Evaluating Aesthetic Outcome for Breast Reconstruction; a Delphi Consensus Process for Expert Panel Assessment as a Baseline for an Objective Aesthetic Assessment Tool.
Association of Breast Surgery ePoster Library. Godden A. 05/13/19; 257148; P104
Ms. Amy Godden
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P104
Topic: Oncoplastic and aesthetic surgery
Introduction: Evaluation of reconstructive aesthetics is challenging. In the absence of a gold standard, panel assessment is a widely adopted method. Heterogeneity and poor internal consistency renders comparison challenging. We describe the development of an expert panel method using a Delphi Consensus Model. MethodsREC approved. Consultation with experts in reconstructive breast surgery and literature review shaped the questionnaire for use in a Delphi consensus process. 20 criteria relating to aesthetic assessment were represented. Participants rated each criterion according to importance (1,very important - 9,not important). Distribution of the questionnaire was via iBRA.net and ABS. Iterative rounds of voting with predefined elimination criteria identified key elements of aesthetic assessment for consensus discussion and final round voting. Results61 surgeons (88% consultants) completed Round 1, 49 Round 2, and 18 of them participated in consensus discussion and final round voting. Oncoplastic (75%) and plastic (25%) surgeons were represented. Iterative voting focussed the criteria from 20 to 13 items. After discussion, final voting resulted in symmetry, volume, shape, position of breast mound, nipple position, and a global opinion to be included. It was agreed that panels should comprise 3-5 members and each item should be scored on a 5-point Likert scale. ConclusionsConsensus discussion identified the need for a clear definition of each item to be provided to panel members and final voting resulted in 6 items for inclusion. This provides a framework for panel assessment in the development of an objective outcome tool within a proposed multi-centre study.
Topic: Oncoplastic and aesthetic surgery
Introduction: Evaluation of reconstructive aesthetics is challenging. In the absence of a gold standard, panel assessment is a widely adopted method. Heterogeneity and poor internal consistency renders comparison challenging. We describe the development of an expert panel method using a Delphi Consensus Model. MethodsREC approved. Consultation with experts in reconstructive breast surgery and literature review shaped the questionnaire for use in a Delphi consensus process. 20 criteria relating to aesthetic assessment were represented. Participants rated each criterion according to importance (1,very important - 9,not important). Distribution of the questionnaire was via iBRA.net and ABS. Iterative rounds of voting with predefined elimination criteria identified key elements of aesthetic assessment for consensus discussion and final round voting. Results61 surgeons (88% consultants) completed Round 1, 49 Round 2, and 18 of them participated in consensus discussion and final round voting. Oncoplastic (75%) and plastic (25%) surgeons were represented. Iterative voting focussed the criteria from 20 to 13 items. After discussion, final voting resulted in symmetry, volume, shape, position of breast mound, nipple position, and a global opinion to be included. It was agreed that panels should comprise 3-5 members and each item should be scored on a 5-point Likert scale. ConclusionsConsensus discussion identified the need for a clear definition of each item to be provided to panel members and final voting resulted in 6 items for inclusion. This provides a framework for panel assessment in the development of an objective outcome tool within a proposed multi-centre study.
P104
Topic: Oncoplastic and aesthetic surgery
Introduction: Evaluation of reconstructive aesthetics is challenging. In the absence of a gold standard, panel assessment is a widely adopted method. Heterogeneity and poor internal consistency renders comparison challenging. We describe the development of an expert panel method using a Delphi Consensus Model. MethodsREC approved. Consultation with experts in reconstructive breast surgery and literature review shaped the questionnaire for use in a Delphi consensus process. 20 criteria relating to aesthetic assessment were represented. Participants rated each criterion according to importance (1,very important - 9,not important). Distribution of the questionnaire was via iBRA.net and ABS. Iterative rounds of voting with predefined elimination criteria identified key elements of aesthetic assessment for consensus discussion and final round voting. Results61 surgeons (88% consultants) completed Round 1, 49 Round 2, and 18 of them participated in consensus discussion and final round voting. Oncoplastic (75%) and plastic (25%) surgeons were represented. Iterative voting focussed the criteria from 20 to 13 items. After discussion, final voting resulted in symmetry, volume, shape, position of breast mound, nipple position, and a global opinion to be included. It was agreed that panels should comprise 3-5 members and each item should be scored on a 5-point Likert scale. ConclusionsConsensus discussion identified the need for a clear definition of each item to be provided to panel members and final voting resulted in 6 items for inclusion. This provides a framework for panel assessment in the development of an objective outcome tool within a proposed multi-centre study.
Topic: Oncoplastic and aesthetic surgery
Introduction: Evaluation of reconstructive aesthetics is challenging. In the absence of a gold standard, panel assessment is a widely adopted method. Heterogeneity and poor internal consistency renders comparison challenging. We describe the development of an expert panel method using a Delphi Consensus Model. MethodsREC approved. Consultation with experts in reconstructive breast surgery and literature review shaped the questionnaire for use in a Delphi consensus process. 20 criteria relating to aesthetic assessment were represented. Participants rated each criterion according to importance (1,very important - 9,not important). Distribution of the questionnaire was via iBRA.net and ABS. Iterative rounds of voting with predefined elimination criteria identified key elements of aesthetic assessment for consensus discussion and final round voting. Results61 surgeons (88% consultants) completed Round 1, 49 Round 2, and 18 of them participated in consensus discussion and final round voting. Oncoplastic (75%) and plastic (25%) surgeons were represented. Iterative voting focussed the criteria from 20 to 13 items. After discussion, final voting resulted in symmetry, volume, shape, position of breast mound, nipple position, and a global opinion to be included. It was agreed that panels should comprise 3-5 members and each item should be scored on a 5-point Likert scale. ConclusionsConsensus discussion identified the need for a clear definition of each item to be provided to panel members and final voting resulted in 6 items for inclusion. This provides a framework for panel assessment in the development of an objective outcome tool within a proposed multi-centre study.
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