title: Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.
abstract: BACKGROUND
  The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care.
  
  
  OBJECTIVE
  To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care.
  
  
  METHODS
  A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE.
  
  
  METHODS
  Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting.
  
  
  RESULTS
  A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'.
  
  
  CONCLUSIONS
  Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.
authors.affiliation: 1 Institute of General Practice, Hannover Medical School, Hannover, Germany.|6 Research Unit Ethics, University Hospital Cologne, 50923 Cologne, Germany.
authors.forename: Saskia
authors.initials: S
authors.lastname: Jünger
authors.affiliation: 2 International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Payne
authors.affiliation: 3 Lancaster University Library, Academic Services, Lancaster University, Lancaster, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Brine
authors.affiliation: 4 Klinik und Poliklinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Germany.|5 Zentrum für Palliativmedizin, Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: 2 International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Brearley
mesh_terms: D003657:Decision Making; D003697:Delphi Technique; D055317:Evidence-Based Practice; D006801:Humans; D010166:Palliative Care
keywords: Delphi technique; methodological systematic review; palliative care; reporting standard