🧠 Consensus Methodology [Neurosurgery Wiki]

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===== 🧠 Consensus Methodology =====

**[[Consensus]] methodology** refers to structured approaches used to achieve agreement among a group of experts or stakeholders, particularly when empirical data is incomplete or expert opinions diverge.

==== 🔑 Main Consensus Methods ====

=== 1. Delphi Method ===
  * **Process:** Iterative rounds of anonymous questionnaires among experts. Feedback is shared between rounds.
  * **Goal:** Converge toward consensus.
  * **Applications:** Health guidelines, forecasting, policy development.
  * **Advantages:** Anonymity reduces bias; allows remote participation.
  * **Limitations:** Time-consuming; risk of participant drop-off.

=== 2. Nominal Group Technique (NGT) ===
  * **Process:** Structured in-person session. Ideas are generated silently, then shared and ranked.
  * **Goal:** Rapid prioritization through voting.
  * **Applications:** Needs assessment, guideline creation.
  * **Advantages:** Promotes equal participation; fast.
  * **Limitations:** Requires physical presence; no anonymity.

=== 3. RAND/UCLA Appropriateness Method (RAM) ===
  * **Process:** Combines Delphi with systematic literature review. Experts rate clinical scenarios in two rounds.
  * **Goal:** Assess appropriateness of interventions.
  * **Applications:** Clinical decision-making tools.
  * **Advantages:** Evidence-informed; highly structured.
  * **Limitations:** Resource and time-intensive.

=== 4. Consensus Conference ===
  * **Process:** Public or expert panel discusses and issues a joint consensus statement.
  * **Goal:** Incorporate diverse perspectives.
  * **Applications:** Ethical issues, public health, biotechnology.
  * **Advantages:** Democratic, transparent.
  * **Limitations:** Complex logistics; unpredictable outcomes.

=== 5. Modified Delphi / e-Delphi ===
  * **Process:** Online version of Delphi; often with fewer rounds.
  * **Goal:** Speed up consensus while maintaining rigor.
  * **Applications:** Virtual expert panels, core outcome sets.
  * **Advantages:** Efficient and accessible.
  * **Limitations:** May lack depth or iterative refinement.

==== 📌 When to Use Consensus Methods ====
  * Evidence is limited or conflicting
  * Expert opinion is needed to guide practice
  * Developing:
    - Clinical practice guidelines
    - Core outcome sets
    - Ethical or policy frameworks

==== 📘 Reporting and Standards ====
  * **CREDES** – for Delphi methodology
  * **COS-STAD** – for developing Core Outcome Sets
  * **AGREE II** – for guideline reporting quality

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Feel free to adapt for specific projects (e.g. cranioplasty outcome sets or neurosurgical guidelines).