1 research outputs found
Optimizing the use of expert panel reference diagnoses in diagnostic studies of multidimensional syndromes
__Abstract__
Background: In the absence of a gold standard, a panel of experts can be invited to assign a reference diagnosis
for use in research. Available literature offers limited guidance on assembling and working with an expert panel
for this purpose. We aimed to develop a protocol for an expert panel consensus diagnosis and evaluated its
applicability in a pilot project.
Methods: An adjusted Delphi method was used, which started with the assessment of clinical vignettes by 3
experts individually, followed by a consensus discussion meeting to solve diagnostic discrepancies. A panel
facilitator ensured that all experts were able to express their views, and encouraged the use of argumentation to
arrive at a specific diagnosis, until consensus was reached by all experts. Eleven vignettes of patients suspected of
having a primary neurodegenerative disease were presented to the experts. Clinical information was provided
stepwise and included medical history, neurological, physical and cognitive function, brain MRI scan, and follow-up
assessments over 2 years. After the consensus discussion meeting, the procedure was evaluated by the experts.
Results: The average degree of consensus for the reference diagnosis increased from 52% after individual
assessment of the vignettes to 94% after the consensus discussion meeting. Average confidence in the diagnosis
after individual assessment was 85%. This did not increase after the consensus discussion meeting. The process
evaluation led to several recommendations for improvement of the protocol.
Conclusion: A protocol for attaining a reference diagnosis based on expert panel consensus was shown feasible in
research practice