分。
我们的发现支持在构建共识是目标的情况下进行 Delphi 调查而不是使用单一问卷。反思时间和替代思维，通过看到其他参与者的评分来促进，是评分变化的重要驱动因素。因此，如何在两轮间向参与者呈现结果以及 Delphi 调查的持续时间和两轮间的时间间隔可能会影响结果，应该清楚地报告。
