The Delphi method is a gold-standard technique to achieve group consensus. In health care, when treatment protocols are absent or robust evidence is unavailable, the Delphi method can play a vital role in facilitating decision-making.

A group of US-based researchers from PRECISIONheor aimed to identify areas of consensus and disagreement among hematologists regarding therapeutic options for patients with severe hemophilia A. The Welphi platform was used to achieve this goal.

How was the study done?

Veeranki and colleagues (2021) brought together a group of hematologists to gain a broader understanding of management practices of difficult-to-treat severe hemophilia A without inhibitors.

First, they conducted an extensive literature review to identify available treatments, advantages, and unmet needs as well as perceived challenges encountered by physicians who treat patients with severe hemophilia A without inhibitors.

Then, the study team used Welphi, our online survey platform that implements the Delphi method in a virtual setting, to conduct a 3-round web-based Delphi process.

In the first round, 13 clinical experts reviewed different clinical scenarios designed to reveal their preferences for a particular treatment option using a scale of 1-100, where 1 was considered a highly undesirable treatment option and 100 was considered a highly recommended option. They also ranked factors affecting treatment decision-making. In the second round, the experts participated in an asynchronous online discussion on the Welphi platform to debate and review the first round’s findings. Finally, in the third round, experts were asked to once again answer the initial Round 1 questions in light of the previous round’s responses.

Results

The experts reached a consensus regarding the use of factor VIII (FVIII) replacement therapy in combination with emicizumab, an antibody prophylaxis in the treatment of high-risk hemophilia patients.  

This includes the appropriate use of FVIII in combination with emicizumab during and immediately post-surgery for patients with elective surgery and episodic FVIII followed by emicizumab for newborns with post-circumcision bleeding.

Most of the panelists preferred FVIII over emicizumab due to established evidence on safety and efficacy.

These recommendations complement existing treatment guidelines and support physicians in the management of hemophilia A patients without inhibitors.

For further detail, you can access the study publication here. To learn more about our Welphi Platform, visit our website or send us a message!

 

References:

Veeranki SP, Pednekar P, Graf M, Tuly R, Recht M, Batt K. A Delphi Consensus Approach for difficult-to-treat Patients with Severe Hemophilia A without Inhibitors. J Blood Med. 2021 Oct 21;12:913-928. doi: 10.2147/JBM.S334852. PMID: 34707422; PMCID: PMC8544791.

Using the Welphi software to help creating a tool to assess products sustainability

The excessive exploitation of natural resources led the industry to seek for new strategies that can direct companies towards a more sustainable world. Indeed, delivering sustainable products requires procedures that incorporates all the relevant dimensions to assess products sustainability. 

Within this context, a company focused on sustainability identified the need to have a tool, to be used in a daily basis, to determine if a product is sustainable enough to be part of their products portfolio. Building such a tool, involves understanding what are the main concerns underlying products sustainability. To this aim, the Delphi method was proposed to uncover all relevant indicators for the evaluation of products sustainability. 

 

The Welphi software, exercising the Delphi Method, was the preferred platform, as it enhanced the speed of the process, and it allowed the consolidation of a wide range of opinions from geographically dispersed individuals with diverse backgrounds whilst ensuring anonymity.  

 

The process: 

• Aim: apply the Welphi platform to inform the selection of a set of indicators considered relevant to evaluate product sustainability combining scientific evidence and the points of view of experts and stakeholders. 

 

• Objects of study: 34 indicators, previously identified through literature review - grouped in 3 areas of concern: environmental, social and economic.  

 

• Panel: 55 experts and stakeholders from different countries, with applicable knowledge in a variety of domains and a keen level of interest in the field. 

 

The process comprised 3 rounds: 

• First round: panelists were required to indicate their agreement or disagreement with the following statement. I.e.: “Is this indicator relevant in assessing the sustainability of a product?”. The panel answered using a 6-level Likert scale: Strongly Disagree; Disagree; Neither Agree nor Disagree; Agree; Strongly Agree; and No Answer. 

 

• Second and third round: panelists were presented with the results of the previous round (see below), and had the opportunity to maintain or revise their answers.  

 

Results: 

In the first round, 55 participants engaged in the process and 49 responded to the questionnaire (89% response rate). In the second round, the process had 90% response rate and 91% in the third round.  

Overall, this Delphi process, by creating awareness and discussion among a group of experts and stakeholders, provided some important insights on what are the key aspects that need to be considered in product sustainability. In fact, among 34 indicators proposed to the panel, 91.2% reached group agreement and were approved as relevant to evaluate product sustainability. These outputs are the first step to create a transparent, user-friendly and well-understood decision support tool designed to evaluate product sustainability. 

 

Welphi platform - feedback: 

The results of this Delphi process were achieved by employing the Welphi platform. Welphi allowed the establishment of consensus among a diverse and geographically dispersed group of experts and stakeholders. Welphi’s automated procedures, such as the answers statistics and analysis and the follow-up round creation, enabled transitioning towards the subsequent rounds much quicker and easier. The Welphi platform permitted communication among the participants in a non-face-to-face format and also permitted monitoring participants responses and send them timely reminders, reducing panel drop-out and enhancing the speed and efficiency of the process. 

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