Fully Completed Spherical Fuzzy Approach-Based Z Numbers(PHIModel)for Enhanced Group Expert Consensus

This study aims to establish an expert consensus and enhance the efficacy of decision-making processes by integrating Spherical Fuzzy Sets(SFSs)and Z-Numbers(SFZs).A novel group expert consensus technique,the PHImodel,is developed to address the inherent limitations of both SFSs and the traditional Delphi technique,particularly in uncertain,complex scenarios.In such contexts,the accuracy of expert knowledge and the confidence in their judgments are pivotal considerations.This study provides the fundamental operational principles and aggregation operators associated with SFSs and Z-numbers,encompassing weighted geometric and arithmetic operators alongside fully developed operators tailored for SFZs numbers.Subsequently,a case study and comparative analysis are conducted to illustrate the practicality and effectiveness of the proposed operators and methodologies.Integrating the PHI model with SFZs numbers represents a significant advancement in decision-making frameworks reliant on expert input.Further,this combination serves as a comprehensive tool for decision-makers,enabling them to achieve heightened levels of consensus while concurrently assessing the reliability of expert contributions.The case study results demonstrate the PHI model’s utility in resolving complex decision-making scenarios,showcasing its ability to improve consensus-building processes and enhance decision outcomes.Additionally,the comparative analysis highlights the superiority of the integrated approach over traditional methodologies,underscoring its potential to revolutionize decision-making practices in uncertain environments.

Validation of adherence prediction system for lifestyle interventions in nonalcoholic fatty liver disease

This editorial delves into the research article by Zeng et al published in the latest issue of World Journal of Gastroenterology.The manuscript contributes significantly to addressing the global health issue of nonalcoholic fatty liver disease(NAFLD)by introducing and validating the Exercise and Diet Adherence Scale(EDAS).The article effectively conveys the importance of the study,highlighting the prevalence of NAFLD,the lack of approved drugs for its treatment,and the crucial role of lifestyle correction.The use of the Delphi method for scale development and the subsequent evaluation of its reliability add scientific rigor to the methodology.The results demonstrate that the scale is correlated with key lifestyle indicators,which makes it a promising tool for assessing patient adherence to interventions.The identification of specific score thresholds for predicting adherence to daily calorie intake and exercise adds practical value to the scale.The differentiation among scores indicative of good,average,and poor adherence enhances its clinical applicability.In conclusion,the manuscript introduces EDAS,a valuable instrument that can contribute substantially to the field of NAFLD research and clinical practice.

手术科室高质量发展评价指标体系构建及应用

目的构建一套科学适宜可靠的手术科室高质量发展评价指标体系,应用该体系评价分析手术科室高质量发展的成效与不足。方法运用文献研究和专家讨论明确手术科室高质量发展评价指标库。运用德尔菲法和层次分析法确定指标权重,形成指标体系。结果构建了一套手术科室高质量发展评价指标体系,其中一级指标3个、二级指标19个。运用该评价指标体系,以某医院某科室2019—2021年运营数据为例,进行应用研究,该科室2021年高质量发展得分最高(92.999分),提质维度的满分比最高(2021年为95.52%)。结论探索实践应用,构建科学指标体系,精准评价手术科室高质量发展;保持提质领先态势,改善降本增效薄弱环节,提升医疗服务效能;推进智慧管理,搭建高质量发展数据平台,形成监测评价反馈闭环。

上海城市健康影响因素指标体系初步研究

目的探索和建立上海城市健康影响因素指标体系,推进健康影响评估工作的进程。方法阅研世界卫生组织(World Health Organization,WHO)和其他国家及地区的环境健康影响因素、健康效应及健康影响评估案例并梳理指标框架,参考我国和上海市实际建立城市健康影响因素和健康效应及代表性指标列表,采用德尔菲法对指标开展咨询论证。结果WHO及国外健康影响因素和健康效应的框架范围基本相同,但各国的具体指标不同。依据国外框架,上海城市健康影响因素包括环境,社会、文化,经济与产业,生活方式4大类共210项代表性指标;健康效应包括人群整体健康水平、死亡和肿瘤、慢性病和精神健康、职业病和地方病、其他伤害或疾病、生殖健康、妇女儿童健康7大类共69项代表性指标。专家咨询积极系数为95%,指标重要性、可操作性、一致性较好,专家协调系数为0.204和0.214(P<0.05)。结论研究建立的指标有助于推进上海城市健康影响评估工作,但需依据评估对象特点增补和筛选代表性指标,并对代表性指标进行权重配比或重要性评判。

应用德尔菲法探索消毒人员队伍建设和培养思路

目的探索构建符合上海市传染病防控需要的消毒人员队伍建设和培养的思路。方法通过德尔菲法结合需求调研、专家咨询,对职业化消毒人员队伍建设和培养思路进行调研。结果疾病预防控制机构、卫生监督、专业学会协会等20名专家参加了咨询,问卷回收率达100.00%。消毒人员重要性评分依次为事中职责、保障措施、事前准入和事后考核。三类消毒人员需求各不相同,消毒核心人员消毒知识技能以及承担工作的能力要求最高,分别为(4.73±0.46)分和(4.73±0.47)分。消毒服务人员任职资格最重要,为(4.90±0.45)分。消毒从业人员承担工作的能力要求最高,为(4.83±0.39)分。培训和知识技能在3类人员中都有着重要地位,且最重要的技能均为个人防护,其次为实际操作能力。结论本次调查专家积极程度和协调程度高,发现目前消毒人员专业队伍建设面临较大挑战。建议加强消毒员的职业认定和保障,同时针对性地分类培养,满足各类消毒人员的职业需求。

健康发展力评价指标体系构建

目的构建健康发展力评价指标体系,用于分析地区健康水平,助力健康中国建设。方法用德尔菲法进行2轮专家咨询,分析咨询结果,筛选并修改指标,建立最终的评价指标体系。结果2轮咨询的专家积极系数分别为80%和73%,专家权威系数均数为0.73。第2轮咨询中,所有指标的重要性、数据可得性和敏感性评分的专家协调系数分别为0.403、0.466和0.266(P<0.05),所有指标的重要性、数据可得性和敏感性整体评分都在4.00分以上,专家支持率在75.00%以上,变异系数小于0.25。最终构建的健康发展力评价指标体系包括5个一级指标、18个二级指标、52个三级指标。结论构建的健康发展力评价指标体系专家积极性较高,专家权威程度、协调程度和集中程度较好,可用于评价地区健康发展力,发现地区健康水平的影响因素。

中非妇幼健康南南合作核心培训内容遴选

目的构建中非妇幼健康南南合作的培训内容。方法在查阅文献的基础上形成初始问卷,培训内容分为领导与治理、卫生筹资与保障、卫生人力、卫生信息、卫生产品和技术、卫生服务提供6个维度。用电子邮件进行2轮专家函询。结果2轮函询的有效问卷回收率均为100.0%,专家积极系数为100.0%。专家对37个条目达成了共识,包括领导与治理14个条目、卫生筹资与保障5个条目、卫生人力3个条目、卫生信息2个条目、卫生产品和技术5个条目、卫生服务提供8个条目。结论研究形成了关于中非妇幼健康南南合作培训内容的中方专家共识,结果可为进一步调查非洲学员的培训需求提供参考。

上海市三级甲等医院科研竞争力评价

目的评价上海市38家三级甲等医院2018年的科研竞争力,以期为政府在医疗卫生领域的宏观决策提供参考,为各医疗单位的管理者了解自身科研实力及同行水平,进而在工作中发挥优势、改进劣势提供科学依据。方法用德尔菲法确定医院科研竞争力评价指标,收集相关数据,用因子分析法评估科研竞争力。结果科研竞争力评价指标共纳入15个评价指标,提取到科研人才建设、奖励性成果、产权性成果3个公因子,累积方差贡献率为83.895%。科研竞争力综合得分排名前5位的医院分别为A医院、B医院、C医院、D医院和E医院。结论上海市三级甲等医院的科研竞争力存在一定的差距,科研人才建设对于科研发展至关重要。各家医院应结合自身发展现状,完善科研人才培养机制和科研管理机制,鼓励并引导高质量科研成果的产出,提高科研竞争力。

创新药品价值评价指标体系构建

目的 基于价值构建创新药品评价指标体系,以期为我国创新药品价值测评、有关部门基于价值对药品定价、遴选机制建设提供理论基础和实践依据。方法 主要采用文献调研法、专家咨询法进行研究。结果 第一轮专家咨询的积极系数为90.00%,第二轮为94.44%;第一轮专家咨询的权威系数为0.85;第一轮咨询一、二级指标的专家意见一致性系数分别为0.59、0.28(P<0.001);第二轮咨询一、二级指标的专家意见一致性系数分别为0.57、0.31(P<0.001)。最终构建的创新药品价值评价指标体系包括出5个一级指标、24个二级指标,一级指标及其权重分别为创新性(0.253 3)、有效性(0.254 0)、安全性(0.224 7)、经济性(0.156 0)、可及性(0.112 0)。结论 构建的创新药品价值评价指标体系具有较好的准确性、客观性与可靠性,为我国创新药品价值评测与合理定价奠定了一定的理论基础。

国家三级公立医院绩效考核非监测指标权重研究

目的 根据上海市的国家三级公立医院绩效考核非监测指标数据,研究国家三级公立医院绩效考核29项非监测指标的权重系数,为提高三级公立医院绩效评价效果提供借鉴。方法 运用专家咨询法与熵权法分别对29项国家非监测指标进行赋权,最终以主客观赋值结合的方法得到权重系数。结果 两种赋权方法的指标对比,人才培养、学科建设等部分的权重系数存在较大差异。结论 根据上海市的绩效考核数据,通过主客观结合的方法建立国家三级公立医院绩效考核非监测指标权重系数有助于其他省市及其他医院开展相关绩效评价,能够更好地促进公立医院按照国家要求高质量发展。

Study on the Multi-dimension Evaluation Index System of Agricultural Water Resources in Liaoning Province

[Objective] This study aimed to establish the multi-dimensional evaluation index system of agricultural water resources in Liaoning Province. [Method] Delphi method in conjunction with AHP method was adopted to establish the multi-dimensional evaluation index system of agricultural water resources in Liaoning Province, and all the indexes in each hierarchy were ranked overall according to their weights. [Result] There were three hierarchies in this index system, totally including 21 indexes, among which water resource exploitation and utilization rate, sewage treatment rate and utilization of available water resources were the three crucial factors influencing the sustainable development. [Conclusion] This evaluation index system can reflect the true sustainable situation of the agricultural water resources in Liaoning Province.

面向在线医疗平台的医生能力综合评价体系构建

目的基于服务质量模型、知识贡献理论、结构-过程-结果三维质量评价模型构建面向在线医疗平台的医生能力综合评价指标体系,以期助力平台打造具有公信力的医生榜单,促进患者精准评估医生能力和服务水平。方法采用文献分析法建立初始评价指标体系框架,邀请专家对指标进行筛选和评估,最后通过层次分析法对各级评价指标的权重赋值。结果建立的医生能力综合评价体系包含3个一级指标、7个二级指标、29个三级指标,其中一级指标(及其权重)分别为医生基础条件(0.420)、医生知识贡献(0.219)、医生服务表现(0.361)。结论研究构建了一套科学、可靠的面向在线医疗平台的医生能力综合评价体系,可为平台建立系统化的医生评价标准提供信息基础和参考依据。

Outpatient Experience of Human Caring Scale （OEHC-Scale）： Improvement by Delphi Method

Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.

基于德尔菲法的新发重大传染病预警指标筛选

目的筛选科学、完整、可操作性强的新发重大传染病预警指标。方法运用文献阅读法初步构建预警指标基本框架,采用德尔菲法进行两轮专家咨询对指标进行筛选,结合层次分析法和专家咨询权数法确定指标评价维度权重及指标权重系数。结果两轮专家咨询的积极系数分别为91.67%和100.00%,权威系数均数分别为(0.82±0.18)和(0.88±0.03),协调系数分别为0.379和0.412(均P<0.001)。最终筛选出包括3个一级指标、10个二级指标、45个三级指标的新发重大传染病预警指标,其中“医疗机构发现不明原因疾病的聚集性病例数(0.0244)”“参照以往的监测系统以及历年的传染病流行曲线预警等资料的预警指标(0.0241)”“诊断或疑似的各类传染病病例报告数和死亡数(0.0239)”“罕见传染病病例报告(0.0239)”“不明原因的严重症候群报告(0.0238)”的权重系数较高。结论应用德尔菲法和层次分析法筛选出的新发重大传染病预警指标具有一定的科学性和合理性,符合实际情况,可为发展和完善新发重大传染病预警监测系统提供思路和参考。

上海市二级公立医院经济运营评价指标体系构建

目的建立符合二级公立医院功能定位以及发展导向的经济运营评价指标体系,为主管部门科学、精准管理提供支撑。方法采用文献调研法、德尔菲法以及层次分析法构建指标体系并确定指标权重。结果通过2轮专家咨询问卷形成7个一级指标(包含预算管理、风险管理、成本管理、运营效率、费用负担、收支结构、发展能力共7个维度)、38个二级指标的上海市二级公立医院经济运营评价指标体系。结论指标体系综合考虑二级公立医院功能定位和经济管理需求,能够有效反映医院经济运营成效,可供主管部门对医院进行综合评价。建议明确指标参数计算口径,合理设置评价标准,探讨科学的综合评价方法,为后续开展实证分析提供基础。

Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence--taking stroke as an example

Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.

健康功能社区建设评价指标体系构建

目的 构建一套能指引健康功能社区建设并能较为客观地反映建设成效的评价指标体系。方法 通过文献回顾、小组讨论和专家会议法初步确定指标体系框架和指标池,在此基础上通过3轮专家咨询确定评价指标体系,采用层次分析法确定各指标权重。结果 健康功能社区建设评价指标包括4项基本条件,健康服务、健康环境、健康人群、健康文化、组织管理5项一级指标及14项二级指标、63项三级指标。3轮咨询的专家积极系数均为100%,专家平均权威系数为0.84,协调系数分别为0.179、0.232、0.309(P < 0.05)。层次分析的一级指标权向量为0.177 ~ 0.211,最大特征值为5.000 ~ 5.218;二级指标的权向量为0.035 ~ 0.105,最大特征值为2.000 ~ 4.201;三级指标的权向量为0.003 ~ 0.105,最大特征值为1.000 ~ 14.529。判断矩阵的一致性比率均低于0.100。结论 3轮咨询的专家代表性、积极性、权威程度和协调程度较高,判断矩阵的一致性比率符合要求,构建的指标体系可为推进健康功能社区建设提供指引,今后还需结合实证研究不断予以完善。

Construction of clinical research nurse training program based on position competence

BACKGROUND As one of the most important members in clinical trials,the number of clinical research nurses(CRN)can't keep up with the growth of experimental projects,so it is urgent to build clinical research training and strengthen the background knowledge of nurses.AIM To construct CRN training program based on position competence,accelerate the construction of CRN talent pool,and provide scientific guidance significance for CRN training.METHODS Based on the position competence model,combined with literature research and qualitative interview results,the first draft was prepared of the CRN training program.Two rounds of correspondence with 16 experts were conducted using the Delphi method to determine the training program.RESULTS The effective recovery rate of the expert correspondence questionnaire was 100%and the authority coefficients of the 2 rounds of experts were 0.826 and 0.895.Finally,4 first-level indicators and determine 15 s-level indicators of training objectives.The training program included 4 first-level indicators,training requirements,content,methods,assessment and evaluation,15 s-level indicators,and 74 third-level indicators.CONCLUSION The CRN training program based on position competence is scientific and extendable,providing a basis for participation in CRN training.

Development of student simulated patient training and evaluation indicators in a high-fidelity nursing simulation:a Delphi consensus study

Objective:This study is aimed to develop student simulated patient(SSP)training content and evaluation indicators,and further explores their validity and reliabilities.Methods:Delphi consultations with 20 nursing exper ts were conducted.The weights of indicators were calculated through the analytic hierarchy process.SSP training was conducted with a high-fidelity nursing simulation.Results:The expert positive coefficients were 0.952 in the first round consultation and 1.00 in the second round consultation.The expert authority coefficient was reported as 0.87.The training included role and responsibility of simulated patient(SP),script interpretation,plot performance,and training for a rater,with a total of 17 indicators.SSP evaluation consisted of disease knowledge,role portrayal,and performance fidelity and since being a rater,it consists of 20 indicators in total.The coordination coefficients of two rounds of consultation ranged from 0.530 to 0.918.The content validity of SSP evaluation indicators was 0.95.The inter-rater reliability was repor ted as 0.866,and the internal consistency established using Cronbach’sαwas 0.727.Conclusions:Students as SPs should have first-hand knowledge and experience within the simulated scenarios.SSP training content and evaluation indicators were determined through the Delphi consensus combined with analytic hierarchy process.The evaluation indicators were valid and reliable,and provided the objective and quantifiable measurements for SSP training in nursing。

Identifying nursing research priorities in Vietnam: a modified Delphi study

Objective: There is no single study that has examined nursing research priorities in Vietnam. This study aimed to gain consensus from experts on the nursing research priorities in Vietnam.Methods: A three-round modified Delphi study was used in this study. A focus group discussion among experts was conducted in round I to identify the nursing research priorities(n=23). Data in round I were analyzed using content analysis. In round Ⅱ, participants were invited to rate the importance of each nursing priority topic in a 5-point Likert scale questionnaire, which had a 74%(n=17) response rate. In round Ⅲ, the questionnaire was returned to the experts(n=17) until consensus was reached. Data from round Ⅱ and round Ⅲ were analyzed to produce mean score and final rank.Results: The top 12 research priority lists were identified, which included subthemes and areas of possible investigations. All priorities were classified into three groups in the rank order, namely:(i) nursing management and leadership, which included(1) nursing care quality,(2) management and leadership of nurse managers,(3) nursing image,(4) professional nurse competency, and(5) human resource management;(ii) nursing education, which included(1) knowledge-specific domain,(2) the linkage between education and practice, and(3) nurse teacher workforce;and(iii) nursing service, which included(1) adult nursing concern,(2) patient safety,(3) public health nursing concern, and(4) quality of life of patients and nurses.Conclusions: Consensus among experts was achiever, and the findings are considered as the basis of resources to the most essential research needs in Vietnam.