Delphi Consensus in Otolaryngology: A Systematic Review of Reliability and Reporting Completeness

Area of Science:

• Otolaryngology
• Medical Research Methodology
• Evidence-Based Medicine

Background:

• The Delphi method is frequently employed in otolaryngology for consensus development in areas with limited evidence.
• Consensus documents guide expert opinion and inform personalized patient care.
• Variability in methodological rigor and reporting of Delphi studies raises concerns about transparency, reproducibility, and bias.

Purpose of the Study:

• To systematically review the methodological quality and reporting consistency of Delphi-based consensus studies in otolaryngology.
• To identify limitations in transparency, reproducibility, and potential bias in these studies.
• To assess the reliability and completeness of reporting using established frameworks and checklists.

Main Methods:

• A systematic review adhering to PRISMA guidelines was performed.
• Searches were conducted in MEDLINE, Embase, and Web of Science for otolaryngology Delphi studies.
• Studies were evaluated using methodological frameworks, bias assessment, and the DELPHISTAR reporting checklist.

Main Results:

• Of 86 included studies, most lacked transparency in panel selection, anonymity, feedback, and stopping criteria.
• Only 10.5% of studies achieved "good" reliability based on methodological bias domains; most were "fair."
• Just 3.5% of studies demonstrated good reporting completeness according to DELPHISTAR, with heterogeneity across subspecialties.

Conclusions:

• Delphi studies significantly influence otolaryngology clinical practice but suffer from methodological and reporting deficiencies.
• Standardized frameworks are needed to enhance transparency, reproducibility, and clinical impact.
• Improving these studies will ensure consensus statements support evidence-informed and personalized patient care.