European Delphi Panel Consensus on Use of a Surgical Device

Aim

Glaucoma is a leading cause of blindness in Europe. A surgical device had been shown to be effective in lowering intraocular pressure in patients with glaucoma, which is key to slowing the progression of glaucoma and preserving vision. However, guidelines on best practice for patient selection and care management before, during, and after surgical implantation of the device were lacking. We were asked to conduct a modified Delphi panel to gather expert consensus on the use of the surgical device in the treatment of glaucoma, with an aim to help guide future clinical practice.

Approach

Evidence gathering

First, we conducted a targeted literature review to collate published information on use of the surgical device. This information formed the basis of discussions during a steering committee meeting, where we gathered three experts in the field of ophthalmology from across Europe to discuss the scope of questions to be explored in Round 1 of the Delphi panel.

Delphi panel

In collaboration with the steering committee, we developed a detailed Delphi protocol to outline the study objectives and approach. Based on the discussions from the steering committee meeting and further feedback, statements for each round of the Delphi panel were drafted. In total, 12 panellists representing 11 European countries participated in the Delphi panel across three rounds of survey. Each survey was distributed to Delphi panellists using our web-based Delphi App. This offered panellists the flexibility to complete each survey using a single platform, at a time that was convenient to them within an agreed timeframe.

Quantitative and qualitative responses from each round were analysed, discussed with the steering committee, and used to inform statements for subsequent rounds. Final results of the Delphi panel were discussed with the steering committee and panellists to align on key messaging for the associated publications.

Consensus publication

The results of the Delphi panel provided the framework for a peer-reviewed consensus manuscript and congress publications. We provided full medical writing support for these publications from initiation through to submission. We also provided post-submission support including addressing peer-review comments, checking final proofs, and upload of presentations to congress websites.

The list of final publications resulting from this consensus exercise comprised an abstract, a poster and a symposium presentation for the European Glaucoma Society congress, as well as a peer-reviewed manuscript published in Ophthalmology and Therapy just one year following project kick-off.

Impact

The information gathered during this consensus exercise and disseminated through multiple publications will be used by surgeons to guide their use of the device in clinical practice, improving outcomes for people with glaucoma. A second Delphi panel on use of the device has been conducted and published since the completion of this project, helping to provide more detailed guidance for surgeons.

We also conducted some independent research by surveying the panellists involved in both Delphi panels to gain insights into how they used the study outcomes. The results are available here and highlight a number of participants changing their surgical technique and sharing the findings more widely with colleagues.