• Kathryn Mulryan, Jan Sorensen, and Karen Redmond.
• Professor Eoin O'Malley National Thoracic and Transplant Centre, Mater Misericordiae University Hospital, Eccles St., Dublin, D07R2WY, Ireland. mulryak@tcd.ie.
• Ir J Med Sci. 2024 Apr 1; 193 (2): 843849843-849.

BackgroundLung volume reduction (LVR) is an effective treatment option offered to patients with emphysema. There is no formalised LVR referral network in Ireland. A rigorous approach to agreeing and implementing a LVR referral framework in an Irish context is required. A Delphi process was used to provide a basis for a framework of multi-disciplinary teams (MDTs) which can provide LVR as a management option. A Delphi process offers a framework for understanding variations and developing a consensus from expert opinion.AimThe aim of this study was to develop consensus on recommendations for LVR referral guidelines in an Irish context and provide a national scope based on current practice and evidence.DesignIn accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building Delphi study was performed. Thirty-three statements informed from review of research literature were identified and presented to participants. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ≥ 70% agreement was defined as consensus and items with a consensus rating of < 70% were revised during the process. In total, Delphi questionnaires were distributed to 18 experts with a response rate of 78% (n = 14) and a follow-up response-rate of 50% (n = 7).Setting/ParticipantsThe expert panel in Ireland consisted of representatives from respiratory medicine, cardiothoracic surgery and allied-health professionals with expertise in COPD care.ResultsOf the initial 33 statements in five dimensions, there were consensus regarding 31 statements.ConclusionsThe 31 statements agreed through this Delphi study clarify a coherent direction for development of a LVR framework in Ireland. The Delphi study methodology described is a useful process to reach consensus among multi-disciplinary experts.© 2023. The Author(s).

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