Recommandations par consensus formalisé (RCF) - Formal consensus rating - Quick methodology guide - 4 pages

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Posted on Jan 07 2011 Quick methodology guide As a consensus method, its purpose is to formalise the degree of agreement among experts by identifying and selecting, through iterative ratings with feedback, the points on which experts agree and the points on which they disagree or are undecided. The guidelines are subsequently based on agreement points.As a practice guideline method, its purpose is the drafting of a small number of concise unambiguous recommendations, which address the questions asked.It is a rigorous and explicit method based on the involvement of professionals in the field to which the guideline relates and of patient or user representatives, on the use of an external peer review phase, and on transparency, independence of development, and prevention and management of conflicts of interest.The full methodology guide "Recommandations par consensus formalisé" is available in French at http://www.has-sante.fr/portail/jcms/c_272505/recommandations-par-consensus-formalise-rcf To summarise the method for developing practice guidelines and describes the rules for rating and analysis of the scores, according to the "Formal consensus" method used by the French National Authority for Health (HAS) As a consensus method, its purpose is to formalise the degree of agreement among experts by identifying and selecting, through iterative ratings with feedback, the points on which experts agree and the points on which they disagree or are undecided. The guidelines are subsequently based on agreement points.As a practice guideline method, its purpose is the drafting of a small number of concise unambiguous recommendations, which address the questions asked.It is a rigorous and explicit method based on the involvement of professionals in the field to which the guideline relates and of patient or user representatives, on the use of an external peer review phase, and on transparency, independence of development, and prevention and management of conflicts of interest.The full methodology guide "Recommandations par consensus formalisé" is available in French at http://www.has-sante.fr/portail/jcms/c_272505/recommandations-par-consensus-formalise-rcf To summarise the method for developing practice guidelines and describes the rules for rating and analysis of the scores, according to the "Formal consensus" method used by the French National Authority for Health (HAS) Posted on Jan 07 2011

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• Publié par: haute-autorite-sante-methodologie
• Publié le: 01 décembre 2010
• Nombre de lectures: 13
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QUICK METHODOLOGY GUIDE

Practice guidelines “Formal consensus” method Rating rules and score analysis

  December 2010

This document describes the rules for the rating and analysis of the scores used for developing practice guideline according to the “Formal consensus” method.

These rules are defineda prioriand communicated to the rating group before the first round of rating. They are suitable for a group of at least 9 experts and can be adjusted if this group comprises more than 15 experts.   R ATING RULES     The members of the rating group must complete all the submitted items of the questionnaire to ensure that no values are missing   take part in the meeting between the two rounds cannot take part inThose who did not the second round of rating and in subsequent meetings.   Beside each item of the questionnaire there is a discrete numerical scale running from 1 to 9.   of 1 means that the assessor considers the proposala value totally inappropriate  (or not indicated, or unacceptable)   a value of 9 means that the assessor considers the proposaltotally appropriate  (or indicated, or acceptable)   values of 2 to 8 represent possible intermediate situations   a value of 5 means that the assessor isundecided 

Meaning of the discontinuous numerical scale running from 1 to 9    1 2 3 4 5 6 7 8 9   Totally   } Totally ina ro riate   Undecided   a ro riate   For each proposal, the assessor must give a response by ticking in one of the boxes between 1 and 9. Responses placed between 2 numbers or across 2 numbers are not accepted.  

S CORE ANALYSIS   First round of rating    inappropriateness of the proposal is defined by the value of theThe appropriateness or median and the distribution of all the scores obtained on the scale of 1 to 9.   defined on the basis of the distribution of all theAgreement among the experts can be scores obtained: there is agreement when the scores included are all≤5 or all≥5.   A proposal is deemed   rppariopeat, when the value of the median is≥7andthe scores are all≥5   taepoirparpin, when the value of the median is≤3.5andthe scores are all≤5   ofnuniatrecappropriateness, when the value of the median is between 4 and 6.5 (undecided) or there is no consensus among the members of the rating when group (all other situations)   If a value is missing (no response given for one of the proposals even though the assessor has filled in and returned this questionnaire), the proposal is deemed uncertain.    Proposals for which there was a strong agreement are accepted as they are. They aren’t discussed in a meeting, neither submitted for the second round of rating.

Second round of rating    The analysis is made on the basis of the available questionnaires from the members who took part in the meeting: if a member of the rating group fails to return the questionnaire, that member is excluded from the group, and the failure to respond is not counted as a missing value for each proposal.     If missing values remain despite efforts to avoid them, the analysis is considered valid if at least 9 scores are obtained for a proposal (when the group initially comprises more than 10 persons, at least 80% of the responses must be obtained).   If there are no missing values, one of the scores can be excluded from the analysis of the degree of agreement according to the following rules   is excluded if the median is strictly greater than 5the minimum value   maximum value is excluded if the median is less than or equal to 5.the   The analysis leads to distinguish the proposals that are deemed appropriate and those that are deemed inappropriate or those on which the ratin roup remains undecided. Classification of the proposal according to the value of the median and the distribution of the scores  Proposal A reement amon ex erts Median De ree Distribution of scores Appropriate Strong [7-9]≥7 a reement Relative [5-9]≥7 a reement Inappropriate Strong [1-3]≤3 a reeme t n Relative [1-5]≤3.5 a reement Uncertain Undecided [1-9] [4-6.5]  No consensus  Other situations    

    This document presents the rules for the rating and the analysis of the scores according to the Practice guidelines: “Formal consensus” method -December 2010. The full methodology guide can be consulted (in French) at www.has-sante.fr