An independent jury-based consensus conference model for the development of recommendations in medico-surgical practice

doi:10.1016/j.surg.2013.10.003

Surgery

Volume 155, Issue 3, March 2014, Pages 390-397

https://doi.org/10.1016/j.surg.2013.10.003 Get rights and content

Background

There is an increasing demand for standardization in the choice of treatments for specific conditions, so-called personalized medicine. The task is far from trivial, because the perspectives from many stakeholders must be respected, including patients and health care providers, as well as payers or governments to better control costs while optimizing quality of care. One approach to provide widely accepted therapies is the consensus conference.

Methods

We describe a novel methodology to achieve consensus in controversial areas with the main goal to minimize biases.

Results

The principle of this approach relies on a clear distinction between those who provide the evidence (experts) and those who draw the final recommendations (the jury). The jury consists of individuals with sufficient background knowledge to cover the perspectives of all stakeholders' without being involved directly in the topic under evaluation. The organizing committee, the experts, and the jury interact within 3 phases: Preparation, the actual consensus conference, and deliberations. Each question is addressed by a panel of experts, leading to the proposition of recommendations at the conference meeting, which are challenged by the jury and the audience. Based on all available information, the jury finalizes the consensus recommendations, which are eventually published and made available to all.

Conclusion

This novel model of consensus conference allows the construction of consensual, evidence-based, explicit recommendations for therapies in a process that may also identify issues for further research, eventually fostering progress in the field.

Section snippets

Phase 1: Preparation

The first step was to identify a group of leaders in the field of study to secure adequate coverage of the topics and involvement of key experts worldwide. We also wanted to involve influential scientific societies in the fields of liver disease and transplantation, to obtain broad coverage and possibly better acceptance of the resulting consensus statements. We convinced 9 international societies and a foundation not only to endorse the conference, but also to provide financial support. We

Phase 2: Conference meeting

The consensus conference was open to the public and extended over 2.5 days, fostering a deliberative interaction among the panels, jury, and public. Each question was discussed by the chair of the respective panel in a 15- to 20-minute presentation that ended with a proposition for recommendations. Then, members of the jury had the first round of questions, followed by the organizing committee and the public. During this process, the proposed recommendations could be modified. A real-time poll

Phase 3: Deliberations

The deliberation phase of the jury took place immediately after the conference ended. The jury met independently to finalize the consensual recommendations based on the expert panel reports, the public debates, and audience voting. The jury, chaired by the president, assigned a level of evidence to each recommendation and set the strength of each recommendation according to the adopted grading system. Any persisting disagreement among the jury on a question was registered and disclosed in the

Discussion

In controversial areas, consensus conferences offer a unique tool to develop recommendations for diagnosis and treatment with an attempt to provide simple, unbiased, easy-to-use, and widely accepted statements. Such a method is particularly attractive at a time when we are swamped with information of varying quality regarding complex therapeutic approaches. The absence of a ready-to-use format to design a consensus conference for complex medical topics invited us to report on our experience in

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Original CommunicationAn independent jury-based consensus conference model for the development of recommendations in medico-surgical practice

Background

Methods

Results

Conclusion

Section snippets

Phase 1: Preparation

Phase 2: Conference meeting

Phase 3: Deliberations

Discussion

Lancet Oncol

J Clin Epidemiol

J Clin Epidemiol

The Danish consensus conference model

Evaluating consensus conferences: necessity or luxury?

Original Communication
An independent jury-based consensus conference model for the development of recommendations in medico-surgical practice