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Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Int+J+Surg 2020 ; 79 (ä): 309-316 Nephropedia Template TP
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International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study #MMPMID32531308
Aj B; C B; T A; Harper E R; Rl H; Rj E
Int J Surg 2020[Jul]; 79 (ä): 309-316 PMID32531308show ga
BACKGROUND: International professional bodies have been quick to disseminate initial guidance documents during the COVID-19 pandemic. In the absence of firm evidence, these have been developed by expert committees, limited in participant number. This study aimed to validate international COVID-19 surgical guidance using a rapid Delphi consensus exercise. METHODS: Delphi statements were directly mapped to guidance from surgical professional bodies in the US and Europe (SAGES/EAES), the UK (Joint RCS), and Australasia (RACS), to validate content against international consensus. Agreement from >/=70% participants was determined as consensus agreement. RESULTS: The Delphi exercise was completed by 339 individuals from 41 countries and 52 statements were mapped to the guidance, 47 (90.4%) reaching consensus agreement. Of these, 27 statements were mapped to SAGES/EAES guidance, 21 to the Joint RCS document, and 33 to the RACS document. Within the SAGES/EAES document, 92.9% of items reached consensus agreement (median 89.0%, range 60.5-99.2%), 90.4% within the Joint RCS document (87.6%, 63.4-97.9%), and 90.9% within the RACS document (85.5%, 18.7-98.8%). Statements lacking consensus related to the surgical approach (open vs. laparoscopic), dual consultant operating, separate instrument decontamination, and stoma formation rather than anastomosis. CONCLUSION: Initial surgical COVID-19 guidance from the US, Europe and Australasia was widely supported by an international expert community, although a small number of contentious areas emerged. These findings should be addressed in future guidance iterations, and should stimulate urgent investigation of non-consensus areas.