A modified Delphi study to identify screening items to assess neglected sexual side-effects following prostate cancer treatment

Abstract

Background Neglected sexual side effects (NSSE) are a group of less common sexual side effects that may present after Prostate Cancer (PCa) treatment. There is currently no valid and reliable tool to identify these side effects. A modified Delphi study is an effective way of developing the content of such a screening tool. Methods A modified Delphi study was used to obtain consensus from a multi-disciplinary group of experts over 3 rounds during a 12 week period. Ten statements were presented containing 8 closed-ended statements on individual NSSEs, and 2 open-ended statements on psychosocial impact related to NSSE. Consensus was defined as a 75% strongly agree achievement on each statement, or the final statement evolution at the end of 3 rounds. Statement support in each round was determined by mean, standard deviation and range, after a numerical value was allocated to each statement during specific rounds. All three rounds were structured and suggestions and additions were incorporated in the statement evolution of the three rounds. Results Thirty-five participants were invited, and 27 completed Round 1 (RD 1), 23 participants completed RD2, and 20 participants completed RD3. All 3 rounds were completed in 12 weeks. Statement 1 (sexual arousal incontinence), statement 2 (climacturia) and statement 3 (orgasm intensity) reached consensus after RD2, and statement 9 (sexual dysfunction impact) and statement 10 (experiences) were removed after RD3. Statement 4 (orgasmic pain), statement 5 (anejaculation), statement 6 (sensory disturbances), statement 7 (penile length shortening) and statement 8 (penile curvature) were finalised after the conclusion of RD3. Statements 1–3 were the most stable statements with the most support and least amount of disagreement. Statements 4–8 were less stable, but support for them improved over the 3 rounds. Statements 9–10 both had good stability, but the support indicated that they needed to be removed from the set of statements. Statement 5 had the poorest range due to an outlier opinion. Conclusions Consensus was reached on the items making up the NSSE screening tool. Health care practitioners will be able to use this tool to identify the evidence of NSSE after PCa treatment. Further testing will be undertaken to confirm the reliability and validly of the tool.

Facilitating patient-oncologist communication in advanced treatment-resistant cancer: development and feasibility testing of a question prompt list.

“…A quantitative analysis (frequency, mean and standard deviation) of the importance of overarching questions was performed in order to obtain a list that covered all the themes in a comprehensive and acceptable manner, while remaining concise in order to facilitate its use in clinical practice (30). A 75% rate of 'Important' and 'Very important' responses and a score of 4 or more per question statement for the overall sample was determined in order to retain this question (31). Qualitative comments on rewording or redundancy were taken into account.…”

Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

“…This comprehensive methodology has been used widely to identify research priorities and core outcomes for other conditions and populations. [12][13][14] Traditionally, an open-ended question is proposed, followed by sequential anonymous survey rounds to achieve consensus across a panel of experts. 15 The aim of this international collaborative study was to determine the top prehabilitation research priorities for patients undergoing cancer surgery; based on the consensus opinion of a multidisciplinary group of prehabilitation experts.…”

“…This comprehensive methodology has been used widely to identify research priorities and core outcomes for other conditions and populations. 12 – 14 Traditionally, an open-ended question is proposed, followed by sequential anonymous survey rounds to achieve consensus across a panel of experts. 15 …”