背景:本德尔菲研究的目的是就定义达成共识,视觉追踪(VP)和视觉固定(VF)的操作和评估。
方法:在一项三轮国际德尔菲研究中,意识障碍的临床和研究专家使用5点Likert量表表示他们对87种陈述的一致性水平。共识定义为中位数为5,四分位数间距(IQR)≤1,≥80%表示中度或强烈的一致性。
结果:来自三大洲的43位专家参加了会议,32完成了所有三轮比赛。对于VP,达成最高共识的共识是“追求视觉刺激”,描述“在水平和/或垂直平面上视觉跟随的能力”,持续时间>2s,在水平和垂直平面中跟踪,每次评估的频率超过2次。对于VF,具有最高共识的共识声明是关于“持续VF”的术语,描述“响应显著刺激而持续固定”,每次评估的持续时间>2s,频率为2次或更多次。一致性最高的评估因素是个性化刺激,使用眼动追踪技术,取决于患者的评估时间,充足的环境光线,直立姿势,以及排除眼/动眼问题的必要性。
结论:这项关于意识障碍患者VP和VF的国际Delphi研究提供了临时操作定义和最相关评估因素的概述。
BACKGROUND: The aim of this Delphi study was to reach
consensus about definition, operationalization and assessment of visual pursuit (VP) and visual fixation (VF).
METHODS: In a three-round international Delphi study, clinical and research experts on disorders of consciousness indicated their level of agreement on 87 statements using a 5-point Likert scale.
Consensus for agreement was defined by a median of 5, an interquartile range (IQR) ≤ 1, and ≥ 80% indicating moderate or strong agreement.
RESULTS: Forty-three experts from three continents participated, 32 completed all three rounds. For VP, the
consensus statements with the highest levels of agreement were on the term \'pursuit of a visual stimulus\', the description \'ability to follow visually in horizontal and/or vertical plane\', a duration > 2 s, tracking in horizontal and vertical planes, and a frequency of more than 2 times per assessment. For VF,
consensus statements with the highest levels of agreement were on the term \'sustained VF\', the description \'sustained fixation in response to a salient stimulus\', a duration of > 2 s and a frequency of 2 or more times per assessment. The assessment factors with the highest levels of agreement were personalized stimuli, the use of eye tracking technology, a patient dependent time of assessment, sufficient environmental light, upright posture, and the necessity to exclude ocular/oculomotor problems.
CONCLUSIONS: This first international Delphi study on VP and VF in patients with disorders of consciousness provides provisional operational definitions and an overview of the most relevant assessment factors.