Link: http://www.ncbi.nlm.nih.gov/pubmed/29274787

J Pediatr Surg. 2017 Nov 28. pii: S0022-3468(17)30805-9. doi: 10.1016/j.jpedsurg.2017.11.056. [Epub ahead of print]
Expert surgical consensus for prenatal counseling using the Delphi method.
Berman L1, Jackson J2, Miller K3, Kowalski R4, Kolm P5, Luks FI6.
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Abstract
BACKGROUND:
Pediatric surgeons frequently offer prenatal consultation for congenital pulmonary airway malformation (CPAM) and congenital diaphragmatic hernia (CDH); however, there is no evidence-based consensus to guide prenatal decision making and counseling for these conditions. Eliciting feedback from experts is integral to defining best practice regarding prenatal counseling and intervention.

METHODS:
A Delphi consensus process was undertaken using a panel of pediatric surgeons identified as experts in fetal therapy to address current limitations. Areas of discrepancy in the literature on CPAM and CDH were identified and used to generate a list of content and intervention questions. Experts were invited to participate in an online Delphi survey. Items that did not reach first-round consensus were broken down into additional questions, and consensus was achieved in the second round.

RESULTS:
Fifty-four surgeons (69%) responded to at least one of the two survey rounds. During round one, consensus was reached on 54 of 89 survey questions (61%), and 45 new questions were developed. During round two, consensus was reached on 53 of 60 survey questions (88%).

CONCLUSIONS:
We determined expert consensus to establish guidelines regarding perinatal management of CPAM and CDH. Our results can help educate pediatric surgeons participating in perinatal care of these patients.

LEVEL OF EVIDENCE:
V.

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