Mickaël Lesurtel1, Arnaud Perrier2, Patrick M M Bossuyt3, Bernard Langer4, Pierre-Alain Clavien5. 1. Department of Surgery, University Hospital Zurich, Zurich. 2. Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland. 3. Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands. 4. Department of Surgery, University of Toronto, Toronto, Canada. 5. Department of Surgery, University Hospital Zurich, Zurich. Electronic address: clavien@access.uzh.ch.
Abstract
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.
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.