Construction of Fracture Liaison Service Scheme Under Medical Alliance Framework in China: A Modified Delphi Method...

To devise an implementation blueprint for the fracture liaison service (FLS) model within the context of a medical consortium. The FLS is an integrated system designed to identify, register, assess, treat, and monitor patients with osteoporotic fractures. The FLS constitutes a structured intervention strategy to administer standardized care to osteoporotic fracture patients. Its efficacy has been validated through extensive implementation across various countries. However, large-scale intervention research on this model within China is lacking. This investigation endeavors to construct a comprehensive FLS framework and to establish its core performance indicators within the Chinese medical alliance structure.

The research methodology encompassed focus group interviews and a two-phase Delphi process. An initial inventory of FLS implementation elements was compiled through a systematic literature review and focus group discussions. This was followed by a two-step Delphi survey, wherein experts refined the key indicators. The study calculated metrics such as response rate, composite reliability (CR), coefficient of variation, and the Kendall coefficient of concordance to evaluate the indicators.

The study involved 17 experts who completed 2 rounds of the Delphi consultation, culminating in a consensus on 2 primary and 8 secondary indicators, encompassing 34 specific indicators. The response rate for the first and second round was 100%, with CR values of 0.871 and 0.882, and Kendall's coefficients of 0.161 and 0.179, respectively (P < 0.05).

This work delineated a robust set of indicators specifically tailored for the FLS schema under the medical alliance framework in China. The rigorous application of the Delphi technique led to a consensus on 34 pivotal indicators, elucidating their relative significance.