Consensus of potential modifiable prognostic factors for persistent pain after a first episode of nonspecific idiopathic, non-traumatic neck pain: results of nominal group and Delphi technique approach

Abstract

Background Identify and establish consensus regarding potential prognostic factors for the development of chronic pain after a first episode of idiopathic, non-traumatic neck pain. Design This study used two consensus group methods: a modified Nominal Group (m-NGT) and a Delphi Technique. Methods The goal of the m-NGT was to obtain and categorize a list of potential modifiable prognostic factors. These factors were presented to a multidisciplinary panel in a two-round Delphi survey, which was conducted between November 2018 and January 2020. The participants were asked whether factors identified are of prognostic value, whether these factors are modifiable, and how to measure these factors in clinical practice. Consensus was a priori defined as 70% agreement among participants. Results Eighty-four factors were identified and grouped into seven categories during the expert meeting using the modified NGT. A workgroup reduced the list to 47 factors and grouped them into 12 categories. Of these factors, 26 were found to be potentially prognostic for chronification of neck pain (> 70% agreement). Twenty-one out of these 26 factors were found to be potentially modifiable by physiotherapists based on a two-round Delphi survey. Conclusion Based on an expert meeting (m-NGT) and a two-round Delphi survey, our study documents consensus (> 70%) on 26 prognostic factors. Twenty-one out of these 26 factors were found to be modifiable, and most factors were psychological in nature.

Consensus on the Best Practice Guidelines for Psychomotor Intervention in Preschool Children with Autism Spectrum Disorder

“…A comparison with other studies that used a similar methodology with the aim of developing intervention guidelines, shows that the combination of NGT and the Delphi technique are found in medical research [ 40 , 41 , 42 ]. Nevertheless, this combination was not found in therapeutic studies.…”

“…The specific research question and the methods are novel in psychomotor-intervention research. The combination of the two techniques was used to answer our research question, following a prescribed set of procedures [ 32 , 41 ]. A Delphi survey preceded by an NGT process made for a complex data analysis that was necessary to guarantee that guidelines were based on the heterogeneity of experts’ opinions.…”

“…A Delphi survey preceded by an NGT process made for a complex data analysis that was necessary to guarantee that guidelines were based on the heterogeneity of experts’ opinions. However, the use of the RAND/UCLA method (a hybrid of the Delphi and NGT) is suggested, to simplify the consensus process [ 41 ] in a future replication of this study.…”

A study protocol for the validation of a prognostic model with an emphasis on modifiable factors to predict chronic pain after a new episode of acute- or subacute nonspecific idiopathic, non-traumatic neck pain presenting in primary care

“…The candidate prognostic factors are based on our previous systematic review and Delphi study [ 16 , 24 ]. From the systematic review, we included the variables significantly predictive of pain chronification or non-recovery.…”

“…However, to strengthen a prognostic model, it can be relevant to include some non-modifiable factors. Based on a recent consensus study of potential modifiable prognostic factors, including psychosocial factors in prognostic research for chronification is relevant [ 24 ]. It seems that psychosocial factors in particular can be modified.…”