Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice

David E. Cohn, Laura J. Havrilesky, Kathryn Osann, Joseph Lipscomb, Susie Hsieh, Joan L. Walker, Alexi A. Wright, Ronald D. Alvarez, Beth Y. Karlan, Robert E. Bristow, Paul A. DiSilvestro, Mark T. Wakabayashi, Robert Morgan, Dana B. Mukamel, Lari Wenzel

Research output: Contribution to journalArticle

Abstract

Objectives To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. Methods A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. Results The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Conclusions Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.

Original languageEnglish (US)
Pages (from-to)712-716
Number of pages5
JournalGynecologic Oncology
Volume138
Issue number3
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Drug Therapy
Survival
Ovarian Neoplasms
Comorbidity
Therapeutics
Surveys and Questionnaires

Keywords

  • Delphi technique
  • Intraperitoneal (IP)
  • Opinion
  • Ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology
  • Medicine(all)

Cite this

Cohn, D. E., Havrilesky, L. J., Osann, K., Lipscomb, J., Hsieh, S., Walker, J. L., ... Wenzel, L. (2015). Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice. Gynecologic Oncology, 138(3), 712-716. https://doi.org/10.1016/j.ygyno.2015.07.014

Consensus in controversy : The modified Delphi method applied to Gynecologic Oncology practice. / Cohn, David E.; Havrilesky, Laura J.; Osann, Kathryn; Lipscomb, Joseph; Hsieh, Susie; Walker, Joan L.; Wright, Alexi A.; Alvarez, Ronald D.; Karlan, Beth Y.; Bristow, Robert E.; DiSilvestro, Paul A.; Wakabayashi, Mark T.; Morgan, Robert; Mukamel, Dana B.; Wenzel, Lari.

In: Gynecologic Oncology, Vol. 138, No. 3, 01.09.2015, p. 712-716.

Research output: Contribution to journalArticle

Cohn, DE, Havrilesky, LJ, Osann, K, Lipscomb, J, Hsieh, S, Walker, JL, Wright, AA, Alvarez, RD, Karlan, BY, Bristow, RE, DiSilvestro, PA, Wakabayashi, MT, Morgan, R, Mukamel, DB & Wenzel, L 2015, 'Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice', Gynecologic Oncology, vol. 138, no. 3, pp. 712-716. https://doi.org/10.1016/j.ygyno.2015.07.014
Cohn, David E. ; Havrilesky, Laura J. ; Osann, Kathryn ; Lipscomb, Joseph ; Hsieh, Susie ; Walker, Joan L. ; Wright, Alexi A. ; Alvarez, Ronald D. ; Karlan, Beth Y. ; Bristow, Robert E. ; DiSilvestro, Paul A. ; Wakabayashi, Mark T. ; Morgan, Robert ; Mukamel, Dana B. ; Wenzel, Lari. / Consensus in controversy : The modified Delphi method applied to Gynecologic Oncology practice. In: Gynecologic Oncology. 2015 ; Vol. 138, No. 3. pp. 712-716.
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title = "Consensus in controversy: The modified Delphi method applied to Gynecologic Oncology practice",
abstract = "Objectives To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. Methods A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. Results The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62{\%}, type 2 patient, 43{\%}); 2) percentage of patients surviving 5 years (type 1 patient, 66{\%}, type 2 patient, 47{\%}); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24{\%}, type 2 patient, 35{\%}). Conclusions Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.",
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AU - Osann, Kathryn

AU - Lipscomb, Joseph

AU - Hsieh, Susie

AU - Walker, Joan L.

AU - Wright, Alexi A.

AU - Alvarez, Ronald D.

AU - Karlan, Beth Y.

AU - Bristow, Robert E.

AU - DiSilvestro, Paul A.

AU - Wakabayashi, Mark T.

AU - Morgan, Robert

AU - Mukamel, Dana B.

AU - Wenzel, Lari

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N2 - Objectives To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. Methods A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. Results The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Conclusions Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.

AB - Objectives To determine the degree of consensus regarding the probabilities of outcomes associated with IP/IV and IV chemotherapy. Methods A survey was administered to an expert panel using the Delphi method. Ten ovarian cancer experts were asked to estimate outcomes for patients receiving IP/IV or IV chemotherapy. The clinical estimates were: 1) probability of completing six cycles of chemotherapy, 2) probability of surviving five years, 3) median survival, and 4) probability of ER/hospital visits during treatment. Estimates for two patients, one with a low comorbidity index (patient 1) and the other with a moderate index (patient 2), were included. The survey was administered in three rounds, and panelists could revise their subsequent responses based on review of the anonymous opinions of their peers. Results The ranges were smaller for IV compared with IP/IV therapy. Ranges decreased with each round. Consensus converged around outcomes related to IP/IV chemotherapy for: 1) completion of 6 cycles of therapy (type 1 patient, 62%, type 2 patient, 43%); 2) percentage of patients surviving 5 years (type 1 patient, 66%, type 2 patient, 47%); and 3) median survival (type 1 patient, 83 months, type 2 patient, 58 months). The group required three rounds to achieve consensus on the probabilities of ER/hospital visits (type 1 patient, 24%, type 2 patient, 35%). Conclusions Initial estimates of survival and adverse events associated with IP/IV chemotherapy differ among experts. The Delphi process works to build consensus and may be a pragmatic tool to inform patients of their expected outcomes.

KW - Delphi technique

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KW - Opinion

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