Priority setting for improved leukemia management and research in South Africa: a modified Delphi study

In resource-limited environments, setting priorities for leukemia care becomes essential to ensure effective and efficient use of available resources. This study aimed to identify the key areas of leukemia care and services by determining their prioritization within the South African healthcare system and developing a set of improvement and research priorities.

A two-round modified Delphi method was used to identify leukemia care priorities and rank areas of leukemia management improvement and research priorities. Healthcare professional experts comprised of Clinical Hematologists and Hematopathologists. In round 1, participants independently rated the importance of 125 iterative statements on leukemia care and services derived from literature. In round 2, agreement within the expert participants was considered to finalize the list of priority statements and 17 improvement and research priorities were ranked based on level of importance.

In total, a list of 67 priority statements reached consensus, and 17 improvement and research priorities were established. A high agreement (≥ 90%) was reached for 24 statements within the six themes, these included accurate and advanced diagnostic techniques, factors in determining treatment strategies (e.g., risk stratification), supportive care measures (e.g., pain management and infection prevention), ensuring adequate healthcare workforce, and creating multidisciplinary teams. The highest ranked improvement and research priorities were timely delivery of diagnosis and treatments and biomarker development for early detection, prognosis, and treatment response.

This study identified key priorities for leukemia care within the South African healthcare system, providing an evidence-based framework through expert consensus.