Identification of essential steps in laser procedure for twin-twin transfusion syndrome using the Delphi methodology

SILICONE study

S. H P Peeters, J. Akkermans, M. Westra, E. Lopriore, J. M. Middeldorp, F. J. Klumper, L. Lewi, R. Devlieger, J. Deprest, E. V. Kontopoulos, R. Quintero, R. H. Chmait, J. S. Smoleniec, L. Otaño, D. Oepkes

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: To determine, by expert consensus, the essential substeps of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) that could be used to create an authority-based curriculum for training in this procedure among fetal medicine specialists. Methods: A Delphi survey was conducted among an international panel of experts (n=98) in FLS. Experts rated the substeps of FLS on a five-point Likert-type scale to indicate whether they considered them to be essential, and were able to comment on each substep, using a dedicated online platform accessed by the invited tertiary care facilities that specialize in fetal therapy. Responses were returned to the panel until consensus was reached (Cronbach's α≥0.80). All substeps that were rated≥4 by 80% of the experts were included in the evaluation instrument. Results: After the first iteration of the Delphi procedure, a response rate of 74% (73/98) was reached, and in the second and third iterations response rates of 90% (66/73) and 81% (59/73) were reached, respectively. Among a total of 81 substeps rated in the first round, 21 substeps had to be re-rated in the second round. Finally, from the initial list of substeps, 55 were agreed by experts to be essential. In the third round, the 18 categorized substeps were ranked in order of importance, with 'coagulation of all anastomoses that cross the equator' and 'determination of fetoscope insertion site' as the most important. Conclusions: A total of 55 substeps of FLS for TTTS were defined by a panel of experts to be essential in the procedure. This list is the first authority-based evidence to be used in the development of a final training model for future fetal surgeons.

Original languageEnglish
JournalUltrasound in Obstetrics and Gynecology
DOIs
StateAccepted/In press - 2015

Fingerprint

Fetoscopy
Fetofetal Transfusion
Laser Therapy
Lasers
Fetoscopes
Fetal Therapies
Tertiary Healthcare
Curriculum
Medicine

Keywords

  • Delphi methodology
  • Evaluation
  • Fetoscopic laser therapy
  • Training
  • Twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine

Cite this

Identification of essential steps in laser procedure for twin-twin transfusion syndrome using the Delphi methodology : SILICONE study. / Peeters, S. H P; Akkermans, J.; Westra, M.; Lopriore, E.; Middeldorp, J. M.; Klumper, F. J.; Lewi, L.; Devlieger, R.; Deprest, J.; Kontopoulos, E. V.; Quintero, R.; Chmait, R. H.; Smoleniec, J. S.; Otaño, L.; Oepkes, D.

In: Ultrasound in Obstetrics and Gynecology, 2015.

Research output: Contribution to journalArticle

Peeters, SHP, Akkermans, J, Westra, M, Lopriore, E, Middeldorp, JM, Klumper, FJ, Lewi, L, Devlieger, R, Deprest, J, Kontopoulos, EV, Quintero, R, Chmait, RH, Smoleniec, JS, Otaño, L & Oepkes, D 2015, 'Identification of essential steps in laser procedure for twin-twin transfusion syndrome using the Delphi methodology: SILICONE study', Ultrasound in Obstetrics and Gynecology. https://doi.org/10.1002/uog.14761
Peeters, S. H P ; Akkermans, J. ; Westra, M. ; Lopriore, E. ; Middeldorp, J. M. ; Klumper, F. J. ; Lewi, L. ; Devlieger, R. ; Deprest, J. ; Kontopoulos, E. V. ; Quintero, R. ; Chmait, R. H. ; Smoleniec, J. S. ; Otaño, L. ; Oepkes, D. / Identification of essential steps in laser procedure for twin-twin transfusion syndrome using the Delphi methodology : SILICONE study. In: Ultrasound in Obstetrics and Gynecology. 2015.
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abstract = "Objective: To determine, by expert consensus, the essential substeps of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) that could be used to create an authority-based curriculum for training in this procedure among fetal medicine specialists. Methods: A Delphi survey was conducted among an international panel of experts (n=98) in FLS. Experts rated the substeps of FLS on a five-point Likert-type scale to indicate whether they considered them to be essential, and were able to comment on each substep, using a dedicated online platform accessed by the invited tertiary care facilities that specialize in fetal therapy. Responses were returned to the panel until consensus was reached (Cronbach's α≥0.80). All substeps that were rated≥4 by 80{\%} of the experts were included in the evaluation instrument. Results: After the first iteration of the Delphi procedure, a response rate of 74{\%} (73/98) was reached, and in the second and third iterations response rates of 90{\%} (66/73) and 81{\%} (59/73) were reached, respectively. Among a total of 81 substeps rated in the first round, 21 substeps had to be re-rated in the second round. Finally, from the initial list of substeps, 55 were agreed by experts to be essential. In the third round, the 18 categorized substeps were ranked in order of importance, with 'coagulation of all anastomoses that cross the equator' and 'determination of fetoscope insertion site' as the most important. Conclusions: A total of 55 substeps of FLS for TTTS were defined by a panel of experts to be essential in the procedure. This list is the first authority-based evidence to be used in the development of a final training model for future fetal surgeons.",
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T1 - Identification of essential steps in laser procedure for twin-twin transfusion syndrome using the Delphi methodology

T2 - SILICONE study

AU - Peeters, S. H P

AU - Akkermans, J.

AU - Westra, M.

AU - Lopriore, E.

AU - Middeldorp, J. M.

AU - Klumper, F. J.

AU - Lewi, L.

AU - Devlieger, R.

AU - Deprest, J.

AU - Kontopoulos, E. V.

AU - Quintero, R.

AU - Chmait, R. H.

AU - Smoleniec, J. S.

AU - Otaño, L.

AU - Oepkes, D.

PY - 2015

Y1 - 2015

N2 - Objective: To determine, by expert consensus, the essential substeps of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) that could be used to create an authority-based curriculum for training in this procedure among fetal medicine specialists. Methods: A Delphi survey was conducted among an international panel of experts (n=98) in FLS. Experts rated the substeps of FLS on a five-point Likert-type scale to indicate whether they considered them to be essential, and were able to comment on each substep, using a dedicated online platform accessed by the invited tertiary care facilities that specialize in fetal therapy. Responses were returned to the panel until consensus was reached (Cronbach's α≥0.80). All substeps that were rated≥4 by 80% of the experts were included in the evaluation instrument. Results: After the first iteration of the Delphi procedure, a response rate of 74% (73/98) was reached, and in the second and third iterations response rates of 90% (66/73) and 81% (59/73) were reached, respectively. Among a total of 81 substeps rated in the first round, 21 substeps had to be re-rated in the second round. Finally, from the initial list of substeps, 55 were agreed by experts to be essential. In the third round, the 18 categorized substeps were ranked in order of importance, with 'coagulation of all anastomoses that cross the equator' and 'determination of fetoscope insertion site' as the most important. Conclusions: A total of 55 substeps of FLS for TTTS were defined by a panel of experts to be essential in the procedure. This list is the first authority-based evidence to be used in the development of a final training model for future fetal surgeons.

AB - Objective: To determine, by expert consensus, the essential substeps of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) that could be used to create an authority-based curriculum for training in this procedure among fetal medicine specialists. Methods: A Delphi survey was conducted among an international panel of experts (n=98) in FLS. Experts rated the substeps of FLS on a five-point Likert-type scale to indicate whether they considered them to be essential, and were able to comment on each substep, using a dedicated online platform accessed by the invited tertiary care facilities that specialize in fetal therapy. Responses were returned to the panel until consensus was reached (Cronbach's α≥0.80). All substeps that were rated≥4 by 80% of the experts were included in the evaluation instrument. Results: After the first iteration of the Delphi procedure, a response rate of 74% (73/98) was reached, and in the second and third iterations response rates of 90% (66/73) and 81% (59/73) were reached, respectively. Among a total of 81 substeps rated in the first round, 21 substeps had to be re-rated in the second round. Finally, from the initial list of substeps, 55 were agreed by experts to be essential. In the third round, the 18 categorized substeps were ranked in order of importance, with 'coagulation of all anastomoses that cross the equator' and 'determination of fetoscope insertion site' as the most important. Conclusions: A total of 55 substeps of FLS for TTTS were defined by a panel of experts to be essential in the procedure. This list is the first authority-based evidence to be used in the development of a final training model for future fetal surgeons.

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