Multi-Round versus Real-Time Delphi survey approach for achieving consensus in the COHESION core outcome set: a...

Area of Science:

• Clinical Trials Methodology
• Health Outcomes Research

Background:

• Delphi surveys are crucial for developing core outcome sets (COS).
• This study compares Multi-Round Delphi (MRD) and Real-Time Delphi (RTD) methods for outcome prioritization in neonatal encephalopathy treatments.
• Investigates 'feedback', 'iteration', and 'initial condition' effects in both survey methods.

Purpose of the Study:

• To compare the efficacy of MRD versus RTD in prioritizing outcomes for a COS.
• To explore and identify differences in 'feedback', 'iteration', and 'initial condition' effects between MRD and RTD.

Main Methods:

• Recruited 269 participants (parents, healthcare providers, researchers); 222 randomized to MRD or RTD.
• Analyzed prioritized outcomes and survey effects to identify differences between the two Delphi methods.
• Assessed participant completion rates, score changes, and convergence.

Main Results:

• RTD completion rate was 83% (92 participants); MRD completion rate was 54% (60 participants).
• 28% of outcomes were prioritized differently between RTD and MRD.
• RTD showed a smaller 'feedback effect' and less score amendment after feedback compared to MRD. Variance reduced in MRD rounds; RTD showed 'initial condition' effects.

Conclusions:

• RTD offers considerable benefits over MRD, including less participant drop-out and faster completion.
• The 'feedback effect' difference was minimal; three rounds in MRD did not significantly improve score change.
• RTD demonstrates greater score convergence and efficiency for core outcome set development.