Abstract：
BACKGROUND: Shoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants creates significant pressure on orthopaedic services. Surveillance offers the opportunity to study implant longevity, detect failing implants and potentially perform revision at lower morbidity and cost. There is a paucity of evidence to support recommendations on long-term follow-up in shoulder arthroplasty. Prospective studies comparing long-term follow-up and structure are impractical from time, resource and cost perspectives. A real-time Delphi technique represents a mechanism by which experts involved in long-term follow-up of primary shoulder arthroplasty can formulate recommendations via a transparent, reproducible and efficient process. We outline the protocol for a real-time Delphi study seeking consensus on long-term follow-up and surveillance of primary shoulder arthroplasty .
METHODS: A real-time Delphi technique will be used. A planning committee will design the Delphi statements. A steering committee will supervise and monitor the real-time Delphi process. Participants will be asked to rate their agreement with statements using a 5-point Likert scale. The Delphi statements will be derived from review of published literature, and the strength of evidence available for each statement will be provided. We will offer participation to all surgeons and extended-scope practitioners who are current members of the British Elbow & Shoulder Society (BESS) and have clinical practice involving shoulder arthroplasty follow-up. The questionnaire will be active for 4 weeks and requires a minimum of 20 participants. Consensus agreement is defined as 70% of participants selecting at least a 4-point on a 5-point Likert scale.
CONCLUSIONS: We anticipate the outlined study will achieve consensus on long-term follow-up and surveillance of primary shoulder arthroplasty. We intend to use the expert consensus recommendations achieved, in addition to the limited applicable published evidence available, to produce BESS-affiliated guidelines on long-term follow-up and surveillance of primary shoulder arthroplasty.EthicsEthical approval is not required for the real-time Delphi study.We expect the results of this initiative will be published in a peer-reviewed, high-impact journal.
METHODS: A real-time Delphi technique will be used. A planning committee will design the Delphi statements. A steering committee will supervise and monitor the real-time Delphi process. Participants will be asked to rate their agreement with statements using a 5-point Likert scale. The Delphi statements will be derived from review of published literature, and the strength of evidence available for each statement will be provided. We will offer participation to all surgeons and extended-scope practitioners who are current members of the British Elbow & Shoulder Society (BESS) and have clinical practice involving shoulder arthroplasty follow-up. The questionnaire will be active for 4 weeks and requires a minimum of 20 participants. Consensus agreement is defined as 70% of participants selecting at least a 4-point on a 5-point Likert scale.
CONCLUSIONS: We anticipate the outlined study will achieve consensus on long-term follow-up and surveillance of primary shoulder arthroplasty. We intend to use the expert consensus recommendations achieved, in addition to the limited applicable published evidence available, to produce BESS-affiliated guidelines on long-term follow-up and surveillance of primary shoulder arthroplasty.EthicsEthical approval is not required for the real-time Delphi study.We expect the results of this initiative will be published in a peer-reviewed, high-impact journal.
摘要：
背景：肩关节置换术的发生率预计将继续呈指数级增长，因此监测肩关节置换术患者的负担给骨科服务带来了巨大压力。监测提供了研究植入物寿命的机会，检测失败的植入物，并可能以较低的发病率和成本进行翻修。缺乏支持肩关节置换术长期随访建议的证据。比较长期随访和结构的前瞻性研究从时间上讲是不切实际的，资源和成本观点。实时Delphi技术代表了一种机制，通过该机制，参与原发性肩关节置换术长期随访的专家可以通过透明的，可重复和高效的过程。我们概述了一项实时Delphi研究的方案，以寻求对原发性肩关节置换术的长期随访和监测的共识。
方法：将使用实时Delphi技术。规划委员会将设计Delphi报表。指导委员会将监督和监控实时Delphi流程。参与者将被要求使用5分李克特量表对他们与陈述的协议进行评分。德尔菲声明将来自对已发表文献的回顾，并将提供每份声明的可用证据强度。我们将为所有外科医生和扩展范围的从业者提供参与，他们是英国肘关节和肩关节协会（BESS）的现任成员，并具有涉及肩关节成形术随访的临床实践。问卷将持续4周，至少需要20名参与者。共识协议定义为70％的参与者在5点的李克特量表上选择至少4点。
结论：我们预计所概述的研究将在原发性肩关节置换术的长期随访和监测方面达成共识。我们打算利用所达成的专家共识建议,除了可用的有限的适用公开证据外，制定BESS附属的原发性肩关节置换术长期随访和监测指南。EthicsEthicalEthicalapprovalisnotrequiredforthereal-timeDelphistudy.我们预计这一举措的结果将在同行评审中公布，高影响力期刊。
方法：将使用实时Delphi技术。规划委员会将设计Delphi报表。指导委员会将监督和监控实时Delphi流程。参与者将被要求使用5分李克特量表对他们与陈述的协议进行评分。德尔菲声明将来自对已发表文献的回顾，并将提供每份声明的可用证据强度。我们将为所有外科医生和扩展范围的从业者提供参与，他们是英国肘关节和肩关节协会（BESS）的现任成员，并具有涉及肩关节成形术随访的临床实践。问卷将持续4周，至少需要20名参与者。共识协议定义为70％的参与者在5点的李克特量表上选择至少4点。
结论：我们预计所概述的研究将在原发性肩关节置换术的长期随访和监测方面达成共识。我们打算利用所达成的专家共识建议,除了可用的有限的适用公开证据外，制定BESS附属的原发性肩关节置换术长期随访和监测指南。EthicsEthicalEthicalapprovalisnotrequiredforthereal-timeDelphistudy.我们预计这一举措的结果将在同行评审中公布，高影响力期刊。
