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When expert agreement replaces evidence: The rise of Delphi consensus in geriatrics.

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Τίτλος: When expert agreement replaces evidence: The rise of Delphi consensus in geriatrics.
Συγγραφείς: Coelho-Júnior HJ; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: coelhojunior@hotmail.com.br., Marzetti E; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: emanuele.marzetti@unicatt.it.
Πηγή: Ageing research reviews [Ageing Res Rev] 2026 Jun; Vol. 118, pp. 103121. Date of Electronic Publication: 2026 Apr 02.
Τύπος έκδοσης: Journal Article; Review
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Science Country of Publication: England NLM ID: 101128963 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-9649 (Electronic) Linking ISSN: 15681637 NLM ISO Abbreviation: Ageing Res Rev Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, UK : Elsevier Science, c2002-
Ιατρικοί όροι (MeSH): Geriatrics*/methods , Geriatrics*/standards , Geriatrics*/trends , Delphi Technique* , Evidence-Based Medicine* , Consensus Statements as Topic*, Sarcopenia/diagnosis ; Sarcopenia/therapy ; Aged ; Humans
Περίληψη: Expert consensus is intended to guide clinical reasoning when evidence is scarce. In contemporary geriatrics, however, the Delphi method is increasingly used where data are not absent but abundant. Sarcopenia and frailty exemplify this dilemma. Repeated consensus statements have redefined diagnostic criteria and thresholds, yet prevalence estimates range dramatically depending on the framework applied. The proliferation of overlapping definitions and tools has generated conceptual instability, fragmented research efforts, and hindered therapeutic development. When expert agreement becomes the endpoint rather than a bridge to empirical confirmation, consensus risks hardening into doctrine. Geriatrics stand at a methodological crossroads. A discipline that cares for more than 830 million older adults cannot rely on authority in place of evidence. Consensus methods retain value in genuine uncertainty, but their output must be explicitly provisional and rapidly subjected to validation against meaningful clinical outcomes. Without recalibrating the balance between expertise and data, geriatrics risk weakening its scientific credibility at precisely the moment when demographic change demands greater rigor. Evidence, not agreement, must define the future of the field.
(Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Evidence-based medicine; Frailty; Gerontology; Practice-based medicine; Sarcopenia
Entry Date(s): Date Created: 20260405 Date Completed: 20260509 Latest Revision: 20260511
Update Code: 20260512
DOI: 10.1016/j.arr.2026.103121
PMID: 41935582
Βάση Δεδομένων: MEDLINE
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  Data: When expert agreement replaces evidence: The rise of Delphi consensus in geriatrics.
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  Data: <searchLink fieldCode="AU" term="%22Coelho-Júnior+HJ%22">Coelho-Júnior HJ</searchLink>; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: coelhojunior@hotmail.com.br.<br /><searchLink fieldCode="AU" term="%22Marzetti+E%22">Marzetti E</searchLink>; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: emanuele.marzetti@unicatt.it.
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  Data: Expert consensus is intended to guide clinical reasoning when evidence is scarce. In contemporary geriatrics, however, the Delphi method is increasingly used where data are not absent but abundant. Sarcopenia and frailty exemplify this dilemma. Repeated consensus statements have redefined diagnostic criteria and thresholds, yet prevalence estimates range dramatically depending on the framework applied. The proliferation of overlapping definitions and tools has generated conceptual instability, fragmented research efforts, and hindered therapeutic development. When expert agreement becomes the endpoint rather than a bridge to empirical confirmation, consensus risks hardening into doctrine. Geriatrics stand at a methodological crossroads. A discipline that cares for more than 830 million older adults cannot rely on authority in place of evidence. Consensus methods retain value in genuine uncertainty, but their output must be explicitly provisional and rapidly subjected to validation against meaningful clinical outcomes. Without recalibrating the balance between expertise and data, geriatrics risk weakening its scientific credibility at precisely the moment when demographic change demands greater rigor. Evidence, not agreement, must define the future of the field.<br /> (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
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