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Consensus development methods: a review of best practice in creating clinical guidelines
1Health Services Research Unit, London School of Hygiene and Tropical Medicine, UK.
Journal of Health Services Research & Policy
|January 6, 2000
Summary
Clinical guideline development using consensus methods is influenced by task design, participant selection, information presentation, interaction structure, and judgment synthesis. Adhering to best practices enhances guideline validity and impact.
Area of Science:
- Health Services Research
- Clinical Decision-Making
- Methodology
Background:
- Clinical guidelines aid clinician decision-making amidst practice debates.
- Consensus development methods (Delphi, nominal group technique, consensus development conference) synthesize subjective judgments under uncertainty.
Purpose of the Study:
- Identify factors influencing clinical guidelines from consensus methods.
- Recommend best practices for using these consensus methods.
Main Methods:
- Searched five databases (Medline, PsychLIT, Social Science Citation Index, ABI Inform, Sociofile) from 1966-1996.
- Reviewed 177 empirical and review articles identified through searches and reference lists.
Main Results:
- Guideline output is affected by task setup, participant selection (homogeneity, background, number), scientific information presentation (quality assessment), interaction structure (equitable participation, environment), and judgment synthesis (agreement definition, outlier rules, aggregation methods).
Conclusions:
- Research on consensus methods is ongoing, with some aspects requiring further investigation.
- Current advice relies on user commonsense and experience.
- Best practice adherence is crucial for guideline validity, reliability, and impact.