Abstract：
BACKGROUND: Rib fractures are associated with significant morbidity and mortality, and providing adequate analgesia is paramount in preventing early complications from these injuries. Multiple regional anaesthetic techniques can be used to provide analgesia for these injuries; however, few evidence-based guidelines exist for their use. The aim of this study was to establish consensus within an expert group on the selection criteria used when choosing regional anaesthetic techniques for rib fractures.
METHODS: The Delphi technique is a mixed-methods study format which uses a longitudinal survey process to develop consensus opinion amongst an expert group. A three-round modified e-Delphi study was undertaken using an online survey platform. Round one established cohort characteristics and identified key factors considered important by the group when selecting regional anaesthetic techniques for rib fractures. Subsequent rounds used Likert scales and free text comments to rate the participants\' level of agreement with various statements generated from the first-round responses. The final consensus threshold was established as at least 70% of respondents stating, \'Strongly Disagree\' or \'Disagree\' or alternatively \'Agree\' or \'Strongly Agree\'.
RESULTS: An expert panel of UK-based consultants in anaesthesia and/or intensive care medicine was recruited. Participants worked in a variety of tertiary- and non-tertiary trauma care settings and were varied in their years of experience, approximate annual rib fracture caseload and preference for various anaesthetic techniques in rib fracture management. 54 participants took part in round one and generated 60 statements which were further analysed in an iterative process involving a total of three rounds. A total of 28 statements ultimately reached the pre-defined threshold for consensus within the expert group.
CONCLUSIONS: This e-Delphi study succeeded in building consensus across multiple statements relating to the selection criteria for regional anaesthesia in patients with rib fractures. These consensus statements can inform clinical practice, guide future research priorities and can be integrated into decision-making pathways across multiple hospital settings.
METHODS: The Delphi technique is a mixed-methods study format which uses a longitudinal survey process to develop consensus opinion amongst an expert group. A three-round modified e-Delphi study was undertaken using an online survey platform. Round one established cohort characteristics and identified key factors considered important by the group when selecting regional anaesthetic techniques for rib fractures. Subsequent rounds used Likert scales and free text comments to rate the participants\' level of agreement with various statements generated from the first-round responses. The final consensus threshold was established as at least 70% of respondents stating, \'Strongly Disagree\' or \'Disagree\' or alternatively \'Agree\' or \'Strongly Agree\'.
RESULTS: An expert panel of UK-based consultants in anaesthesia and/or intensive care medicine was recruited. Participants worked in a variety of tertiary- and non-tertiary trauma care settings and were varied in their years of experience, approximate annual rib fracture caseload and preference for various anaesthetic techniques in rib fracture management. 54 participants took part in round one and generated 60 statements which were further analysed in an iterative process involving a total of three rounds. A total of 28 statements ultimately reached the pre-defined threshold for consensus within the expert group.
CONCLUSIONS: This e-Delphi study succeeded in building consensus across multiple statements relating to the selection criteria for regional anaesthesia in patients with rib fractures. These consensus statements can inform clinical practice, guide future research priorities and can be integrated into decision-making pathways across multiple hospital settings.
摘要：
背景：肋骨骨折与显著的发病率和死亡率相关，提供足够的镇痛对于预防这些损伤的早期并发症至关重要。多种区域麻醉技术可用于为这些损伤提供镇痛；然而，很少有基于证据的指南供他们使用。这项研究的目的是在专家组内就选择肋骨骨折区域麻醉技术时使用的选择标准达成共识。
方法：Delphi技术是一种混合方法研究格式，它使用纵向调查过程在专家组中形成共识意见。使用在线调查平台进行了三轮修改的e-Delphi研究。第一轮确定了队列特征，并确定了该小组在选择肋骨骨折的区域麻醉技术时认为重要的关键因素。随后的几轮使用Likert量表和自由文本评论来评估参与者与第一轮回应产生的各种陈述的一致性水平。最终的共识门槛是建立的，因为至少70%的受访者表示，\'强烈不同意\'或\'不同意\'或\'同意\'或\'强烈同意\'。
结果：招募了一个由英国麻醉和/或重症监护医学顾问组成的专家小组。参与者在各种三级和非三级创伤护理环境中工作，他们多年的经验各不相同，每年的肋骨骨折病例数和对肋骨骨折处理中各种麻醉技术的偏好。54名参与者参加了第一轮，并产生了60份陈述，并在总共三轮的迭代过程中进行了进一步分析。共有28项声明最终达到了专家组内达成共识的预定阈值。
结论：这项e-Delphi研究成功地在与肋骨骨折患者区域麻醉选择标准相关的多个陈述中达成共识。这些共识声明可以为临床实践提供信息，指导未来的研究重点，并可以整合到跨多个医院设置的决策路径。
方法：Delphi技术是一种混合方法研究格式，它使用纵向调查过程在专家组中形成共识意见。使用在线调查平台进行了三轮修改的e-Delphi研究。第一轮确定了队列特征，并确定了该小组在选择肋骨骨折的区域麻醉技术时认为重要的关键因素。随后的几轮使用Likert量表和自由文本评论来评估参与者与第一轮回应产生的各种陈述的一致性水平。最终的共识门槛是建立的，因为至少70%的受访者表示，\'强烈不同意\'或\'不同意\'或\'同意\'或\'强烈同意\'。
结果：招募了一个由英国麻醉和/或重症监护医学顾问组成的专家小组。参与者在各种三级和非三级创伤护理环境中工作，他们多年的经验各不相同，每年的肋骨骨折病例数和对肋骨骨折处理中各种麻醉技术的偏好。54名参与者参加了第一轮，并产生了60份陈述，并在总共三轮的迭代过程中进行了进一步分析。共有28项声明最终达到了专家组内达成共识的预定阈值。
结论：这项e-Delphi研究成功地在与肋骨骨折患者区域麻醉选择标准相关的多个陈述中达成共识。这些共识声明可以为临床实践提供信息，指导未来的研究重点，并可以整合到跨多个医院设置的决策路径。
