When a response option achieved consensus, it was shown in the next rounds, but with no possibility to be rated again. The questionnaire was self-administered, in a paper-pencil format along with an Belinostat price instruction sheet indicating how to rate the response options for each scenario. Table 1 shows an example of one of the scenarios assessed by the Delphi panel. Table 1 Results from the 3 round Delphi study, showing the distribution of doctors�� ratings for each response option of the 19 scenarios, and the round in which final consensus was achieved Content validity was assessed to determine the relevance of the content of the instrument. After the scenarios were drafted, their content was evaluated by two pulmonologists belonging to the Delphi panel.
Later on, before starting the second round of the Delphi, each of the panelists was interviewed about the realism of the situations described on the scenarios and the frequency of these problems nowadays. All experts agreed that the content of the scenarios represented most of the common problems encountered in asthma self-management today. First round For this round, participants were recruited at the annual meeting of pulmonologists working in the Italian-speaking region of Switzerland. Nine out of eleven specialists attending the meeting agreed to participate, and eight of them responded the questionnaire. Therefore, two more specialists from the region were invited to participate, to complete a group of ten experts, as initially planned (Figure 1). These two doctors were contacted through online directories of physicians in Switzerland.
Inclusion criteria were having a specialty in lung diseases and working with adult patients in the Italian speaking region. Participation was voluntary and no remuneration was offered. Figure 1 Flow of the recruitment and participation process of the Delphi panelist, & outcomes achieved per round. From the first round, 15 out of 76 response options contained in the questionnaire were rated similarly by more than 60% of the doctors. One scenario depicting the use of a new medicine and its side effects, and another referring to the use of Written Asthma Action Plans (WAAP) resulted in contradictory ratings due to a mismatch between the scenarios and their response options. They were discussed with one of the pulmonologists and replaced.
The expert feedbacks and ratings helped to identify drawbacks of some scenarios, including coherence between the scenario and the response options, appropriateness of language used, clarity of the topic, and precision in the description of the symptoms. Amendments regarding these issues were made Dacomitinib for the second round questionnaire. Second round All ten experts who participated in the first round were available for the second round. Since only nine of them answered the questionnaire, two more doctors were invited to participate.