Tuesday, April 20, 2010

The Delphi Technique In Developing International Health Policies: Experience From The SARSControl Project.

The study entitled The Delphi Technique In Developing International Health Policies: Experience From The SARSControl Project, main objective was to evaluate the “Delphi technique” as a tool to assist in developing international policies for SARDS and SARS-like diseases using the criteria found in the literature and its application in the SARSControl Delphi study.


The European Community funded research project SARSControl was made up of 17 international organizations. Its policy evaluation work package was the setting of this study and the basis of our study was the SARSControl hence, data and results from it have been used for our analysis.
This paper uses the criteria defined in the literature to assess the process of using the Delphi technique in one of the largest up to-date projects aimed at developing international emerging infectious disease policies. The evaluation was done using the qualitative description of the SARSControl Delphi and carrying out a critical analysis of different aspects of each criterion.

The Delphi process, which was carried out over a period of nine months consisted of a pilot round, two written rounds and a final face-to-face meeting. Sixty infectious disease experts who were national experts in the field of infectious diseases who working at senior levels nationally and internationally, and represented their country on the Advisory Forum of the European Centre for Disease Control, Stockholm (ECDC) were approached. Of the 60, 47 accepted the invitation-written consent was obtained from them. Thirty-eight experts (from 22 countries) participated in the 1st written round and 28 experts (from 19 countries) in the 2nd written round; and 11 newly recruited experts with similar expertise as the participants from the written rounds (as five panellists invited from the written rounds were not able to participate ) from 9 countries participated in the face-to-face meeting. A possible explanation for this is that as national experts, they were extremely busy, and also the panelists were not invited early enough and nor were they informed of it at the recruitment phase. Two reminders were sent after the written round invitations. The response rate for the 1st round was 80% and the 2nd round was 74%. Seven replies received after the face-to-face meeting were excluded from the analysis. Misinterpretations of questions in the written rounds were rectified by either deleting or clarifying them in the 2nd round questionnaire.
The Delphi panel participants consisted from various health-related disciplines, however their specific experience with SARS was not known. Other relevant specialists for e.g. behavioural scientists and communication specialists were not included in the Delphi panel. European countries were well represented- France, Germany, Singapore, Sweden and the U.K. were countries with experience of 'probable' SARS cases. Learning from Chinese and Canadian experiences was one of the aims of the project. Two experts from China (with the most SARS experience) were invited to the written rounds but they were unable to participate. Canadian experts were not invited.

The Delphi technique can aid the international policy development process and it can be a versatile tool, which creatively collects expert opinions and suggestions in a new topic. Central criteria to be met include representative panel composition, high panelist motivation, and effective but flexible administration of the Delphi process. Based on the assessment of SARSControl Delphi technique, it can be concluded that when rigorously administered, analyzed and reported, is a valuable method to develop international health policy recommendations for emerging infectious diseases, even though discrepancies in its application existed. The SARSControl Delphi technique was a positive experience, and can also be considered by others for similar purposes.

Strengths and Weaknesses:

This is the first methodological study to assess the Delphi technique in developing international infectious disease policies. Although this is a case study within one project, it exemplifies some crucial issues in applying the Delphi technique.
The major strength of the policy Delphi used was its ability to ascertain expert opinions and potential policy options, including new alternative ones, from countries representing different cultures and health policies on the timely issue of infectious disease control. This contributed to the policy recommendations to be put forward to policy makers to agree upon.
The major weakness of the Delphi was that the panel represented mostly European experts, missing countries with most SARS experience, and also the discontinuity from the written rounds to the face-to-face meetings due to drop out and financial constraints.

Syed, A., Hjarnoe, L., & Aro, A. (2009). The Delphi Technique In Developing International Health Policies: Experience From The SARSControl Project. Internet Journal of Health, 8(2), 5. Retrieved from Academic Search Complete database.

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