September 08, 2017
2 min read

Delphi exercise seen as a valuable tool in reaching expert consensus on large vessel vasculitis

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An international Delphi exercise appears to be useful in attaining expert consensus opinion regarding the items needed to identify disease activity in cases of large vessel vasculitis and will influence future development of large vessel vasculitis outcome measures, according to recently published findings.

Researchers conducted an international Delphi exercise to determine factors considered to be important in identifying active disease status in large vessel vasculitis (LVV) in clinical trials. Researchers identified 317 LVV experts who were involved in clinical research in vasculitis and/or attended academic vasculitis meetings, and sent the Delphi survey to these experts by email. Researchers placed special emphasis on the inclusion of diverse geographic areas and medical specialties. When considering multiple proposed items in the survey, respondents were asked, “Should the following item be used to assess disease activity in Takayasu arteritis (TA)/giant cell arteritis (GCA)in clinical trials?” Voting on these items was conducted separately for GCA and TA.

In the first round, respondents rated 99 items on a five-point scale (strongly disagree, disagree, neutral, agree, and strongly agree). Respondents also had an option to say, “don’t know.” The items were taken from published disease activity assessment tools. Survey participants could give feedback and suggest additional items in the first round of voting. For GCA, 62 items were voted on; while 63 items were voted in round 2 for TA. Twenty-four items for GCA and 28 items for TA were voted in round 3. Researchers also compared the voting results of participants who had seen more than10 cases of each LVV subtype in their career vs. less experienced respondents.

Researchers found the first round was completed by 148 participants, the second round by 111 participants and the third round was completed by 108 participants. The expert respondents represented rheumatology, internal medicine, cardiology, vascular surgery, nephrology, pediatric rheumatology, ophthalmology and radiology. Sixty-one percent of participants had been practicing for more than 10 years. A total of 96 participants had seen more than 10 cases of GCA, while 84 respondents had seen more than10 cases of TA.

Sixty-seven percent of the respondents voted in favor of a common approach for the two subtypes of LVV, but also supported development of further disease-specific instruments. Eleven percent supported a goal of developing one set of outcome measures for both GCA and TA.

“This Delphi exercise was an important step in achieving expert consensus opinion on items necessary to identify disease activity in LVV and these results will guide future work in outcome measure development in LVV,” the researchers wrote. “Further studies are planned to determine a core set of activity domains for use in clinical trials of GCA and TA.”


Disclosure s : The researchers report no relevant disclosures.