Modified Delphi process to define a standard acupuncture treatment

Objective

We intend to conduct a randomised controlled trial (RCT) of acupuncture for the treatment of tennis elbow and therefore require a standard protocol for optimum treatment. We aimed to achieve this by consensus of experts using a modified Delphi process.

Materials and methods

A total of 22 doctors teaching on British Medical Acupuncture Society training courses were defined as ‘experts’. All were sent an e-mail giving information on, and inviting participation in, the study. A list of treatment factors was developed by the authors from experience, and refined according to STRICTA criteria. Respondents were asked to consider their standard acupuncture treatment of tennis elbow in general practice, and to describe their treatment in the form of open-ended responses in eight specific areas: point selection, needle length and diameter, depth of insertion, treatment duration, interval between treatments, needle stimulation, response to needling and number of treatments.

The authors collated the responses, and wrote a draft treatment protocol, which was circulated to the respondents; their responses led to minor revisions to the protocol, which was then circulated a third time, inviting agreement.

Results

Numbers of doctors that responded to each of the three rounds were 14, 7 and 11, respectively. Good concordance was achieved after the first round, leading to rapid consensus on the protocol and acceptance by all participants within three rounds.

Conclusion

A modified Delphi process can be a simple and effective way of achieving expert consensus on an acupuncture treatment protocol.