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Phd Studentship: Understanding the impact of feedback in Delphi consensus methodology: a case study

Employer
Global Academy Jobs
Location
United Kingdom
Closing date
Apr 27, 2017

Job Details

Background to the project: Core Outcome Sets are an agreed set of outcomes recommended to use in all randomized controlled trials of a particular treatment, to improve data synthesis across trials, reduce research waste and limit outcome reporting bias. They require stakeholders to identify and agree the core set, prioritizing outcomes from a long list of potential items. An increasing number of COSs employ a Delphi survey as a method to obtain consensus amongst stakeholders. Participants rate the importance of different outcomes in a questionnaire; summarized responses are fed back in subsequent questionnaires or ‘rounds’ such that initial responses may be changed in light of this feedback. This is the only mechanism for gaining consensus within the Delphi. The exact methodology used varies and the most appropriate methods are unknown.

1 Previous work has demonstrated that feedback, and type of feedback, impacts on subsequent responses, but the rationale for such impact is not always clear.

2 Consensus is fundamental to the Delphi process and it is crucial to ensure it is not simply a result of participants ‘conforming’. Qualitative work is now needed to gain further understanding of how participants respond to feedback and to what extent consensus is reached within a Delphi survey. This will inform optimal future development of COSs.

This methodological work will be embedded within the development of a new COS for diabetic foot ulcer treatment. Foot ulceration is a major cause of morbidity in people with diabetes. Delayed or inadequate treatment may result in leg amputation. There are around 100 amputations per week in the UK, with 85% preceded by a foot ulcer.

3 The evidence base for relevant treatment is of poor quality and outcomes reported across trials are heterogeneous and poorly defined;

4 hence treatment decisions are based on unfounded patient and clinician preferences. There is an urgent need for a minimum set of outcomes (a COS), agreed by key stakeholders, to be reported in all trials of treatment for diabetic foot ulcer.

What the studentship will encompass:

• Systematic review: Identify methodological studies exploring consensus within Delphi surveys and the influence of providing feedback on subsequent decision-making.

• The development of a COS for diabetic foot ulcer: (i) Phase 1 - identification of a ‘long list’ of outcomes including a systematic review of treatments for foot ulcer and development of a survey questionnaire; (ii) Phase 2 - prioritization of outcomes by patients and clinicians using a 3 round Delphi survey, and; (iii) Phase 3 - consensus meeting to finalize COS.

• Qualitative interviews: Within Phase 2, qualitative interviews will explore how participants respond to feedback. Purposive samples of patients and clinicians (25-30) completing round 1 of the Delphi will be recruited. ‘Think aloud’5 cognitive interviews will be conducted whilst participants complete rounds 2 and 3. Focus will be on how a respondent makes the decision to initially score an item and how they rescore that item based firstly on feedback from their own stakeholder group and then based on that of other stakeholder groups. Different styles of feedback will be considered (quantitative and qualitative data). Recommendations for conducting a Delphi process in COS development will be generated.

Supervisors: Dr. Brookes, Professor Hinchliffe, Professor Adamson, Professor Williamson. Professor Hinchliffe is Professor of Vascular Surgery interested in clinical trials, Board member of the International Working Group of the Diabetic Foot and Editor of British Journal of Surgery. Dr. Brookes is joint lead of the ConDuCT-II Hub outcomes theme and has contributed substantially to the development of COSs. Professor Adamson is Professor of Applied Health Research and Ageing with extensive qualitative and mixed method expertise. Professor Williamson is experienced in COS development, she chairs the COMET Management Group.

 

Supervisor: Dr Brookes

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Global Academy Jobs works with over 250 universities worldwide to promote academic mobility and international research collaboration. Global problems need international solutions. Our jobs board and emails reach the academics and researchers who can help.

"The globalisation of higher education continues apace, driving in turn the ongoing development of the global knowledge economy, striving for solutions to the world’s problems and educating a next generation of leaders and contributors."

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