Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
BMC Med Res Methodol. 2021 Apr 17;21(1):73. doi: 10.1186/s12874-021-01267-0.
Recommendations within guidelines are developed by synthesising the best available evidence; when limited evidence is identified recommendations are generally based on informal consensus. However, there are potential biases in group decision making, and formal consensus methods may help reduce these.
We conducted a case study using formal consensus, to develop one set of recommendations within the Neonatal Parenteral Nutrition guideline being produced for the National Institute for Health and Care Excellence. Statements were generated through identification of published guidelines on several topics relating to neonatal parenteral nutrition. Ten high quality guidelines were included, and 28 statements were generated; these statements were rated by the committee via two rounds of voting. The statements which resulted in agreement were then used to develop the recommendations.
The approach was systematic and provided transparency. Additionally, a number of lessons were learnt; including the value of selecting the appropriate topic, giving adequate time to the process, and ensuring methodologies are understood by the committee for their value and relevance.
Formal consensus is a valuable option for use within guideline development when specific criteria are met. The approach provides transparent methodology, ensuring clarity on how recommendations are developed.
指南中的推荐意见是通过综合最佳现有证据制定的；当确定的证据有限时，建议通常基于非正式共识。然而，群体决策中存在潜在的偏差，正式的共识方法可能有助于减少这些偏差。
我们使用正式共识进行了一项案例研究，为国家卫生与保健卓越研究所（National Institute for Health and Care Excellence）制定新生儿肠外营养指南中的一套推荐意见。通过确定与新生儿肠外营养相关的几个主题的已发表指南来生成陈述。纳入了 10 项高质量指南，并生成了 28 条陈述；委员会通过两轮投票对这些陈述进行了评分。达成一致的陈述随后被用于制定建议。
该方法是系统的，具有透明度。此外，还吸取了一些经验教训；包括选择适当主题的价值、为该过程提供充足时间，以及确保委员会理解方法的价值和相关性。
当满足特定标准时，正式共识是指南制定中一种有价值的选择。该方法提供了透明的方法，确保了推荐意见制定过程的清晰性。
