Summary: An iterative questionnaire designed to measure consensus among individual responses. In the classic Delphi approach, there is no interaction between responder and interviewer.
Publications269 found, 100 shown here
- Public health worker competencies for emergency responseKristine Gebbie
Center for Health Policy, Columbia University School of Nursing, New York, New York, USA
J Public Health Manag Pract 8:73-81. 2002..Documentation of the qualitative research methods used, which include competency validation with the practice community, can be applied to competency development in other areas of public health practice...
- Factors associated with the effectiveness of continuing education in long-term carePaul Stolee
Southwestern Ontario Regional Geriatric Program, c o St Joseph s Health Care London, 801 Commissioners Road East, London, Ontario N6C 5J1, Canada
Gerontologist 45:399-409. 2005..This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education...
- Defining the Bobath concept using the Delphi techniqueSue Raine
Regional Neurological Rehabilitation Centre, Newcastle upon Tyne, UK
Physiother Res Int 11:4-13. 2006..The aim of the present study was to use the Delphi technique to enable experts in the field to define the current Bobath concept.
- Categorization of major and minor complications in the treatment of patients with resectable rectal cancer using short-term pre-operative radiotherapy and total mesorectal excision: a Delphi roundR Bakx
Department of Surgery, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
Colorectal Dis 8:302-8. 2006..The aim of this study was to reach consensus regarding major and minor complications after short-term radiotherapy followed by total mesorectal excision in the treatment of rectal carcinoma, using the Delphi technique.
- [Spanish physicians point of view on irritable bowel syndrome (IBS). Results of a Delphi survey]C Almansa
Servicio de Aparato Digestivo, Hospital Clinico San Carlos, Madrid, Spain
Rev Esp Enferm Dig 99:210-7. 2007..lack of evidence in most clinical situations regarding irritable bowel syndrome (IBS) enhances the importance of an expert s opinion, which will guide management and even the concept underlying the disease...
- Research guidelines for the Delphi survey techniqueF Hasson
Centre for Nursing Research, University of Ulster, Newtownabbey, Northern Ireland
J Adv Nurs 32:1008-15. 2000..The paper does not claim to be definitive; it purports to act as a guide for those researchers who wish to exploit the Delphi methodology...
- Developing a quality criteria framework for patient decision aids: online international Delphi consensus processGlyn Elwyn
Department of General Practice, Centre for Health Sciences Research, Cardiff University, Cardiff CF14 4YS
BMJ 333:417. 2006..To develop a set of quality criteria for patient decision support technologies (decision aids)...
- The Delphi technique: myths and realitiesCatherine Powell
Lecturer in Child Health Nursing, School of Nursing and Midwifery, University of Southampton, Southampton, UK
J Adv Nurs 41:376-82. 2003To outline the key concepts and principles of the Delphi technique.
- A critical review of the Delphi technique as a research methodology for nursingS Keeney
Centre for Nursing Research, University of Ulster, Shore Road, Newtownabbey BT37 0QB, Northern Ireland, UK
Int J Nurs Stud 38:195-200. 2001The Delphi technique is an approach used to gain consensus among a panel of experts. This is normally achieved through a series of rounds where information is fed back to panel members using questionnaires...
- Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstrumentsL B Mokkink
Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
BMC Med Res Methodol 6:2. 2006..The COSMIN standards will be made available in the form of an easily applicable checklist...
- Consulting the oracle: ten lessons from using the Delphi technique in nursing researchSinead Keeney
Senior Research Fellow, Institute of Nursing Research, University of Ulster, Belfast, UK
J Adv Nurs 53:205-12. 2006The aim of this paper was to provide insight into the Delphi technique by outlining our personal experiences during its use over a 10-year period in a variety of applications.
- Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic CriteriaSilvia Evers
Department of Health Policy and Economics, Institute for Rehabilitation Research, Maastricht University, The Netherlands
Int J Technol Assess Health Care 21:240-5. 2005..The criteria list resulting from this CHEC project should be regarded as a minimum standard...
- A quality management model for integrated care: results of a Delphi and Concept Mapping studyMirella Minkman
Vilans, Centre of Excellence in Long term Care, Catharijnesingel 47, 3511 GC Utrecht, The Netherlands
Int J Qual Health Care 21:66-75. 2009..The objective of this study is to identify the elements and clusters of a quality management model for integrated care...
- Delphi as a method to establish consensus for diagnostic criteriaBrent Graham
Toronto Western Hospital, 399 Bathurst Street, FP 174 M5T 2S8, Toronto, ON, Canada
J Clin Epidemiol 56:1150-6. 2003..To achieve a consensus, among a panel of experts, on the best clinical criteria for the clinical diagnosis of carpal tunnel syndrome (CTS)...
- Reporting data on homeopathic treatments (RedHot): a supplement to CONSORTM E Dean
Department of Health Sciences, Seebohm Rowntree Building, University of York, UK
Homeopathy 96:42-5. 2007..The authors recommend these for adoption by authors and journals when reporting trials of homeopathy...
- Development of generic quality indicators for patient-centered cancer care by using a RAND modified Delphi methodEleonora P M M Uphoff
Scientific Institute for Quality of Healthcare, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, The Netherlands
Cancer Nurs 35:29-37. 2012..Despite growing attention to patient-centered care, the needs of cancer patients are not always met...
- Designing a proficiency-based, content validated virtual reality curriculum for laparoscopic colorectal surgery: a Delphi approachVanessa N Palter
University of Toronto, Toronto, Ontario, Canada
Surgery 151:391-7. 2012..The purpose of this study was to develop a proficiency-based VR technical skills curriculum for laparoscopic colorectal surgery...
- Self-help strategies that are helpful for sub-threshold depression: a Delphi consensus studyAmy J Morgan
Orygen Youth Health Research Centre, Department of Psychiatry, University of Melbourne, Australia
J Affect Disord 115:196-200. 2009..Sub-threshold depressive symptoms cause substantial disability in the population and are often managed with self-help strategies. However, it is unclear which self-help strategies are likely to be helpful and should be encouraged...
- Delphi: myths and realityPenelope M Mullen
Health Services Management Centre, University of Birmingham, Birmingham, UK
J Health Organ Manag 17:37-52. 2003..Through critical examination of some of the controversies and misunderstandings that surround Delphi, this paper aims to dispel some of the myths and demonstrates the wide scope and potential of this versatile approach...
- Dysfunctional tear syndrome: a Delphi approach to treatment recommendationsAshley Behrens
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287 9278, USA
Cornea 25:900-7. 2006..To develop current treatment recommendations for dry eye disease from consensus of expert advice...
- The management of thymoma: a systematic review and practice guidelineConrad B Falkson
Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, Ontario, Canada
J Thorac Oncol 4:911-9. 2009..Thymoma is a rare tumor for which there is little randomized evidence to guide treatment. Because of the lack of high-quality evidence, a formal consensus-based approach was used to develop recommendations on treatment...
- The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi studyLidwine B Mokkink
Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
Qual Life Res 19:539-49. 2010..We present the COSMIN checklist and the agreement of the panel on the items of the checklist...
- Prescribing indicators for UK general practice: Delphi consultation studyS M Campbell
National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL
BMJ 321:425-8. 2000..To identify prescribing indicators based on prescribing analysis and cost (PACT) data that have face validity for measuring quality or cost minimisation...
- Helping someone with problem drinking: mental health first aid guidelines - a Delphi expert consensus studyAnna H Kingston
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, 35 Poplar Rd Locked Bag 10, Parkville, Victoria 3052, Australia
BMC Psychiatry 9:79. 2009..This paper describes the development of mental health first aid guidelines that inform community members on how to help someone who may have, or may be developing, a drinking problem (i.e., alcohol abuse or dependence)...
- Preliminary core sets of measures for disease activity and damage assessment in juvenile systemic lupus erythematosus and juvenile dermatomyositisNicolino Ruperto
IRCCS G Gasalini, Pediatria II, Genova, Italy
Rheumatology (Oxford) 42:1452-9. 2003..To identify preliminary core sets of outcome variables for disease activity and damage assessment in juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM)...
- The quality of communication about older patients between hospital physicians and general practitioners: a panel study assessmentHelge Garåsen
Department of Public Health and General Practice, Faculty of Medicine, The Norwegian University of Science and Technology NTNU, Trondheim, Norway
BMC Health Serv Res 7:133. 2007..The main objectives of this study were to assess the quality of the written communication between physicians and to estimate the number of patients that could have been treated at primary care level instead of at a general hospital...
- Migration and perinatal health surveillance: an international Delphi surveyAnita J Gagnon
School of Nursing and Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
Eur J Obstet Gynecol Reprod Biol 149:37-43. 2010....
- Internet-delivered interventions aimed at adolescents: a Delphi study on dissemination and exposureRik Crutzen
Department of Health Education ealth Promotion, School for Public Health and Primary Care CAPHRI, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
Health Educ Res 23:427-39. 2008..Overall, the results of this exploration serve as a handle for the formation of further research questions to be tested and answered in research among adolescents...
- Criteria to determine readiness for hospital discharge following colorectal surgery: an international consensus using the Delphi techniqueJulio F Fiore
Melbourne School of Health Sciences, The University of Melbourne, Victoria, Australia
Dis Colon Rectum 55:416-23. 2012..Standardized discharge criteria are considered valuable to reduce the risk of premature discharge and avoid unnecessary hospital stays. The most appropriate criteria to indicate readiness for discharge after colorectal surgery are unknown...
- Practical application of the Delphi technique in a bicultural mental health nursing study in New ZealandDerrylea J Hardy
School of Health Sciences, Massey University, Palmerston North, New Zealand
J Adv Nurs 46:95-109. 2004Numerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice...
- A Delphi survey of evidence-based nursing priorities in Hong KongPeter French
Department of Nursing and Health Sciences, The Hong Kong Polytechnic University, Hong Kong
J Nurs Manag 10:265-73. 2002..The top 10 items were used to inform the advisory and selection processes for the evidence-based practice development project...
- Consensus-based standards for best supportive care in clinical trials in advanced cancerS Yousuf Zafar
Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Lancet Oncol 13:e77-82. 2012..Availability of resources was cited as a challenge to implementation of best supportive care standards...
- Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi techniqueGabrielle Rankin
Development and Research Unit, Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED, UK
Physiotherapy 98:260-72. 2012..To define research priorities to strategically inform the evidence base for physiotherapy practice...
- Nursing diagnoses (NANDA-I) in hematology-oncology: a Delphi-studyHerma T Speksnijder
Erasmus MC, Rotterdam, The Netherlands
Int J Nurs Terminol Classif 22:77-91. 2011..To identify NANDA-I diagnoses that are most relevant to hematology-oncology nursing in Europe...
- Identifying appropriate tasks for the preregistration year: modified Delphi techniqueJ Stewart
Postgraduate Institute for Medicine and Dentistry, Newcastle upon Tyne NE2 4AB
BMJ 319:224-9. 1999..To identify the tasks that should constitute the work of preregistration house officers to provide the basis for the development of a self evaluation instrument...
- The development of indicators to measure the quality of clinical care in emergency departments following a modified-delphi approachPatrice Lindsay
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Acad Emerg Med 9:1131-9. 2002..To develop and apply a systematic approach to identify and define valid, relevant, and feasible measures of emergency department (ED) clinical performance...
- Indicators for follow-up of multidisciplinary teamwork in care processes: results of an international expert panelSvin Deneckere
Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 35, Leuven, Belgium
Eval Health Prof 34:258-77. 2011..Scientific researchers and hospital managers that want to study and improve multidisciplinary teamwork in care processes should primarily focus on these team indicators...
- An accessible analytical approach for investigating what happens between the rounds of a Delphi studyJ Greatorex
University of Cambridge Local Examinations Syndicate, England
J Adv Nurs 32:1016-24. 2000..An example Delphi study from a healthcare setting is used to illustrate the methodology...
- International identification of research priorities for postgraduate theses in musculoskeletal physiotherapy using a modified Delphi techniqueAlison Rushton
School of Health and Population Sciences, College of Medicine and Dentistry, 52 Pritchatts Road, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
Man Ther 15:142-8. 2010..Establishing priorities provides a vision of how postgraduate theses can contribute to the developing evidence base and offer a focus for international collaboration...
- Factors underlying smoking relapse prevention: results of an international Delphi studyI Elfeddali
Department of Health Promotion and Health Education, Maastricht University, The Netherlands
Health Educ Res 25:1008-20. 2010..Generally speaking, the researchers and coaches provided similar suggestions. The results paint a picture of the current state of knowledge on relapse-related factors and point the way to areas for further research...
- Considering the implication of variations within Delphi researchMiles Thompson
Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, UK
Fam Pract 26:420-4. 2009..This paper provides an overview of the technique and explains these variations and their implications before highlighting possible ways forward...
- Towards consensus in operational definitions in functional capacity evaluation: a Delphi SurveyRemko Soer
Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands
J Occup Rehabil 18:389-400. 2008..This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE...
- Simulation performance checklist generation using the Delphi techniquePamela J Morgan
Department of Anesthesia, Women s College Hospital, University of Toronto, Toronto, Ontario, Canada
Can J Anaesth 54:992-7. 2007..The Delphi technique is a consensus based content generation method used for multiple purposes such as policy development, best-..
- Stability of response characteristics of a Delphi panel: application of bootstrap data expansionRalitsa B Akins
Quality and Patient Safety Initiatives, Rural and Community Health Institute, The Texas A and M University System Health Science Center, College Station, Texas, USA
BMC Med Res Methodol 5:37. 2005..Despite this wide applicability of the Delphi methodology, there is no clear identification of what constitutes a sufficient number of Delphi survey participants to ensure stability of results...
- Development of an instrument to assess the quality of acupuncture: results from a Delphi processCaroline A Smith
Centre for Complementary Medicine Research, The University of Western Sydney, Penrith South, Australia
J Altern Complement Med 17:441-52. 2011..Quality acupuncture influences the outcomes of clinical research, and issues associated with effective administration of acupuncture in randomized controlled trials need to be addressed when appraising studies...
- Problems in psychiatric care of 'difficult patients': a Delphi-studyBauke Koekkoek
Altrecht Mental Health Care, Department of Outpatient Community Care, Zeist, The Netherlands
Epidemiol Psichiatr Soc 18:323-30. 2009....
- Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi studyClaire M Kelly
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
BMC Psychiatry 10:49. 2010..However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed...
- Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi processHamideh M Esmaily
Division of International Health IHCAR, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
BMC Med Educ 8:33. 2008..The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education...
- An exploration of the use of simple statistics to measure consensus and stability in Delphi studiesElizabeth A Holey
School of Health and Social Care, University of Teesside, Middlesbrough, TS1 3BA, UK
BMC Med Res Methodol 7:52. 2007..The criteria for stopping Delphi studies are often subjective. This study aimed to examine whether consensus and stability in the Delphi process can be ascertained by descriptive evaluation of trends in participants' views...
- The Delphi technique in health sciences education researchMarietjie R de Villiers
School of Public and Primary Health Sciences, University of Stellenbosch, South Africa
Med Teach 27:639-43. 2005The Delphi technique is a method of collecting opinion on a particular research question...
- A web-based Delphi study on the indications of chest radiographs for patients in ICUsGilles Hejblum
U707, Hopital Saint Antoine, Assistance Publique Hopitaux de Paris, Paris, France
Chest 133:1107-12. 2008..The opinions of intensivists about ordering CXRs have not been reported. Comparing these opinions to established guidelines and identifying situations where opinions diverge in the absence of guidelines are of considerable interest...
- Hospitalization for ambulatory care-sensitive conditions: a method for comparative access and quality studies using routinely collected statisticsA D Brown
Department of Public Health and Primary Care, University of Oxford
Can J Public Health 92:155-9. 2001..This article describes conditions for which hospitalization rates have a strong and inverse relationship to access to high-quality ambulatory care...
- How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?S M Campbell
National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK
Qual Saf Health Care 13:428-34. 2004..However, little is known about the dynamics of consensus techniques and the factors that influence the judgements and ratings of panels and individual panelists...
- EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)W Zhang
Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
Ann Rheum Dis 66:377-88. 2007..To develop evidence based recommendations for the management of hand osteoarthritis (OA)...
- Guideline-based development of quality indicators for subfertility careS M Mourad
Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
Hum Reprod 22:2665-72. 2007..However, none of the existing subfertility guideline programmes is accompanied by a satisfactory set of quality indicators. In this study, we develop a set of valid guideline-based quality indicators for subfertility care...
- Canadian Consensus Conference on the management of gastroesophageal reflux disease in adults - update 2004David Armstrong
Division of Gastroenterology, McMaster University, Hamilton
Can J Gastroenterol 19:15-35. 2005..Since the last Canadian Consensus Conference in 1996, GERD management has evolved substantially...
- Work ability in sick-listed patients with major depressive disorderFrans G Slebus
Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Occup Med (Lond) 58:475-9. 2008..Major depressive disorder (MDD) is often a chronic relapsing disease resulting in work disability. For evaluation purposes a practical set of aspects of work ability would be helpful...
- Identifying the core components of cultural competence: findings from a Delphi studyMaria Jirwe
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden
J Clin Nurs 18:2622-34. 2009..Existing frameworks of cultural competence reflect the socio-cultural, historical and political context they were developed in. To date, there has been no research examining cultural competence within a Swedish context...
- The development of an internet-based outpatient cardiac rehabilitation intervention: a Delphi studyCorneel Vandelanotte
Centre for Physical Activity Studies, Institute for Health and Social Sciences Research, Central Queensland University, Rockhampton 4702, Australia
BMC Cardiovasc Disord 10:27. 2010..Only a very limited number of Internet-based OCR programs have been developed and evaluated. Therefore, the purpose of this study was to identify issues that are relevant to the development of an Internet-based OCR intervention...
- Pathology reporting of neuroendocrine tumors: application of the Delphic consensus process to the development of a minimum pathology data setDavid S Klimstra
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
Am J Surg Pathol 34:300-13. 2010..Examination of the areas of disagreement reveals significant opportunities for collaborative study to resolve unanswered questions...
- What is a prescribing error?B Dean
Academic Pharmacy Unit, Hammersmith Hospitals NHS Trust, London W12 0HS
Qual Health Care 9:232-7. 2000..To develop a practitioner led definition of a prescribing error for use in quantitative studies of their incidence...
- Real time patient safety audits: improving safety every dayR Ursprung
Children s Hospital Boston, Boston, MA, USA
Qual Saf Health Care 14:284-9. 2005..Methods successful at improving quality and safety in industry may provide avenues for improvement in patient safety...
- A Delphi study to identify performance indicators for emergency medicineE Beattie
Accident and Emergency Department, St Mary s Hospital, London, UK
Emerg Med J 21:47-50. 2004..The aim of this study was to identify performance indicators thought to reflect the quality of patient care in the emergency department...
- Quality indicators for primary care mental health servicesT Shield
National Primary Care Research and Development Centre, University of Manchester, UK
Qual Saf Health Care 12:100-6. 2003..To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement...
- The identification of criteria to evaluate prehospital trauma care using the Delphi techniqueMatthew R Rosengart
Department of Surgery, University of Pittsburgh, PA 15213, USA
J Trauma 62:708-13. 2007..This study identifies the most important filters for auditing prehospital trauma care using a Delphi technique to achieve consensus of expert opinion.
- A proposal for case definitions and outcome measures in studies of infantile spasms and West syndrome: consensus statement of the West Delphi groupAndrew L Lux
Bath Unit for Research in Paediatrics, Royal United Hospital, Bath, United Kingdom
Epilepsia 45:1416-28. 2004..To reach a broad consensus on case definitions, outcomes, and outcome measures that will ease future study design and facilitate comparison of data from different studies of infantile spasms and West syndrome...
- Do different stakeholder groups share mental health research priorities? A four-arm Delphi studyChristabel Owens
Devon Partnership NHS Trust, Exeter, UK
Health Expect 11:418-31. 2008..Conflicting priorities may jeopardize stakeholder engagement in research...
- Eliciting expert opinion using the Delphi technique: identifying performance indicators for cardiovascular diseaseS L Normand
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Int J Qual Health Care 10:247-60. 1998..Methods are demonstrated using the data from five distinct panels convened as part of the Harvard Q-SPAN-CD study, a nationally-funded project whose goal is to identify a set of cardiovascular-related performance measures...
- Expert consensus on the desirable characteristics of review criteria for improvement of health care qualityH M Hearnshaw
Centre for Primary Health Care Studies, University of Warwick, Coventry CV4 7AL, UK
Qual Health Care 10:173-8. 2001..To identify the desirable characteristics of review criteria for quality improvement and to determine how they should be selected...
- Development of ovarian cancer surgery quality indicators using a modified Delphi approachAnna R Gagliardi
Surgical Oncology Program, Cancer Care Ontario, Toronto, Ontario, Canada
Gynecol Oncol 97:446-56. 2005..This work was conducted to develop indicators of quality ovarian cancer surgery using a modified three-step Delphi approach...
- Clinical problems in community mental health care for patients with severe borderline personality disorderB Koekkoek
Department of Outpatient Community Care, Altrecht Mental Health Care, Zeist, The Netherlands
Community Ment Health J 45:508-16. 2009..Patient, professional, and organisational characteristics of community care differ substantially from those of specialized care. The field is thus in need of a more tailored approach that takes these differences into account...
- TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi processJonathan I Bisson
Department of Psychological Medicine and Neurology, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK
Br J Psychiatry 196:69-74. 2010..How best to plan and provide psychosocial care following disasters remains keenly debated...
- Use of the Delphi Technique for developing national clinical guidelines for prescription of lower-limb prosthesesHarmen van der Linde
Rehabilitation Centre Sint Maartenskliniek, Nijmegen, The Netherlands
J Rehabil Res Dev 42:693-704. 2005..This article describes a modified Delphi Technique, which is based on different methods of collecting evidence, and its role in the development of national ..
- An international expert Delphi study to determine research needs in major incident managementKevin Mackway-Jones
Centre for Effective Emergency Care, Manchester Metropolitan University, Manchester, UK
Prehosp Disaster Med 27:351-8. 2012..To collate the opinions of experts and to reach consensus about the research priorities in the management of major incidents...
- Emergency calls not requiring an urgent ambulance response: expert consensusMalcolm Woollard
Pre hospital Emergency Research Unit, University of Wales College of Medicine Welsh Ambulance Services NHS Trust, Cardiff, UK
Prehosp Emerg Care 7:384-91. 2003....
- Feasibility of implementing recommendations to improve communicable diseases surveillance--a modified Delphi studyN Sahal
Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark SDU, Esbjerg, Denmark
Afr Health Sci 11:S93-9. 2011....
- Required competencies of occupational physicians: a Delphi survey of UK customersK N Reetoo
Healthy Working Lives Research Group, Public Health and Health Policy Section, Division of Community Based Sciences, University of Glasgow, UK
Occup Environ Med 62:406-13. 2005..Occupational physicians can contribute to good management in healthy enterprises. The requirement to take into account the needs of the customers when planning occupational health services is well established...
- [Consensus methods: review of original methods and their main alternatives used in public health]F Bourrée
Laboratoire santé, Travail, environnement EA 3672, ISPED, Universite Victor Segalen Bordeaux 2, Bordeaux, France
Rev Epidemiol Sante Publique 56:415-23. 2008....
- Determinants of forward stage transitions: a Delphi studyEmely De Vet
Department of Health Education romotion, Universiteit Maastricht, 6200 MD, Maastricht, The Netherlands
Health Educ Res 20:195-205. 2005..The Delphi study identified hypotheses worthy of further examination in longitudinal observational and experimental studies...
- Clinical and laboratory follow-up for treating and monitoring patients with ankylosing spondylitis: development of recommendations for clinical practice based on published evidence and expert opinionEmmanuelle Dernis
Service de Rhumatologie, CH Le Mans, Le Mans, France
Joint Bone Spine 74:330-7. 2007..To develop French recommendations about the clinical and laboratory follow-up of patients with axial ankylosing spondylitis (AS) seen in everyday practice...
- The International Universities Walking Project: development of a framework for workplace intervention using the Delphi techniqueNicholas Gilson
School of Human Movement Studies, University of Queensland, Queensland, Australia
J Phys Act Health 6:520-8. 2009This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention.
- The creation of an objective assessment tool for ultrasound-guided regional anesthesia using the Delphi methodJeffrey J H Cheung
Department of Anesthesia, Sunnybrook Health Sciences Centre and the Holland Orthopedic and Arthritic Centre, University of Toronto, Toronto, Canada
Reg Anesth Pain Med 37:329-33. 2012..The objective of this study was to develop a checklist to assess training progress and to detect training gaps in ultrasound-guided regional anesthesia using the Delphi method...
- Development and validation of quality indicators for dementia diagnosis and management in a primary care settingMarieke Perry
Geriatric Medicine, 925, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
J Am Geriatr Soc 58:557-63. 2010..To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting...
- Is there a role for TNFα antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi techniqueJoerg H W Distler
Department of Rheumatology, University of Erlangen Nuremberg, Germany
Clin Exp Rheumatol 29:S40-5. 2011..To obtain experiences and expert opinion on treatment of SSc patients with TNF-α antagonists...
- Identifying priority areas for longitudinal research in childhood obesity: Delphi technique surveySusan Byrne
School of Psychology, The University of Western Australia, Nedlands, WA 6009
Int J Pediatr Obes 3:120-2. 2008..and adolescent obesity research questions remain to be addressed through longitudinal research?" Using the Delphi Technique, ACAORN members individually generated then refined and prioritised a set of research ideas...
- Preventing drug-related morbidity--the development of quality indicatorsC J Morris
School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Oxford Road, Manchester, UK
J Clin Pharm Ther 28:295-305. 2003..To describe the process that has been undertaken to (i) validate further UK indicators for preventable drug-related morbidity (PDRM) generated by a previous study and (ii) develop additional new indicators derived from UK clinical practice...
- Development of a clinical examination in non-specific low back pain: a Delphi techniqueChristopher J McCarthy
Centre for Rehabilitation Science, University of Manchester, Manchester Royal Infirmary, Manchester, UK
J Rehabil Med 38:263-7. 2006..To establish the discriminatory items of the clinical examination of non-specific low back pain, important to physiotherapists...
- Development of an objective evaluation tool to assess technical skill in laparoscopic colorectal surgery: a Delphi methodologyVanessa N Palter
Wilson Centre, Toronto, ON, Canada
Am J Surg 201:251-9. 2011..The aim of this study was to determine expert consensus regarding items required on a rating scale for LCS, using a Delphi technique.
- The ICF Core Set for stroke from the perspective of physicians: a worldwide validation study using the Delphi techniqueI Lemberg
Institute for Health and Rehabilitation Sciences IHRS, Ludwig Maximilian University, Munich, Germany
Eur J Phys Rehabil Med 46:377-88. 2010..The ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with stroke...
- The comprehensive ICF core sets for spinal cord injury from the perspective of occupational therapists: a worldwide validation study using the Delphi techniqueK H Herrmann
Institute for Health and Rehabilitation Sciences, Ludwig Maximilian University, Munich, Germany
Spinal Cord 49:600-13. 2011....
- Management of the injured patient: identification of research topics for systematic review using the delphi techniqueAvery B Nathens
Department of Surgery, Harborview Injury Prevention and Research Center, University of Washington, Seattle, 98104, USA
J Trauma 54:595-601. 2003..This study identifies the most important research questions pertaining to the acute care of the injured patient using a Web-based Delphi technique to achieve consensus of expert opinion.
- Engaging communication experts in a Delphi process to identify patient behaviors that could enhance communication in medical encountersJaya K Rao
Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, 2202 Kerr Hall, CB 7573, Chapel Hill, NC 27599, USA
BMC Health Serv Res 10:97. 2010..Using the Four Habits Model as a starting point, we asked communication experts to identify the verbal communication behaviors of patients that are important in outpatient encounters...
- Delphi survey of experts' opinions on strategies used by community pharmacists to reduce over-the-counter drug misuseAndrew J McBride
Specialist Community Addiction Service, The Rectory Centre, Oxford UK
Addiction 98:487-97. 2003....
- Predictive factors of chronic pediatric pain and disability: a Delphi pollJordi Miró
Department of Psychology, Rovira i Virgili University, Catalonia, Spain
J Pain 8:774-92. 2007..If supported by further research, these results may ultimately help develop intervention programs that could prevent long-term pain in disability in children and adolescents...
- Indicators of lumbar zygapophyseal joint pain: survey of an expert panel with the Delphi techniqueViktoria E Wilde
School of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia
Phys Ther 87:1348-61. 2007..The purpose of this study was to obtain a consensus from an expert panel on the indicators of LZJ pain...
- Determination of required pharmacological knowledge for clinical practice in emergency medicine using a modified Delphi techniqueD A Kilroy
College of Emergency Medicine, London, UK
Emerg Med J 24:645-7. 2007..To identify the content of the national postgraduate pharmacology curriculum for trainees in UK emergency medicine...
- The development of a national pediatric trauma curriculumRahim A Valani
University of Toronto, Toronto, Ontario, Canada
Med Teach 32:e115-9. 2010..Post-certification fellowships in pediatric medicine all mandate education in the assessment and management of the injured child. The purpose of this study was to develop a blueprint for a national pediatric trauma training curriculum...
- Content validation of the infant malnutrition and feeding checklist for congenital heart disease: a tool to identify risk of malnutrition and feeding difficulties in infants with congenital heart diseaseAstrid St Pierre
Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, B C, Canada
J Pediatr Nurs 25:367-74. 2010..This study is the first step in establishing the validity and reliability of a screening tool for early intervention of feeding difficulties and inadequate nutritional intake in infants with CHD...
- Reliability of clinical guideline development using mail-only versus in-person expert panelsDonna L Washington
VA Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
Med Care 41:1374-81. 2003..The RAND-UCLA Appropriateness Method is one commonly used method for collecting expert opinion. We tested whether a less expensive, mail-only process could substitute for the standard in-person process normally used...
- Methodological and conceptual issues confronting a cross-country Delphi study of educational program evaluationHsin Ling Hung
Evaluation Services Center, University of Cincinnati, PO Box 21015, One Edwards Center, Cincinnati, OH 45221 0105, USA
Eval Program Plann 31:191-8. 2008..Some of these problems are generic to the Delphi whereas others related to the specifics of the investigation. What we learned should be useful for future Delphis with a similar focus...
- Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi studyLaura M Hart
Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
BMC Psychiatry 10:78. 2010..g. abuse or dependence)...
- CESSATION IN HEAVY SMOKERS USING NRT AND ADJUVANT VIDEOBeti Thompson; Fiscal Year: 2001..With an anticipated difference of 10 percentage points between the two arms, a .05 level of significance, and 80 percent power, approximately 200 heavy smokers will need to be recruited to each arm of the study. ..
- TRIPTORELIN FOR OVARY PROTECTION IN CHILDHOOD LIPUSHermine Brunner; Fiscal Year: 2007..Abstract Not Provided ..
- COMMUNITY RANDOMIZED TRIAL OF HISPANIC CANCER PREVENTIONBeti Thompson; Fiscal Year: 2003..The sample sizes take into account intraclass correlation and are sufficient to examine differences among Hispanics as well as the entire Valley population. The analysis is based on intent to treat. ..
- WEB-BASED DRUG-FREE WORKPLACE DEVELOPMENTJ Walsh; Fiscal Year: 2004..Furthermore, we intend to develop a mechanism to evaluate the use of the website and utilize the information to demonstrate the feasibility and commercial viability of the concept. ..
- Development of a Skin Cancer Quality of Life InsturmentJohn Rhee; Fiscal Year: 2005....
- Comparative Effectiveness Research in Pediatric Rheumatic Diseases: Leveraging CACAROL A contact WALLACE; Fiscal Year: 2010..Consensus methodology (Delphi Technique and Nominal Group Technique) will be used to identify data elements to be used in novel methods of analysis ..
- Advanced Center for Latino and MH Systems ResearchMargarita Alegria; Fiscal Year: 2009..conduct statistical analyses of data from a large quasi-experimental project (ACCESS) and a 2-stage modified Delphi technique to generate recommendations for the modification of assertive community treatment (ACT) when applied to ..
- Development of a Tai Chi Program to Overcome Barriers to Cardiac RehabilitationElena Salmoirago-Blotcher; Fiscal Year: 2013..Specifically, (aim 1) we will use a modified Delphi technique to develop a Tai Chi intervention tailored to the specific rehabilitative needs of patients with recent ..
- Adolescent Vaccination in the Medical HomePeter G Szilagyi; Fiscal Year: 2011..We will use a modified Delphi technique to select the most optimal strategy to evaluate;2...
- Predicting implementation from organizational readiness to changeChristian Helfrich; Fiscal Year: 2013..g., leadership, salary) and organizational stress. Content validity will be assessed using a modified Delphi technique conducted with an expert panel...
- The Revolving Door of Cancer Care For Older AmericansJoan M Teno; Fiscal Year: 2012..e. transition) was appropriate in the first place. Using a modified Delphi technique with focus groups and expert advisory panel, we propose to develop measures of potentially burdensome ..
- Delphi Evaluation of Alcohol Advertising CodesThomas Babor; Fiscal Year: 2009..Study 1 will examine the validity of Delphi technique as an enhanced method to evaluate advertising code violations...
- ETHICAL DECISION-MAKING IN OCCUPATIONAL SETTINGSM E Rodgers; Fiscal Year: 1990..ethical dilemmas experienced by 150 practicing occupational health nurses through use of a four-round Delphi technique. In Phase II, twelve practicing occupational health nurses representing regions of the country will develop ..
- ADOLESCENT ACCESS TO HEALTH CARE--THE TEENS' PERSPECTIVEGail Slap; Fiscal Year: 1993..to come for health care?" The methodology involves open focus groups, Nominal Group Technique (NGT), and Delphi Technique. Each format is selected for its particular strength in idea generation, prioritization, or clarification...
- COMPONENTS OF PRENATAL CARE AND LOW BIRTHWEIGHTShirley Beresford; Fiscal Year: 1991..will be used to assign levels of intensity to each set of services belonging to a component, using a modified Delphi technique. In general higher levels of intensity will be associated with more complex or more costly services, which in ..
- MEASURING QUALITY OF CARE FOR HOMELESS ADOLESCENTSBARBARA ENSIGN; Fiscal Year: 2004..national expert consensus on appropriate process and outcome measures of quality health care using a modified Delphi technique. Finally, the research will include a pilot testing study of existing youth health-related quality of life ..
- Health Services Research Competencies Development & ConferencesDiane Martin; Fiscal Year: 2007..facilitate communication, collect and summarize data from programs and stakeholders, and use a modified Delphi technique to finalize the HSR competencies...
- Attentional Dysfunction in Children with PhenylketonuriaGeorgianne Arnold; Fiscal Year: 2008....
- Control of menstrual bleeding disturbances in womenIan Fraser; Fiscal Year: 2006..This study aims to explore these possibilities in large scale clinical studies, scientific study of vascular and molecular changes in endometrium and with the exploration of molecular mechanisms in mice. ..
- Effect of leukoreduction on infection risk in traumaAvery Nathens; Fiscal Year: 2004..abstract_text> ..
- Promoting Self-Care with Telehomecare: Impact on OutcomeKathryn Bowles; Fiscal Year: 2008..Findings will help guide optimal use of telehomecare in promoting self-care in the growing population of chronically ill elders whose conditions are characterized by high morbidity, complex therapies and poor quality and cost outcomes. ..
- Depression, adherence and health outcomes in Rheumatoid Arthritis (RA) patientsSUSAN BARTLETT; Fiscal Year: 2008..Depression will be associated with increased non-adherence. To test these hypotheses, we will utilize a one year observational study of 200 RA patients seen in the Johns Hopkins Arthritis Center. ..
- TAMOXIFEN & BREAST CANCER--ACCEPTANCE/COST EFFECTIVENESSJoy Melnikow; Fiscal Year: 2002..abstract_text> ..
- DVD Consent for Research in Older Schizophrenia PatientsDilip Jeste; Fiscal Year: 2008..The DVD-based consent is not intended to supplant, but rather to supplement, the researcher-participant in-person interaction involved in consent process. ..
- Improving Use of CIS in the Underserved Through Mobile Access & Decision SupportSuzanne Bakken; Fiscal Year: 2007..Differences in patients' use of tobacco-related CIS resources will be explored by sociodemographic variables (gender, age, race, ethnicity, zip code, and health insurance status). [unreadable] [unreadable] [unreadable]..
- CANCER EDUCATION PROGRAMJulia White; Fiscal Year: 2007..Longitudinal tracking of student participants at a later point in their medical training is done to assess the long-term impact of the research experience on career paths. ..
- Computerized Assistance for Treatment Professionals in Assessment of Sexual RiskDonald Calsyn; Fiscal Year: 2008..This project proposes to develop computer assisted procedures to assist patients and providers in getting needed discussions started regarding sexual risk behaviors. [unreadable] [unreadable] [unreadable]..
- NURSING CDROM ON ETHICAL ISSUES OF GENETIC TESTINGJanet Williams; Fiscal Year: 2002..Increased knowledge of ethical aspects of genetic testing will enable professional nurses to incorporate this knowledge into their professional nursing roles. ..
- HEALTH SERVICES IMPACTS OF YOUTH ALCOHOL MEASURESDavid Levy; Fiscal Year: 2001..abstract_text> ..
- CULTURE SPECIFIC, PROBLEM BASED PATIENT SELF MANAGEMENTRobert Anderson; Fiscal Year: 2001....
- Back pain Outcomes using Longitudinal Data (BOLD)Jeffrey G Jarvik; Fiscal Year: 2010....
- RAPID MR VS XRAY: RANDOMIZED OUTCOME TRIAL FOR BACK PAINJEFFREY JARVIK; Fiscal Year: 2001..We have a window of opportunity before the rapid MRI becomes widely disseminated and a randomized trial is made impossible by the expectations of both patients and physicians. ..
- Biological Markers of Recovery for the KidneyJohn A Kellum; Fiscal Year: 2010..For analyses requiring serial samples and urine samples, we propose to study a subset of trial patients enrolled at 5 sites who consent to additional sample collection (208 patients) ..
- The effect of alternative keyboards on discomfort and typing kinematicsNancy A Baker; Fiscal Year: 2010..The effectiveness of alternative keyboards must be verified to ensure that they are providing interventions that will reduce musculoskeletal pain/discomfort and potentially prevent MSD-UE. ..
- Surveillance Strategies Following Treatment for CINJoy Melnikow; Fiscal Year: 2007..Alternative strategies for post-treatment surveillance will be evaluated. [unreadable] [unreadable] [unreadable]..
- Systems Engineering of Pheresis Intervention for SepsisJohn Kellum; Fiscal Year: 2009..We will also call on the expertise of two companies, one specializing in adsorbent polymer technology (MedaSorb Technologies, LLC) and the other in complex systems modeling (Immunetrics, Inc.). ..
- Metabolic Effects of Newer Antipsychotics in Older PtsDilip Jeste; Fiscal Year: 2009..abstract_text> ..
- Evaluating the Clinical Impact of Simulation & Team Training on OB SafetyJeanne Marie Guise; Fiscal Year: 2007..Our current work evaluates performance in the simulated environment; this proposal focuses on the translation of simulation and team training to the clinical environment. [unreadable] [unreadable] [unreadable]..
- Implementing Evidence-Based Guidelines for Treating NHAPEvelyn Hutt; Fiscal Year: 2007..unreadable] [unreadable]..
- Optimal Strategies for PID Prevention and ManagementKenneth Smith; Fiscal Year: 2007..abstract_text> ..
- Planning Grant for Xylitol Trial in Caries-Active AdultsJames Bader; Fiscal Year: 2005....
- Evaluation of Diabetes Self-Management Consultant CareRobert Anderson; Fiscal Year: 2005..HypothesisThe SMC intervention will be more effective than usual care in improving blood glucose control and diabetes-related quality of life. ..
- Effects of Vasoactive Drugs on Perfusion in Septic ShockPatrick Murray; Fiscal Year: 2005..focusing on prevention and management of septic acute renal failure, as a surrogate endpoint to optimize systemic perfusion in hyperdynamic states. ..
- Randomized Study to Decrease Smoking in College StudentsBeti Thompson; Fiscal Year: 2004..Durability and dissemination of the program will be structured into the project. Departments of Health in Oregon and Washington are supporting this project and contributing in-kind resources. ..
- The Epidemiology of Fecal Incontinence after ChildbirthJeanne Marie Guise; Fiscal Year: 2004..These data will provide a better understanding of the extent of the problem and will provide data essential for future trials of prevention and treatment of fecal incontinence. ..
- Family Health After Predictive HD TestingJanet Williams; Fiscal Year: 2004..This study will document the health care needs of family members of persons who receive a positive result from presymptomatic gene testing for an inherited degenerative neurologic disease. ..
- LATE ONSET SCHIZOPHRENIA--A NEUROPSYCHIATRIC STUDYDilip Jeste; Fiscal Year: 2002..g., MRI quantitative analysis, outcome and functioning measures) to the new questions being asked. Our studies should have a major impact on the understanding of schizophrenia and aging. ..
- Conference: Elders' Oral Health SummitJudith Jones; Fiscal Year: 2004....
- HORMONE REPLACEMENT THERAPY AND BREAST CANCERPatricia Carney; Fiscal Year: 2004..abstract_text> ..
- HISTOMETRIC ANALYSIS OF PREMALIGNANT ENDOMETRIAL LESIONSFrancisco Garcia; Fiscal Year: 2003..abstract_text> ..
- NEUROLEPTIC-INDUCED MOVEMENT DISORDERS IN OLDER PATIENTSDilip Jeste; Fiscal Year: 2003..We believe that our findings will have major therapeutic implications for the use of antipsychotics, particularly in older patients. ..
- Developing an Instrument to Measure Keyboarding StyleNancy Baker; Fiscal Year: 2006..This information will be integrated into the final tool, the PECKS. The PECKS can then be used to identify an individual who have keyboarding...styles that have been associated with MSD-UE. ..
- Building Minority Cancer Research Capacity: NMSU & FHCRCBeti Thompson; Fiscal Year: 2006..This will be accomplished initially by conducting 5 pilot projects during the first three years of the grant with others to follow in years 4 and 5. ..
- Poisoning Incidence and ED Use/Misuse in Young ChildrenBarbara Polivka; Fiscal Year: 2006..unreadable] [unreadable] [unreadable] [unreadable]..
- Improving Safety and Quality with Integrated TechnologyJeanne Marie Guise; Fiscal Year: 2006..The findings, though applied specifically for OB, can be applied to many areas of medicine and surgery. The findings will provide inpatient and outpatient HIT stakeholders needed information to make important decisions. ..
- MEASURING OUTCOMES OF YOUTH MENTAL HEALTH SERVICESAnn Garland; Fiscal Year: 2002....
- Preventing Tobacco Use in Young Latino Workers in TexasAmelie Ramirez; Fiscal Year: 2006..Impact of the program on targeted mediators and tobacco use behaviors will be assessed among samples of young adult workers from these communities through population surveys and an embedded cohort study ..
- Families of Childhood Cancer SurvivorsBradley Zebrack; Fiscal Year: 2006..The information also will be useful to investigators and clinicians interested in developing and testing family support interventions via pilot studies or randomized clinical trials. ..
- CENTER FOR RESEARCH IN OLDER PEOPLE WITH PSYCHOSESDilip Jeste; Fiscal Year: 2006....
- Improving the Quality of Diabetes Eye CarePaul Lee; Fiscal Year: 2006..The insights from the study results should be applicable to other areas of diabetes care and health care in general. ..
- Mobile Decision Support for Advanced Practice NursingSuzanne Bakken; Fiscal Year: 2007..Such tools have the potential to increase CPG adherence, enhance evidence-based practice, promote patient safety, and in the long term improve patient outcomes. ..
- MODELING TREATMENT USE & EFFECTIVENESS IN MENTAL ILLNESSSharon Lise Normand; Fiscal Year: 2007..The methodological advances from this research will enable researchers, policy makers, and methodologists to better characterize factors impacting technology innovation/exnovation and to expand the inferences for usual care. ..
- Managing Chronic Illness: Telemonitoring vs TelephoneKathryn Bowles; Fiscal Year: 2005..Findings regarding health outcomes and advantages and disadvantages of the two interventions will guide the design of a larger clinical trial to compare telemonitoring to telephone disease management. ..
- Continuation of Dialysis Access Consortium Clinical TrialsJonathan Himmelfarb; Fiscal Year: 2007..The health care cost o maintaining adequate vascular access should also decrease from its current rate of over one billion dollars per year. ..