McMaster University

Michael G. DeGroote
National Pain Centre

Scope of Search

Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain

Appendix A-8: Modified Delphi Process used in NAP Consultation Rounds 2 to 4

Before Round 1 of the Modified Delphi process, all NAP members received the following description of methodology:

  • Through structured responses, NAP members are requested to indicate their degree of support for draft recommendations. An "N/A" response offers an option for NAP members not able to give an opinion about a specific statement.
  • The evidence grade for recommendations lacking Grade A or Grade B evidence will be considered Grade C if NAP reaches consensus.
  • The definition of consensus for this Modified Delphi process is:

    80% of National Advisory Panel respondents indicate that they Agree or Strongly Agree with the statement “I support this recommendation.”
  • Results from the Modified Delphi process will identify:
    • recommendations the NAP supports by consensus
    • recommendations that require further consultation with NAP.
  • Following NOUGG analysis of all NAP replies, each respondent will receive a comparison of their own individual feedback and the aggregate NAP responses.
  • The Modified Delphi process will be used in subsequent guideline rounds as required.
  • After Round 2 of the Modified Delphi process, recommendations based on Grade C evidence only and failing to reach consensus will be eliminated. However, recommendations based on Grade A and/or B evidence that fail to achieve consensus will undergo further revision for consideration by NAP in a third round.