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Methodologies for developing and applying consensus-based recommendations in epilepsy care: A narrative review.

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|December 15, 2025
PubMed
Summary
This summary is machine-generated.

Consensus-based recommendations (CBRs) are vital for epilepsy care when evidence is scarce. The Delphi technique is most common, but the best method for developing CBRs depends on study goals and resources.

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Area of Science:

  • Neurology
  • Health Services Research
  • Medical Informatics

Background:

  • Consensus-based recommendations (CBRs) guide healthcare decisions amid limited or conflicting evidence.
  • Established methodologies like Delphi, Nominal Group Technique (NGT), and RAND/UCLA Appropriateness Method (RAM) facilitate CBR development.
  • Epilepsy management often requires CBRs due to the complexity and evolving nature of the condition.

Purpose of the Study:

  • To review the advantages and disadvantages of Delphi, NGT, and RAM.
  • To examine the application and frequency of these consensus methods in epilepsy care.
  • To inform the selection of appropriate consensus methodologies for epilepsy management.

Main Methods:

  • A narrative review of PubMed (2017-2022) identified articles describing Delphi, NGT, and RAM.
  • A comprehensive review of epilepsy studies using consensus methods from 1966 to 2023 was conducted.
  • Included studies were analyzed for method application, advantages, and disadvantages.

Main Results:

  • Sixteen articles described consensus methods, with Delphi being the most frequently used (58 of 64 epilepsy studies).
  • Delphi was applied for general epilepsy management, rare conditions, and epilepsy in pregnancy.
  • NGT and RAM were used for specific applications like cannabidiol use, ethical decision-making, imaging recommendations, and quality indicators.

Conclusions:

  • Consensus methodologies are crucial for developing robust CBRs in epilepsy management, especially when clinical guidelines are lacking.
  • The Delphi technique offers adaptability for limited evidence or remote participation.
  • The choice of consensus method (Delphi, NGT, RAM) should align with specific study objectives and available resources for effective epilepsy care.