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

被引:20
|
作者
Lesurtel, Mickael [1 ]
Perrier, Arnaud [2 ]
Bossuyt, Patrick M. M. [3 ]
Langer, Bernard [4 ]
Clavien, Pierre-Alain [1 ]
机构
[1] Univ Zurich Hosp, Dept Surg, CH-8091 Zurich, Switzerland
[2] Univ Hosp Geneva, Dept Internal Med, Geneva, Switzerland
[3] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Toronto, Dept Surg, Toronto, ON, Canada
关键词
HEPATOCELLULAR-CARCINOMA; LIVER-TRANSPLANTATION;
D O I
10.1016/j.surg.2013.10.003
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
引用
收藏
页码:390 / 397
页数:8
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