Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1995 August 5; 311(7001): 376–380.
PMCID: PMC2550437

Consensus methods for medical and health services research.


Health providers face the problem of trying to make decisions in situations where there is insufficient information and also where there is an overload of (often contradictory) information. Statistical methods such as meta-analysis have been developed to summarise and to resolve inconsistencies in study findings--where information is available in an appropriate form. Consensus methods provide another means of synthesising information, but are liable to use a wider range of information than is common in statistical methods, and where published information is inadequate or non-existent these methods provide a means of harnessing the insights of appropriate experts to enable decisions to be made. Two consensus methods commonly adopted in medical, nursing, and health services research--the Delphi process and the nominal group technique (also known as the expert panel)--are described, together with the most appropriate situations for using them; an outline of the process involved in undertaking a study using each method is supplemented by illustrations of the authors' work. Key methodological issues in using the methods are discussed, along with the distinct contribution of consensus methods as aids to decision making, both in clinical practice and in health service development.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • McGlynn EA, Kosecoff J, Brook RH. Format and conduct of consensus development conferences. Multi-nation comparison. Int J Technol Assess Health Care. 1990;6(3):450–469. [PubMed]
  • Perry S. The NIH Consensus Development Program. A decade later. N Engl J Med. 1987 Aug 20;317(8):485–488. [PubMed]
  • Perry S, Kalberer JT., Jr The NIH consensus-development program and the assessment of health-care technologies: the first two years. N Engl J Med. 1980 Jul 17;303(3):169–172. [PubMed]
  • Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med. 1991 Sep;151(9):1825–1832. [PubMed]
  • Bellamy N, Anastassiades TP, Buchanan WW, Davis P, Lee P, McCain GA, Wells GA, Campbell J. Rheumatoid arthritis antirheumatic drug trials. III. Setting the delta for clinical trials of antirheumatic drugs--results of a consensus development (Delphi) exercise. J Rheumatol. 1991 Dec;18(12):1908–1915. [PubMed]
  • Chin J, Sato PA, Mann JM. Projections of HIV infections and AIDS cases to the year 2000. Bull World Health Organ. 1990;68(1):1–11. [PubMed]
  • Kahan JP, Bernstein SJ, Leape LL, Hilborne LH, Park RE, Parker L, Kamberg CJ, Brook RH. Measuring the necessity of medical procedures. Med Care. 1994 Apr;32(4):357–365. [PubMed]
  • Crotty M. The emerging role of the British nurse teacher in Project 2000 programmes: a Delphi survey. J Adv Nurs. 1993 Jan;18(1):150–157. [PubMed]
  • Fasser CE, Smith QW, Luchi RJ. Geriatrics fellows' perceptions of the quality of their research training. Acad Med. 1992 Oct;67(10):696–698. [PubMed]
  • Elder OC, Jr, Andrew ME. Important curriculum content for baccalaureate allied health programs: a survey of deans. J Allied Health. 1992 Spring;21(2):105–115. [PubMed]
  • Rizzolo MA. Factors influencing the development and use of interactive video in nursing education. A Delphi study. Comput Nurs. 1990 Jul-Aug;8(4):151–159. [PubMed]
  • Attala JM, Gresley RS, McSweeney M, Jobe MA. Health needs of school-age children in two midwestern counties. Issues Compr Pediatr Nurs. 1993 Jan-Mar;16(1):51–60. [PubMed]
  • Moscovice I, Armstrong P, Shortell S, Bennett R. Health services research for decision-makers: the use of the Delphi technique to determine health priorities. J Health Polit Policy Law. 1977;2(3):388–410. [PubMed]
  • Rainhorn JD, Brudon-Jakobowicz P, Reich MR. Priorities for pharmaceutical policies in developing countries: results of a Delphi survey. Bull World Health Organ. 1994;72(2):257–264. [PubMed]
  • Mobily PR, Herr KA, Kelley LS. Cognitive-behavioral techniques to reduce pain: a validation study. Int J Nurs Stud. 1993 Dec;30(6):537–548. [PubMed]
  • Passannante MR, Restifo RA, Reichman LB. Preventive therapy for the patient with both universal indication and contraindication for isoniazid. Chest. 1993 Mar;103(3):825–831. [PubMed]
  • Smith DM, Murphy WM. Histologic changes in prostate carcinomas treated with leuprolide (luteinizing hormone-releasing hormone effect). Distinction from poor tumor differentiation. Cancer. 1994 Mar 1;73(5):1472–1477. [PubMed]
  • Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: characteristics and guidelines for use. Am J Public Health. 1984 Sep;74(9):979–983. [PubMed]
  • Hunter DJ, McKee CM, Sanderson CF, Black NA. Appropriate indications for prostatectomy in the UK--results of a consensus panel. J Epidemiol Community Health. 1994 Feb;48(1):58–64. [PMC free article] [PubMed]
  • Scott EA, Black N. Appropriateness of cholecystectomy in the United Kingdom--a consensus panel approach. Gut. 1991 Sep;32(9):1066–1070. [PMC free article] [PubMed]
  • Ziemba SE, Hubbell FA, Fine MJ, Burns MJ. Resting electrocardiograms as baseline tests: impact on the management of elderly patients. Am J Med. 1991 Dec;91(6):576–583. [PubMed]
  • Brchan MS, Hegge MJ, Stenvig TE. A tiger by the tail: tackling barriers to differentiated practice. J Contin Educ Nurs. 1991 May-Jun;22(3):109–112. [PubMed]
  • McKee M, Priest P, Ginzler M, Black N. Which tasks performed by pre-registration house officers out of hours are appropriate? Med Educ. 1992 Jan;26(1):51–57. [PubMed]
  • Manning D, Balson PM, Barenberg N, Moore TM. Susceptibility to AIDS: what college students do and don't believe. J Am Coll Health. 1989 Sep;38(2):67–73. [PubMed]
  • Neidlinger SH, Ljutic PM, Moed AB, Chin PP, Kowalczyk ME, Anton RS. Defining the major nursing administration issue: doing more with less. J Nurs Adm. 1993 May;23(5):9–10. [PubMed]
  • Felson DT. Choosing a core set of disease activity measures for rheumatoid arthritis clinical trials. J Rheumatol. 1993 Mar;20(3):531–534. [PubMed]
  • Gallagher M, Hares T, Spencer J, Bradshaw C, Webb I. The nominal group technique: a research tool for general practice? Fam Pract. 1993 Mar;10(1):76–81. [PubMed]
  • Liang MH, Katz JN, Phillips C, Sledge C, Cats-Baril W. The total hip arthroplasty outcome evaluation form of the American Academy of Orthopaedic Surgeons. Results of a nominal group process. The American Academy of Orthopaedic Surgeons Task Force on Outcome Studies. J Bone Joint Surg Am. 1991 Jun;73(5):639–646. [PubMed]
  • Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995 Jul 29;311(7000):299–302. [PMC free article] [PubMed]
  • McKee M, Priest P, Ginzler M, Black N. How representative are members of expert panels? Qual Assur Health Care. 1991;3(2):89–94. [PubMed]
  • Jones J, Sanderson C, Black N. What will happen to the quality of care with fewer junior doctors? A Delphi study of consultant physicians' views. J R Coll Physicians Lond. 1992 Jan;26(1):36–40. [PubMed]
  • Hayward RS, Wilson MC, Tunis SR, Bass EB, Rubin HR, Haynes RB. More informative abstracts of articles describing clinical practice guidelines. Ann Intern Med. 1993 May 1;118(9):731–737. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group