Indicators of the appropriateness of long-term prescribing in general practice in the United Kingdom: consensus development, face and content validity, feasibility, and reliability

Ja, Cantrill; Sibbald, Bonnie; Buetow, Stephen

doi:10.1136/qshc.7.3.130

Cited by 113 publications

(98 citation statements)

References 19 publications

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“…They recommend that for rigour a minimum of 70% is required, although there is no support for this statement. Typical response rates in the literature are 82% for round one and 57% for round two [17], 69% for round one and 71% for round two [23], or 58% in round one and 85% in round two [7]; and in an internet survey, 39% in round one, 39% in round two, and 35% for round three. Response rates typically range between half and two-thirds of participants for each round [7].…”

Section: First Questionnairementioning

confidence: 99%

“…Much of Sackman's [16] criticism of the method is based on the contention that 'expert' cannot be properly defined. Definitions of an expert in the literature include: anyone with relevant input to the Delphi topic being studied [8], any individual with relevant knowledge and experience in a particular topic [17], a wide range of experts from different backgrounds as Delphi enables disagreements in a constructive forum that ensures equal participation [7], and individuals with prior experience with the issue at hand [18].…”

Section: Participant Populationmentioning

confidence: 99%

“…the sample size. The sample size should be governed by the purpose of the investigation [17]. The sizes of Delphi panels vary from three to five hundred [19], four to three thousand [17], six [12], six to twelve [8], a minimum of seven [8], seven to twelve [8], ten to fifteen [20], ten to eighteen [14], ten to fifty [9], [7], and twenty to twenty-seven [21].…”

Section: Figure 3: Geographical Distribution Of Identified Respondentsmentioning

confidence: 99%

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Determining the Most Important Factors for Sustainable Energy Technology Selection in Africa

Barry

Steyn

Brent

2009

The South African Journal of Industrial Engineering

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The supply of sustainable energy is crucial for sustainable development in Africa. The aim of the study summarised in this paper is the identification, and prioritisation, of the factors that must be taken into account when selecting the most sustainable technological systems in the African context, by applying the Delphi technique. The questionnaire of the first round was based on factors already identified during a focus group exercise with energy experts. The Delphi participants were required to comment on the factors, add new factors, and rate all the factors. The results were fed back during the second round where respondents were again asked to rate the factors for feasibility, desirability, and importance. The outcome is the identification of the most important factors that can be used by decision makers to ensure better selection of sustainable energy technologies and projects. The top five prioritised factors are: Ease of maintenance and support over the life cycle of the technology; Suitable site readily available for pilot studies; Project management; Economic development; and Access to secured suitable sites for deployment. OPSOMMINGDie verskaffing van volhoubare energie is van kritiese belang vir die volhoubare ontwikkeling van Afrika. Hierdie studie het gefokus op die identifisering en prioritisering van faktore wat in ag geneem moet word wanneer tegnologiese stelsels vir gebruik in Afrika geselekteer word. Die studie maak gebruik van die Delphi-tegniek. Die vraelys van die eerste rondte is gebaseer op die faktore wat gedurende 'n fokusgroep met energiespesialiste geïdentifiseer is. Deelnemers is gevra om kommentaar te lewer op hierdie faktore, om nuwe faktore by te voeg, en om al die faktore te beoordeel. Die resultate is teruggevoer gedurende die tweede rondte van die Delphi waar deelnemers weer eens gevra is om die faktore te beoordeel in terme van uitvoerbaarheid, wenslikheid, en belangrikheid. Die uitkoms is die identifisering van die belangrikste faktore wat deur besluitnemers gebruik kan word om beter seleksie van 'n keuse van volhoubare energietegnologieë en -projekte te verseker. Die vyf belangrikste faktore is: Gemak van instandhouding en ondersteuning oor die lewensiklus van die tegnologie; geskikte liggings beskikbaar vir proefaanlegte; projekbestuur; ekonomiese ontwikkeling; en toegang tot geskikte liggings vir installasie.

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Section: First Questionnairementioning

confidence: 99%

Section: Participant Populationmentioning

confidence: 99%

Section: Figure 3: Geographical Distribution Of Identified Respondentsmentioning

confidence: 99%

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Determining the Most Important Factors for Sustainable Energy Technology Selection in Africa

Barry

Steyn

Brent

2009

The South African Journal of Industrial Engineering

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“…This is, in particular, the case in complex diseases, such as asthma. Face and content validity, on which validation has centred to date [33,34,35], are not adequate substitutes for concurrent validity, checking if an indicator adequately describes what can be observed in actual clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Validity of performance indicators for assessing prescribing quality: the case of asthma

Pont

Denig

Molen

et al. 2003

Eur J Clin Pharmacol

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Validity of performance indicators for assessing prescribing quality Pont, LG; Denig, P; van der Molen, T; van der Veen, WJ; Haaijer-Ruskamp, FM Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Abstract Objectives: The aim of this study was to assess the concurrent validity between the identification of suboptimal treatment based on clinical information and computer generated indicators. Indicators that are associated with sub-optimal treatment in one of the four steps of asthma management were assessed. Design: The ability of each indicator to identify patients with sub-optimal asthma treatment from computerised general practitioner (GP) prescription records was assessed by comparing them with the results of an individual patient assessment using clinical data. Setting: Chronic asthma patients (n=146) registered with 16 Dutch GPs. Main measures: The sensitivity and positive predictive value (PPV) of each performance indicator was determined.Results: The step-1 indicator, focusing on patients not prescribed a short-acting b-agonist, had an acceptable sensitivity (0.86), but a low PPV (0.52). The two step-2 indicators, targeting under-prescription of inhaled corticosteroids, had sensitivities of 0.74 and 0.37 and PPVs of 0.46 and 0.71, respectively. The step-3 indicator, which targeted under-dosing of inhaled corticosteroids, had a sensitivity of 0.07 and a PPV of 0.2. The fourth indicator, focusing on under-prescription of long-acting b-agonists, could not be validated due to inadequate numbers of patients with severe asthma in our study sample. Discussion: None of the indicators investigated was considered valid for assessing prescriber performance, despite having good face and content validity. Performance indicators that have not been validated can only provide a broad-brush approach for assessing prescribing quality and should be used with extreme caution.

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“…11,12 One recent example is its use in the development of health service indicators. 13 Figure 1 shows the steps involved in the two-round Delphi procedure used in this study.…”

Section: Methodsmentioning

confidence: 99%

Identifying and establishing consensus on the most important safety features of GP computer systems: e-Delphi study

Avery¹,

Savelyich²,

Sheikh³

et al. 2005

Journal of Innovation in Health Informatics

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Our objective was to identify and establish consensus on the most important safety features of GP computer systems, with a particular emphasis on medicines management. We used a two-round electronic Delphi survey, completed by a 21-member multidisciplinary expert panel, all from the UK. The main outcome measure was percentage agreement of the panel members on the importance of the presence of a number of different safety features (presented as clinical statements) on GP computer systems. We found 90% or greater agreement on the importance of 32 (58%) statements. These statements, indicating issues considered to be of considerable importance (rated as important or very important), related to: computerised alerts; the need to avoid spurious alerts; making it difficult to override critical alerts; having audit trails of such overrides; support for safe repeat prescribing; effective computer-user interface; importance of call and recall management; and the need to be able to run safety reports. The high level of agreement among the expert panel members indicates clear themes and priorities that need to be addressed in any further improvement of safety features in primary care computing systems.

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Indicators of the appropriateness of long-term prescribing in general practice in the United Kingdom: consensus development, face and content validity, feasibility, and reliability

Cited by 113 publications

References 19 publications

Determining the Most Important Factors for Sustainable Energy Technology Selection in Africa

Determining the Most Important Factors for Sustainable Energy Technology Selection in Africa

Validity of performance indicators for assessing prescribing quality: the case of asthma

Identifying and establishing consensus on the most important safety features of GP computer systems: e-Delphi study

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