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Methodologies for developing and applying consensus-based recommendations in epilepsy care: A narrative review.

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Τίτλος: Methodologies for developing and applying consensus-based recommendations in epilepsy care: A narrative review.
Συγγραφείς: Haffner R; Department of Neuroscience, Duke University, Durham, North Carolina, USA., Mathew B; School of Osteopathic Medicine, Rowan University, Stratford, New Jersey, USA., Brigo F; Innovation, Research, and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy., Qasim A; Alimentiv Inc., London, Ontario, Canada., Antonio-Arce VS; Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany., Ayed HB; Department of Preventive Medicine and Hospital Hygiene, Hedi Chaker University Hospital, Faculty of Medicine of Sfax, Sfax, Tunisia., Ferlazzo E; Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy., Kwon CS; Department of Neurology, Neurosurgery, Epidemiology and the Sergievsky Center, Columbia University, New York, New York, USA., Lim KS; Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Mitchell JW; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK., Salisu MA; Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja, Nigeria., Valente K; Neurophysiology Laboratory, Faculty of Medicine of University of Sao Paulo (FMUSP), São Paulo, Brazil., Vinayan KP; Department of Pediatric Neurology, Amrita Institute of Medical Sciences, Cochin, Kerala, India., Josephson CB; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada., Jette N; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Πηγή: Epilepsia [Epilepsia] 2026 Mar; Vol. 67 (3), pp. 1032-1048. Date of Electronic Publication: 2025 Dec 15.
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE
Imprint Name(s): Publication: Malden, MA : Blackwell Science
Original Publication: Copenhagen : Munskgaard
Ιατρικοί όροι (MeSH): Epilepsy*/therapy , Consensus Statements as Topic*, Humans ; Delphi Technique
Περίληψη: Consensus-based recommendations (CBRs) are essential for health care decision-making when evidence is limited or conflicting. They can be developed using established methodologies such as the Delphi technique, the nominal group technique (NGT), and the RAND Corporation/University of California Los Angeles (UCLA) Appropriateness Method (RAM). This review explores the advantages and disadvantages of these methods and their applications in epilepsy. A narrative review using PubMed (November 22, 2017 to November 22, 2022) was undertaken examining publications describing Delphi, NGT, and RAM. The frequency of use of each method and their applications in epilepsy care were also reviewed (1966 to October 31, 2023). Sixteen articles were included describing the different consensus-based methods. The advantages and disadvantages of each method varied widely. The Delphi technique, the most widely used method, emerged as adaptable for instances with limited evidence or impracticality of face-to-face interactions. Although NGT favors prompt consensus in single-session formats, the RAM offers a balanced approach with its hybrid structure. We identified 64 epilepsy studies that used consensus methods, with 58 utilizing the most widely used technique, the Delphi. The Delphi guided consensus mostly for management including for individuals with rare conditions such as myoclonic-atonic seizures or in those with epilepsy and pregnancy. The NGT guided expert consensus on the use of cannabidiol for Dravet and Lennox-Gastaut syndromes and facilitated decision-making among pharmacy students addressing ethical issues related to patients with epilepsy who drive. The RAM was applied in four studies for its combined individual and group evaluative approach. It was used to develop recommendations or imaging, create quality-of-care indicators for infantile spasms, and establish a web-based tool for assessing surgical candidacy. Consensus methodologies are crucial to inform robust CBR for epilepsy management where clinical practice guidelines are not possible due to limited evidence. The best method depends on the study goal and available resources.
(© 2025 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
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Contributed Indexing: Keywords: expert panel; guidelines; seizure; standards; structured judgment
Entry Date(s): Date Created: 20251215 Date Completed: 20260323 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC13007833
DOI: 10.1111/epi.70039
PMID: 41396016
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1528-1167
DOI:10.1111/epi.70039