Modified Delphi analysis of the clinical guideline “Sedation of patients in the departments of anesthesiology, intensive care and intensive care”

Abstract

INTRODUCTION: Approaches to sedation in the departments of anesthesiology, intensive care and intensive care have changed over the past 20 years. In 2020, the guidelines “Sedation of patients in the departments of anesthesiology, intensive care and intensive care” were placed in the rubric of clinical recommendations. OBJECTIVE: To contribute to improving the quality of planned updating of recommendations with the help of a modified Delphi analysis of the provisions and quality criteria of the current version of the document published in the rubricator of clinical recommendations of the Ministry of Health of the Russian Federation. MATERIALS AND METHODS: We used a modified Delphi method with two rounds of questionnaires to develop a consensus. The agreement of specialists was reached in three stages: preparatory, discussions and the development of a consensus conclusion. To conduct the assessment, a questionnaire was created consisting of 3 blocks: assessment of the provisions of the clinical recommendation; assessment of the quality criteria of the clinical recommendation and an overall assessment of the clinical recommendation. The assessment was made on the basis of the Likert scale. Median, fashion and weighted average score were calculated. If, when evaluating the provisions and quality criteria of a clinical recommendation, the median value or mode of any provision was less than 7, the weighted average score was less than 70 %; the median value or mode of quality criteria is less than 7.5, the weighted average score is less than 75 %, then this provision (quality criterion) should be recommended for processing. RESULTS: The assessment of the provisions and criteria was carried out in the first round of discussion. At the second round of discussion, comments and recommendations were finally developed for the developers of the methodological recommendation. Consensus was reached during two rounds of modified Delphi analysis. As a result of the analysis, 16 out of 21 provisions and 5 out of 6 quality criteria were agreed, the rest required processing. CONCLUSIONS: As a result of an independent assessment by experts, 5 provisions and 1 quality criterion were recommended for processing. Comments and recommendations on all these provisions and quality criteria of the methodological recommendation “Sedation of patients in the departments of anesthesiology, intensive care and intensive care” were also agreed.