title: What is agenda setting in the clinical encounter? Consensus from literature review and expert consultation.
abstract: OBJECTIVE
  To establish consensus on the core domains of agenda setting in consultations.
  
  
  METHODS
  We reviewed the healthcare literature and, using a modified Delphi technique to embrace both patient and clinician perspectives, conducted an iterative online survey, with 30 experts in health communication. Participants described agenda setting and rated the importance of proposed domains. Consensus was determined where the group median was ≥5 on a 7-point Likert-like response scale, and the interquartile range fell to within one point on this scale.
  
  
  RESULTS
  Relevant publications were identified in three overlapping bodies of healthcare literature. Survey respondents considered that agenda setting involved a process whereby patients and clinicians establish a joint focus for both their conversation and their working relationship. Consensus was obtained on six core domains: identifying patient talk topics, identifying clinician talk topics, agreement of shared priorities, establishing conversational focus, collaboration and engagement. New terminology--agenda mapping and agenda navigation--is proposed.
  
  
  CONCLUSIONS
  We identified core agenda setting domains that embraced patient and clinician perspectives.
  
  
  CONCLUSIONS
  An integrated conceptualization of agenda setting may now be used by researchers and educators in both clinician and patient focused interventions.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK. Electronic address: GobatNH@cardiff.ac.uk.
authors.forename: Nina
authors.initials: N
authors.lastname: Gobat
authors.affiliation: Institute of Medical Education, Cardiff University, Cardiff, UK. Electronic address: Kinnersley@cardiff.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Kinnersley
authors.affiliation: Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff, UK. Electronic address: GregoryJW@cardiff.ac.uk.
authors.forename: John W
authors.initials: JW
authors.lastname: Gregory
authors.affiliation: South East Wales Trials Unit, Institute of Translation Innovation Methodology and Engagement, Cardiff University, Cardiff, UK. Electronic address: RoblingMR@cardiff.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Robling
mesh_terms: D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration*; D003697:Delphi Technique; D058015:Health Communication; D006801:Humans; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Agenda mapping; Agenda setting; Clinical encounter; Consensus; Consultation; Establish focus; Long term conditions; Modified Delphi technique