An independent jury-based consensus conference model for the development of recommendations in medico-surgical practice.
BACKGROUND
There is an increasing demand for standardization in the choice of treatments for specific conditions, so-called personalized medicine. The task is far from trivial, because the perspectives from many stakeholders must be respected, including patients and health care providers, as well as payers or governments to better control costs while optimizing quality of care. One approach to provide widely accepted therapies is the consensus conference.


METHODS
We describe a novel methodology to achieve consensus in controversial areas with the main goal to minimize biases.


RESULTS
The principle of this approach relies on a clear distinction between those who provide the evidence (experts) and those who draw the final recommendations (the jury). The jury consists of individuals with sufficient background knowledge to cover the perspectives of all stakeholders' without being involved directly in the topic under evaluation. The organizing committee, the experts, and the jury interact within 3 phases: Preparation, the actual consensus conference, and deliberations. Each question is addressed by a panel of experts, leading to the proposition of recommendations at the conference meeting, which are challenged by the jury and the audience. Based on all available information, the jury finalizes the consensus recommendations, which are eventually published and made available to all.


CONCLUSIONS
This novel model of consensus conference allows the construction of consensual, evidence-based, explicit recommendations for therapies in a process that may also identify issues for further research, eventually fostering progress in the field.
Department of Surgery, University Hospital Zurich, Zurich.
Mickaël
M
Lesurtel
Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland.
Arnaud
A
Perrier
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands.
Patrick M M
PM
Bossuyt
Department of Surgery, University of Toronto, Toronto, Canada.
Bernard
B
Langer
Department of Surgery, University Hospital Zurich, Zurich. Electronic address: clavien@access.uzh.ch.
Pierre-Alain
PA
Clavien
D003245:Consensus Statements as Topic; D003718:Denmark; D019317:Evidence-Based Medicine; D005104:Expert Testimony; D005378:Financial Support; D013502:General Surgery; D006801:Humans; D017146:Models, Organizational; D017410:Practice Guidelines as Topic; D057285:Precision Medicine