Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice.

Area of Science:

• Oncology
• Clinical Trials
• Medical Statistics

Background:

• Intraperitoneal/intravenous (IP/IV) and intravenous (IV) chemotherapy are used for ovarian cancer treatment.
• Estimating patient outcomes for these therapies can vary among experts.

Purpose of the Study:

• To achieve expert consensus on the probabilities of outcomes for ovarian cancer patients receiving IP/IV versus IV chemotherapy.
• To evaluate the effectiveness of the Delphi method in establishing consensus on clinical estimates.

Main Methods:

• A Delphi survey method was employed with ten ovarian cancer experts.
• Experts estimated probabilities for chemotherapy completion, five-year survival, median survival, and emergency room visits for two patient profiles (low and moderate comorbidity).
• The survey involved three rounds, allowing experts to revise estimates based on peer feedback.

Main Results:

• Consensus was achieved on IP/IV chemotherapy outcomes after three rounds.
• Key consensus points included completion of six cycles (62% for low comorbidity, 43% for moderate), five-year survival (66% for low, 47% for moderate), and median survival (83 months for low, 58 months for moderate).
• Consensus on emergency room visit probabilities was reached in the third round (24% for low, 35% for moderate).

Conclusions:

• Expert estimates for survival and adverse events with IP/IV chemotherapy initially varied.
• The Delphi process facilitated consensus-building among experts.
• This consensus can serve as a practical method for informing patients about expected treatment outcomes.