Chusak Limotai1, Kanokwan Boonyapisit2, Piradee Suwanpakdee3, Suda Jirasakuldej4, Kwuanrat Wangponpattanasiri5, Sattawut Wongwiangiunt2, Tipakorn Tumnark5, Panutchaya Noivong4, Sirincha Pitipanyakul4, Chaiwiwat Tungkasereerak6, Phopsuk Tansuhaj7, Watchara Rattanachaisit7, Polchai Pleumpanupatand8, Songchai Kittipanprayoon9, Phattarawin Ekkachon10, Atiporn Ingsathit11, Ammarin Thakkinstian11. 1. Chulalongkorn Comprehensive Epilepsy Center of Excellence, The Thai Red Cross Society, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Electronic address: Chusak.L@chula.ac.th. 2. Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 3. Division of Neurology, Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand. 4. Chulalongkorn Comprehensive Epilepsy Center of Excellence, The Thai Red Cross Society, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 5. Prasat Neurological Institute, Bangkok, Thailand. 6. Maharat Nakhon Ratchasima Hospital, Ministry of Public Health, Nakhon Ratchasima Province, Thailand. 7. Chiangrai Prachanukroh Hospital, Ministry of Public Health, Chiangrai Province, Thailand. 8. Buddhachinaraj Hospital, Ministry of Public Health, Phitsanulok Province, Thailand. 9. Hatyai Hospital, Ministry of Public Health, Songkhla Province, Thailand. 10. Maharaj Nakhon Si Thammarat Hospital, Ministry of Public Health, Nakhon Si Thammarat Province, Thailand. 11. Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Abstract
OBJECTIVE: To establish a consensus which is practical and ready-to-use on investigations (ISE) and for management of status epilepticus (MSE) in adults using a modified Delphi approach. PATIENTS AND METHODS: A 4-round modified Delphi approach was used. First and second rounds were conducted using Google® survey with structured statements and 6-point Likert scale response. Threshold agreement was set to ≥80%. Third round was a face-to-face meeting aimed to facilitate the development of approach algorithms for ISE and MSE. Fourth round was a final review asking participants to rate the algorithms post completion. RESULTS: The panel consisted of 8 board-certified epileptologists along with 6 neurologists from main regional hospitals across Thailand. Thirty-seven statements for ISE and 68 statements for MSE were used for the Round I survey, 17/37 (45.9%) and 49/68 (72.1%) reached threshold agreement (≥80%). The average absolute-agreement intraclass correlation coefficients for ISE and MSE were 0.82 (95% CI 0.71, 0.89) and 0.81 (95% CI 0.73, 0.87), respectively; indicating good extent of consensus among participants. Upon Round II, further 10/18 (55.6%) for ISE and 10/19 (52.6%) for MSE reached agreement. In Round III, face-to-face point-by-point discussion was performed to generate approach algorithms. All (100%) provided positive responses with the algorithms post completion in Round IV. CONCLUSION: A practical and ready-to-use consensus using modified Delphi approach on ISE and MSE was developed in a Thai regional hospital context. In real practice, this approach is more suitable and feasible for a localized setting when compared with totally adopting international guidelines.
OBJECTIVE: To establish a consensus which is practical and ready-to-use on investigations (ISE) and for management of status epilepticus (MSE) in adults using a modified Delphi approach. PATIENTS AND METHODS: A 4-round modified Delphi approach was used. First and second rounds were conducted using Google® survey with structured statements and 6-point Likert scale response. Threshold agreement was set to ≥80%. Third round was a face-to-face meeting aimed to facilitate the development of approach algorithms for ISE and MSE. Fourth round was a final review asking participants to rate the algorithms post completion. RESULTS: The panel consisted of 8 board-certified epileptologists along with 6 neurologists from main regional hospitals across Thailand. Thirty-seven statements for ISE and 68 statements for MSE were used for the Round I survey, 17/37 (45.9%) and 49/68 (72.1%) reached threshold agreement (≥80%). The average absolute-agreement intraclass correlation coefficients for ISE and MSE were 0.82 (95% CI 0.71, 0.89) and 0.81 (95% CI 0.73, 0.87), respectively; indicating good extent of consensus among participants. Upon Round II, further 10/18 (55.6%) for ISE and 10/19 (52.6%) for MSE reached agreement. In Round III, face-to-face point-by-point discussion was performed to generate approach algorithms. All (100%) provided positive responses with the algorithms post completion in Round IV. CONCLUSION: A practical and ready-to-use consensus using modified Delphi approach on ISE and MSE was developed in a Thai regional hospital context. In real practice, this approach is more suitable and feasible for a localized setting when compared with totally adopting international guidelines.
Authors: Fedor Lurie; Rafael D Malgor; Teresa Carman; Steven M Dean; Mark D Iafrati; Neil M Khilnani; Nicos Labropoulos; Thomas S Maldonado; Peter Mortimer; Thomas F O'Donnell; Joseph D Raffetto; Stanley G Rockson; Antonios P Gasparis Journal: Phlebology Date: 2022-03-08 Impact factor: 1.701