Background:The developing of clinical care protocols is essential in the health quality improvement in hospitals. During the clinical care protocol construction, there’s a lack of evidence or evidence that must be contextualised according to the hospital circumstances and the formal consensus seems to be a systematic method to guarantee this goal, considering the clinical expertise and the best-available medical evidence; however, is unknown which formal consensus methods are used in clinical care protocol development.
Objectives: To describe formal consensus methods used in developing clinical care protocols.
Methods: A systematic search of indexed literature was carried out among electronic databases (MEDLINE, EMBASE, Cochrane Library and CRD Database), and web pages of groups that develop clinical care protocols, care protocols, and clinical practice guidelines. The review included clinical care protocols methodology reports available in English, Spanish or French that described the formal consensus method used in the clinical care protocol making. A formal consensus method was defined as an iterative process with controlled feedback that comprehends a systematic process to get and measure the level of agreement, and includes strategies to avoid potential biases associated to social interaction or subordination between the participants.
Results: Five documents were included. The clinical care protocols developed were made in national context or were made by medical associations. The formal consensus techniques used were Delphi, RAND/UCLA and Nominal Group. It was no possible to compare the developing time-lapse, the number and profiles of panel participants or the consensus developer´s activities and professional profiles in the included methods.
Conclusions:Formal consensus methodologies are useful in developing clinical care protocols. Groups that develop clinical care protocols should evaluate the advantages and disadvantages of Delphi, RAND/UCLA and Nominal Group methods to decide the most suitable method in the specific scenario where the clinical care protocol will be carried.