作者: José Expósito , Juan José Bretón , Carmen Domínguez , Joana Pons
DOI: 10.1007/S12094-010-0542-4
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摘要: Clinical scenarios associated with low therapeutic effectiveness (LTE) are especially complex and highly relevant in oncology. The objective was to test a methodological framework for creating consensual clinical recommendations routine practice. study three phases from Mars 2006 January 2008: 1) Definition of LTE situations; 2) Preparation by 10 experts panel situations cancers breast, lung, head neck, colon rectum brain; 3) Development consensus on each situation its optimal treatment gathering agreement disagreements (two-round Delphi method) 68 practicing oncologists Andalusian Community. Three major minor criteria were established an situation, defined when at least one or two met. expert group proposed 48 possible breast (n = 7), lung (10), brain (11), neck (11) colorectal (9). Sixty-eight agreed participate the study; response rate 79% (from 34 medical 17 radiation oncologists) In first round (definition), maximum obtained definition scenarios; second (treatment options), 3 these scenarios. Oncologists reached levels recommendations. This proposes approach improvement cancer management high uncertainty.