• Saskia Jünger, Sheila A Payne, Jenny Brine, Lukas Radbruch, and Sarah G Brearley.
• 1 Institute of General Practice, Hannover Medical School, Hannover, Germany.
• Palliat Med. 2017 Sep 1; 31 (8): 684-706.

BackgroundThe Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care.AimTo systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care.DesignA methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE.Data SourcesOriginal articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting.ResultsA total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'.ConclusionSubstantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.

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