Modifed Delphi analysis of the guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” “The use of non-invasive lung ventilation”

Abstract

INTRODUCTION: The need for an independent assessment of the guidelines before their planned revision based on the third-party opinion of competent specialists is beyond doubt. This analysis allows to adapt the implementation of recommendations in practice, regarding equipment and knowledge of physicians. OBJECTIVE: To analyze the effectiveness, safety and availability of implementation in clinical practice of the guidelines “Application of non-invasive lung ventilation” using the modified Delphi method. MATERIALS AND METHODS: The expertise consisted of three stages. The first stage consisted in the analysis of the guidelines “The use of non-invasive lung ventilation” and the preparation of a questionnaire. At the main stage, a questionnaire was sent out and panel members were asked to evaluate the positions using ten-point Likert scale. The analytical stage consisted in calculating the weighted average, median and mode. The weighted average score were taken into account; the value of the median or mode of criteria for the quality of medical care, weighted average. RESULTS: Fifteen panel members was enrolled. The main remarks and additions were to clarify the terminology, concretize certain recommendations and style. Panel members determined the possibility of implementing the recommendation of the guidelines in practice. The lack of equipment makes therapeutic measures limited. This fact confirms the low results of the weighted average assessment of the criteria for the quality of medical care. CONCLUSIONS: Consensus was reached on 20 of the 21 thesis recommendations, on four of the eight criteria for the quality of medical care, and on the amended wording of certain recommendations. The Delphi analysis made it possible to look at the implementation of the giudelines from the perspective of practicing anesthesiologist and intensive care physician, including in structural units with a low level of material and equipment.