Expert surgical consensus for prenatal counseling using the Delphi method |
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Authors: | Loren Berman Jordan Jackson Kristen Miller Rebecca Kowalski Paul Kolm Francois I Luks |
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Institution: | 1. Sidney Kimmel Medical College of Thomas Jefferson University, 1025 Walnut St. #100, Philadelphia, PA 19107, USA;2. Nemours/Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE 19899, USA;3. University of California San Francisco—East Bay, 1411 East 31st St., QIC 22134, Oakland, CA 94602, USA;4. National Center for Human Factors in Healthcare, MedStar Health 3007 Tilden St NW, Washington, DC 20008, USA;5. Value Institute at Christiana Care Health System and Christiana Care Emergency Department, 4755 Ogletown-Stanton Rd., Newark, DE 19718, USA;6. Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA;g. Hasbro Children''s Hospital, 593 Eddy St., Providence, RI 02903, USA |
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Abstract: | BackgroundPediatric surgeons frequently offer prenatal consultation for congenital pulmonary airway malformation (CPAM) and congenital diaphragmatic hernia (CDH); however, there is no evidence-based consensus to guide prenatal decision making and counseling for these conditions. Eliciting feedback from experts is integral to defining best practice regarding prenatal counseling and intervention.MethodsA Delphi consensus process was undertaken using a panel of pediatric surgeons identified as experts in fetal therapy to address current limitations. Areas of discrepancy in the literature on CPAM and CDH were identified and used to generate a list of content and intervention questions. Experts were invited to participate in an online Delphi survey. Items that did not reach first-round consensus were broken down into additional questions, and consensus was achieved in the second round.ResultsFifty-four surgeons (69%) responded to at least one of the two survey rounds. During round one, consensus was reached on 54 of 89 survey questions (61%), and 45 new questions were developed. During round two, consensus was reached on 53 of 60 survey questions (88%).ConclusionsWe determined expert consensus to establish guidelines regarding perinatal management of CPAM and CDH. Our results can help educate pediatric surgeons participating in perinatal care of these patients.Level of EvidenceV. |
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Keywords: | Congenital diaphragmatic hernia Congenital pulmonary airway malformation Prenatal counseling Delphi method Expert opinion |
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