Working Toward Consensus on Sporadic Vestibular Schwannoma Care: A Modified Delphi Study.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
entrez:
25
1
2021
pubmed:
26
1
2021
medline:
15
4
2021
Statut:
ppublish
Résumé
To address variance in clinical care surrounding sporadic vestibular schwannoma, a modified Delphi study was performed to establish a general framework to approach vestibular schwannoma care. A multidisciplinary panel of experts was established with deliberate representation from key stakeholder societies. External validity of the final statements was assessed through an online survey of registered attendees of the 8th Quadrennial International Conference on Vestibular Schwannoma. Modified Delphi method. The panel consisted of 16 vestibular schwannoma experts (8 neurotology and 8 neurosurgery) and included delegates representing the AAOHNSF, AANS/CNS tumor section, ISRS, and NASBS. The modified Delphi method encompassed a four-step process, comprised of one prevoting round to establish a list of focus areas and three subsequent voting rounds to successively refine individual statements and establish levels of consensus. Thresholds for achieving moderate consensus, at ≥67% agreement, and strong consensus, at ≥80% agreement, were determined a priori. All voting was performed anonymously via the Qualtrics online survey tool and full participation from all panel members was required before procession to the next voting round. Through the Delphi process, 103 items were developed encompassing hearing preservation (N = 49), tumor control and imaging surveillance (N = 20), preferred treatment (N = 24), operative considerations (N = 4), and complications (N = 6). As a result of item refinement, moderate (4%) or strong (96%) consensus was achieved in all 103 final statements. Seventy-nine conference registrants participated in the online survey to assess external validity. Among these survey respondents, moderate (N = 21, 20%) or strong (N = 73, 71%) consensus was achieved in 94 of 103 (91%) statements, and no consensus was reached in 9 (9%). Of the four items with moderate consensus by the expert panel, one had moderate consensus by the conference participants and three had no consensus. This modified Delphi study on sporadic vestibular schwannoma codifies 100% consensus within a multidisciplinary expert panel and is further supported by 91% consensus among an external group of clinicians who regularly provide care for patients with vestibular schwannoma. These final 103 statements address clinically pragmatic items that have direct application to everyday patient care. This document is not intended to define standard of care or drive insurance reimbursement, but rather to provide a general framework to approach vestibular schwannoma care for providers and patients.
Identifiants
pubmed: 33492814
doi: 10.1097/MAO.0000000000002917
pii: 00129492-202012000-00056
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1360-e1371Références
Marinelli JP, Grossardt BR, Lohse CM, et al. Prevalence of sporadic vestibular schwannoma: Reconciling temporal bone, radiologic, and population-based studies. Otol Neurotol 2019; 40:384–390.
Marinelli JP, Lohse CM, Carlson ML. Incidence of vestibular schwannoma over the past half-century: A population-based study of Olmsted County, Minnesota. Otolaryngol Head Neck Surg 2018; 159:717–723.
Stangerup SE, Tos M, Caye-Thomasen P, et al. Increasing annual incidence of vestibular schwannoma and age at diagnosis. J Laryngol Otol 2004; 118:622–627.
Stangerup SE, Tos M, Thomsen J, et al. True incidence of vestibular schwannoma? Neurosurgery 2010; 67:1335–1340.
Carlson ML, Habermann EB, Wagie AE, et al. The changing landscape of vestibular schwannoma management in the United States—A shift toward conservatism. Otolaryngol Head Neck Surg 2015; 153:440–446.
Carlson ML, Van Gompel JJ, Wiet RM, et al. A cross-sectional survey of the North American Skull Base Society: Current practice patterns of vestibular schwannoma evaluation and management in North America. J Neurol Surg B Skull Base 2018; 79:289–296.
Lau T, Olivera R, Miller T Jr, et al. Paradoxical trends in the management of vestibular schwannoma in the United States. J Neurosurg 2012; 117:514–519.
Olson JJ, Kalkanis SN, Ryken TC. Congress of neurological surgeons systematic review and evidence-based guidelines on the treatment of adults with vestibular schwannomas: Executive summary. Neurosurgery 2018; 82:129–134.
Fusco MR, Fisher WS, McGrew BM, et al. Current practices in vestibular schwannoma management: A survey of American and Canadian neurosurgeons. Clin Neurol Neurosurg 2014; 127:143–148.
Van Gompel JJ, Carlson ML, Wiet RM, et al. A cross-sectional survey of the North American Skull Base Society on vestibular schwannoma, Part 2: Perioperative practice patterns of vestibular schwannoma in North America. J Neurol Surg B Skull Base 2018; 79:297–301.
Carlson ML, Glasgow AE, Grossardt BR, et al. Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States. J Neurooncol 2016; 129:269–279.
Witkin BR, Altschuld JW. Planning and Conducting Needs Assessment: A Practical Guide. Thousand Oaks, CA: Sage Publications, Inc; 1995.
Helmer O. Systematic Use of Expert Opinions (Report No. P-3721). Santa Monica, CA: The RAND Corporation; 1967.
Yousuf MI. Using experts’ opinions through Delphi technique. Pract Assessment Res Evaluation 2007; 12:1–8.
Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs 2000; 32:1008–1015.
Dalkey NC. Dalkey NC, Rourke DL, Lewis R, Snyder D. The Delphi method: an experimental study of group opinion. Studies in the Quality of Life: Delphi and Decision-Making.. Lexington: MA-Lexington Books; 1969; 13–54.
Hsu CC, Sandford BA. The Delphi technique: Making sense of consensus practical assessment. Res Evaluation 2007; 12:2.
Sandrey MA, Bulger SM. The Delphi method: An approach for facilitating evidence based practice in athletic training. Athletic Training Educ J 2008; 3:135–142.
Dalkey NOH. An experimental application of the Delphi method to the use of experts. Manage Sci 1963; 9:458–467.
Custer RL, Scarella JA, Stewart BR. The modified Delphi technique: A rotational modification. J Career Tech Educ 1999; 15:2.
Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi technique. J Adv Nurs 2000; 32:1008–1015.
Carlson ML, Vivas EX, McCracken DJ, et al. Congress of neurological surgeons systematic review and evidence-based guidelines on hearing preservation outcomes in patients with sporadic vestibular schwannomas. Neurosurgery 2018; 82:E35–E39.
Gauden A, Weir P, Hawthorne G, et al. Systematic review of quality of life in the management of vestibular schwannoma. J Clin Neurosci 2011; 18:1573–1584.
Zigli E. Adler M, Ziglio E. The Delphi method and its contribution to decision-making. Gazing into the Oracle: The DelphiMethod and its Application to Social Policy and Public Health.. Bristol, PA: Jessica Kingsley Publisher; 1996; 3–33.
Maher TM, Whyte MK, Hoyles RK, et al. Development of a consensus statement for the definition, diagnosis, and treatment of acute exacerbations of idiopathic pulmonary fibrosis using the Delphi technique. Adv Ther 2015; 32:929–943.
McNair AGK, Whistance RN, Main B, et al. Development of a core information set for colorectal cancer surgery: A consensus study. BMJ Open 2019; 9:e028623.
Gidman W, Shah S, Zhang L, et al. Clinicians’ perspectives on cure in adult patients with acute lymphoblastic leukemia with minimal residual disease: A Delphi study. Adv Ther 2019; 36:3017–3029.
Barker FG 2nd, Carter BS, Ojemann RG, et al. Surgical excision of acoustic neuroma: Patient outcome and provider caseload. Laryngoscope 2003; 113:1332–1343.
Patel NS, Gompel JJV, Tombers NM, et al. A cross-sectional survey of the North American Skull Base Society Part 3: The state of lateral skull base surgery training in North America. J Neurol Surg B Skull Base 2019; 80:399–415.