A systematic review of factors affecting the judgments produced by formal consensus development methods in health care.
A systematic review of factors affecting the judgments produced by formal consensus development methods in health care.
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DOI：
10.1258/135581906777641659
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发表时间：
2006-07-01
影响因子：
2.4
通讯作者：
Raine, Rosalind
中科院分区：
文献类型：
--
作者：
Hutchings, Andrew;Raine, Rosalind
目的：正式的共识发展方法是获取和综合专家，意见领袖和其他利益相关者的意见的方法，并且越来越多地用于制定临床实践指南。我们的目标是研究的影响，个人参与者的特点，团体和共识的过程中产生的正式共识的发展方法在healthcare.METHODS：研究的判断确定从早期的方法学审查和检索的五个书目数据库期间1996年1月至2004年12月。如果研究涉及正式的共识发展方法，并且报告了组间或参与者间的判断差异，则研究合格。对于研究比较两个或两个以上的群体的总体百分比协议，kappa系数和优势比的差异，在judgments.RESULTS：有22项研究比较的影响，组内的个人参与者的特点和30项研究比较两个或两个以上的群体产生的结果。执行程序的从业者往往强调程序的适当性，而非执行的从业者，并且来自受性能标准约束的群体的个人比来自其他群体的个人对这些标准更挑剔。有没有明确的模式产生的参与者和团体从不同的countries.CONCLUSIONS：除了参与者专业的判断的差异，很少有一般性的证据，参与者和团体的特点如何影响正式的共识发展方法中产生的判断。多专业小组比单一专业小组更可取，因为它们有可能考虑到更广泛的意见。
OBJECTIVES: Formal consensus development methods are ways of obtaining and synthesising views of experts, opinion leaders and other stakeholders, and are increasingly being used to develop clinical practice guidelines. Our objective was to examine the impact that the characteristics of individual participants, groups and the consensus process have on the judgments produced by formal consensus development methods in health care.METHODS: Studies were identified from an earlier methodological review and a search of five bibliographic databases for the period January 1996 to December 2004. Studies were eligible if they involved formal consensus development methods and reported differences in judgments between groups or participants. For studies comparing two or more groups overall percentage agreement, the kappa coefficient and the odds ratio for differences in judgments were calculated.RESULTS: There were 22 studies comparing the impact of the characteristics of individual participants within groups and 30 studies comparing the results produced by two or more groups. Practitioners who perform a procedure tend to emphasise the appropriateness of the procedure compared with non-performing practitioners, and individuals from groups that were subject to performance criteria are more critical of those criteria than individuals from other groups. There was no clear pattern for the differences in judgments produced by participants and groups from different countries.CONCLUSIONS: Except for participant specialty there is little general evidence for how the characteristics of participants and groups influence the judgments produced in formal consensus development methods. Multi-specialty groups are preferable to single-specialty groups because of their potential for taking account of a wider range of opinions.