title: Using a Delphi process to determine optimal care for patients with pancreatic cancer.
abstract: OBJECTIVE
  Overall 5-year survival for pancreatic cancer is ∼5%. Optimizing the care that pancreatic cancer patients receive may be one way of improving outcomes. The objective of this study was to establish components of care which Australian health professionals believe important to optimally manage patients with pancreatic cancer.
  
  
  METHODS
  Using a Delphi process, a multidisciplinary panel of 250 health professionals were invited to provide a list of factors they considered important for optimal care of pancreatic cancer patients. They were then asked to score and then rescore (from one [no importance/disagree] to 10 [very important/agree]) the factors. The mean and coefficient of variation scores were calculated and categorized into three levels of importance.
  
  
  RESULTS
  Overall, 63 (66% of those sent the final questionnaire; 25% of those initially invited) health professionals from nine disciplines completed the final scoring of 55 statements/factors encompassing themes of presentation/staging, surgery and biliary obstruction, multidisciplinary team details and oncology. Mean scores ranged from 3.7 to 9.7 with the highest related to communication and patient assessment. There was substantial intra- and interdisciplinary variation in views about MDT membership and roles.
  
  
  CONCLUSIONS
  Overall, the opinions of Australian health professionals reflect international guideline recommended care; however, they identified a number of additional factors focusing on where patients should be treated, the importance of clear communication and the need for multidisciplinary care which were not included in current clinical practice guidelines. Differences in priorities between specialty groups were also identified.
authors.affiliation: QIMR Berghofer Medical Research Institute.|School of Public Health.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Burmeister
authors.affiliation: QIMR Berghofer Medical Research Institute.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Jordan
authors.affiliation: Cancer Council NSW.|University of Newcastle.|University of New South Wales.|University of Sydney.
authors.forename: Dianne L
authors.initials: DL
authors.lastname: O'Connell
authors.affiliation: QIMR Berghofer Medical Research Institute.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Beesley
authors.affiliation: University of New South Wales.|Prince of Wales Hospital.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: University of Sydney.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Gooden
authors.affiliation: Queensland University of Technology.
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
authors.affiliation: University of Western Sydney.|Bankstown Hospital, NSW, Australia.
authors.forename: Neil D
authors.initials: ND
authors.lastname: Merrett
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane.|School of Medicine, University of Queensland, Queensland.
authors.forename: David
authors.initials: D
authors.lastname: Wyld
authors.affiliation: QIMR Berghofer Medical Research Institute.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003697:Delphi Technique; D019468:Disease Management; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: Delivery of health care; Delphi technique; health services needs and demand; pancreatic neoplasm