Consensus Development Methods in Health Research

Consensus development methods are structured approaches to synthesise expert judgement in areas where empirical evidence is incomplete, inconsistent or emerging. These methods facilitate collective decision-making by convening panels of experts and guiding them through iterative rounds of elicitation, feedback and revision. Common techniques include the Delphi method, which uses successive questionnaires to refine opinions in anonymity, and the Nominal Group Technique, which relies on face-to-face discussion and ranking exercises. Variants such as modified or rotational Delphi have been introduced to enhance engagement and address logistical constraints. Consensus development underpins the creation of clinical guidelines, the selection of quality indicators and the standardisation of emerging fields—from digital public health to decentralised trials. Strengths of these methods include controlled feedback, geographic flexibility and the ability to integrate multidisciplinary perspectives. Persistent challenges encompass heterogeneity in methodology, varying definitions of agreement thresholds and inconsistent reporting standards. Recent methodological advances aim to improve transparency, optimise panel composition and harness digital platforms to streamline rounds. Globally, consensus methods play a vital role in translating expert insight into practical recommendations, shaping policy and guiding research priorities.

Research from Nature Portfolio

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Research from all publishers

A multidisciplinary Delphi study established 96 indicators to assess the maturity of national digital public health systems, achieving consensus among 54 experts with a 70 percent agreement threshold and highlighting the overlap with existing measurement tools. In dementia research, a modified Delphi approach yielded 40 consensus-based recommendations for conducting decentralised clinical trials in medication prevention, addressing safety, dispensing, outcome assessment and data collection to inform pragmatic trial design. A newly developed reporting guideline for consensus methods in biomedicine, created through a systematic review and three Delphi rounds with 72 international panelists, produced a 35-item checklist covering title, introduction, methods, results, discussion and supplementary information to enhance transparency and reproducibility in consensus-based studies.

Consensus Development Methods in Health Research publication trend

The graph below shows the total number of articles in consensus development methods in health research across all publications each year (not limited to Nature Index journals).

Technical terms

Delphi technique: An iterative, questionnaire-based method that collects and refines expert opinions in anonymity over multiple rounds, using controlled feedback to converge on consensus.

Nominal Group Technique (NGT): A structured face-to-face process where participants independently generate ideas, share them in a round-robin format and collectively rank priorities to achieve agreement.

Consensus threshold: A predefined level of agreement (often expressed as a percentage) among panel members that determines when an item is accepted or rejected.

Reporting guideline (ACCORD): A checklist developed via consensus to standardise the description of methods and results in consensus-based biomedical research, ensuring clarity and transparency.

References

1. International perspectives on measuring national digital public health system maturity through a multidisciplinary Delphi study. npj Digital Medicine (2024).
2. Decentralized clinical trials for medications to reduce the risk of dementia: Consensus report and guidance. Alzheimer's & Dementia (2024).
3. Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review. PLOS ONE (2011).
4. The Modified Delphi Technique - A Rotational Modification. Journal of Career and Technical Education (1999).
5. How to use the nominal group and Delphi techniques. International Journal of Clinical Pharmacy (2016).
6. ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLOS Medicine (2024).