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How Delphi can help overcome four pain points in medical decision-making

  • Claire Terrington
  • Christine Krys
  • Tuesday, 16. May 2023

The Delphi process is a structured method of communi­cation and consensus-building that has proven to be effective in various fields, including life sciences. When it comes to medical decision-making, there are often complex issues that require careful consideration and input from various stakeholders. It is a powerful tool that can help overcome four common pain points in medical decision-making: clarity, collaboration, consensus, and legitimacy.


In life sciences, new therapies can create uncertainty and confusion around definitions and criteria. For example, a new treatment may receive an indication for “locally advanced disease,” which creates uncertainty for physicians because the disease had initially only been described as “localized” or “advanced.” In such cases, a Delphi process can help establish a common understanding and gradually disqualify some hypotheses while confirming others. By testing hypotheses for a common definition and common criteria, a Delphi process can enable participants to arrive at a clearer understanding of the issue at hand.

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Effective collaboration between medical specialties is essential to improve patient outcomes. However, interdisciplinary collaboration is not always easy to achieve. To work effectively, organizations such as medical institutions need to ensure division of labor at the expense of interdisciplinary perspective. For example, to better understand what Best Supportive Care in Hepatocellular Carcinoma comprises, you need to incorporate the views of various specialties – gastroenterologists, oncologists and palliative care specialists from in- and out-patient settings.  Here, the iterative steps of a Delphi process enable better integration of the key specialties. By creating a forum for dialogue and debate, a Delphi process can help participants overcome the barriers to collaboration and work together more effectively.


The impact of Delphi for reaching and disseminating consensus


Building a consensus among medical experts and healthcare providers is essential for innovative therapies to be used more effectively and benefit more patients. However, building consensus is not something that can be imposed or dictated. In some cases, experts are not even aware of the practices of physicians outside centers. For example, to make the best use of a drug against leukemia, adverse cardiovascular events need to be closely managed. However, each institution has different practices, and there are no practical guidelines specific to this class of drugs. Here, a Delphi process helps to create and manage controversial debates and build common guidelines between hematologists, who know the leukemia treatments and their patients best, and cardiologists, who have the expertise to best manage adverse cardiac events. A common path will gradually emerge through a series of discussion steps. By providing a structured process for dialogue and debate, a Delphi process can help participants arrive at a consensus and achieve their goals more effectively.


Scientific communication should be endorsed by medical societies and expert groups to achieve better impact and reach. However, it is sometimes difficult to achieve legitimacy in the medical community, especially when scientific communication is perceived to be driven by commercial interests. A Delphi process is a proven and tested scientific approach that can be independently conducted. Its conclusions can then be endorsed by experts, resulting in publications and recognition by healthcare authorities. 

These pain points are not mutually exclusive and may have a cumulative effect. Therefore, the Delphi process can be a valuable approach to overcoming these challenges in medical decision-making. In such cases, you should consider Delphi as an established expert consensus methodology. 

Claire Terrington

Claire Terrington

is a Senior Consultant at Metaplan and specializes in leading collaborative processes and projects on life science topics, particularly in oncology and hematology.

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Christine Krys

Christine Krys

is a Senior Consultant at Metaplan and guides strategic processes and expert advisory boards for pharmaceutical companies.

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