University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
Derby Shoulder Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.
BMJ Open. 2024 Feb 24;14(2):e081703. doi: 10.1136/bmjopen-2023-081703.
Shoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants creates significant pressure on orthopaedic services. Surveillance offers the opportunity to study implant longevity, detect failing implants and potentially perform revision at lower morbidity and cost. There is a paucity of evidence to support recommendations on long-term follow-up in shoulder arthroplasty. Prospective studies comparing long-term follow-up and structure are impractical from time, resource and cost perspectives. A real-time Delphi technique represents a mechanism by which experts involved in long-term follow-up of primary shoulder arthroplasty can formulate recommendations via a transparent, reproducible and efficient process. We outline the protocol for a real-time Delphi study seeking consensus on long-term follow-up and surveillance of primary shoulder arthroplasty .
A real-time Delphi technique will be used. A planning committee will design the Delphi statements. A steering committee will supervise and monitor the real-time Delphi process. Participants will be asked to rate their agreement with statements using a 5-point Likert scale. The Delphi statements will be derived from review of published literature, and the strength of evidence available for each statement will be provided. We will offer participation to all surgeons and extended-scope practitioners who are current members of the British Elbow & Shoulder Society (BESS) and have clinical practice involving shoulder arthroplasty follow-up. The questionnaire will be active for 4 weeks and requires a minimum of 20 participants. Consensus agreement is defined as 70% of participants selecting at least a 4-point on a 5-point Likert scale.
We anticipate the outlined study will achieve consensus on long-term follow-up and surveillance of primary shoulder arthroplasty. We intend to use the expert consensus recommendations achieved, in addition to the limited applicable published evidence available, to produce BESS-affiliated guidelines on long-term follow-up and surveillance of primary shoulder arthroplasty.EthicsEthical approval is not required for the real-time Delphi study.We expect the results of this initiative will be published in a peer-reviewed, high-impact journal.
肩关节置换术的发病率预计将继续呈指数增长，因此监测肩关节置换植入物患者的负担给骨科服务带来了巨大压力。监测有机会研究植入物的使用寿命，发现有故障的植入物，并有可能以更低的发病率和成本进行翻修。目前几乎没有证据支持肩关节置换术的长期随访建议。从时间、资源和成本的角度来看，比较长期随访和结构的前瞻性研究是不切实际的。实时 Delphi 技术代表了一种机制，通过该机制，参与原发性肩关节置换术长期随访的专家可以通过透明、可重复和高效的过程制定建议。我们概述了一项实时 Delphi 研究的方案，旨在就原发性肩关节置换术的长期随访和监测达成共识。
将使用实时 Delphi 技术。一个规划委员会将设计 Delphi 陈述。一个指导委员会将监督和监测实时 Delphi 过程。参与者将被要求使用 5 分制 Likert 量表对陈述表示同意程度进行评分。 Delphi 陈述将源自对已发表文献的回顾，并且将提供针对每个陈述的可用证据的强度。我们将向所有现任英国肘部和肩部协会（BESS）成员中的外科医生和扩大范围从业者开放参与，并要求其具有肩部置换术随访的临床实践经验。问卷将开放 4 周，需要至少 20 名参与者。共识协议定义为 70%的参与者在 5 分制 Likert 量表上至少选择 4 分。
我们预计该研究将在原发性肩关节置换术的长期随访和监测方面达成共识。我们打算除了使用有限的适用已发表证据外，还使用达成的专家共识建议，制定 BESS 附属的原发性肩关节置换术长期随访和监测指南。
实时 Delphi 研究不需要伦理批准。我们预计这一举措的结果将发表在同行评议的高影响力期刊上。
