Findings on the Use of the Delphi Technique in Health Sciences

The Delphi method is a widely used approach in health sciences, particularly when existing knowledge is incomplete or uncertain, or when alternative methods that provide higher levels of evidence are not feasible. It has been applied across both natural and social sciences to gather expert opinions and identify consensus on specific topics. This method is instrumental in areas where expert judgment is crucial for advancing understanding or forming the basis for future research.

The primary objective of the Delphi technique in health sciences is to facilitate expert-based judgments about epistemic questions. It operates on the assumption that the collective input of a diverse group of experts produces more valid results than the opinion of a single expert, regardless of their stature in the field. While it ranks lower than experimental methods such as randomized controlled trials (RCTs) or meta-analyses in providing causal evidence, it remains valuable for synthesizing expert opinions. In fact, Delphi findings often form the foundation for guidelines, white papers, or subsequent evaluative studies. This method is especially pertinent in contexts where experimental designs are impractical or unethical, as experts rely on a combination of personal experience, systematic reviews, and other studies to form their judgments.

In health sciences, the Delphi method is most commonly used for consensus building, though its applications extend beyond this function. It is also employed for aggregating ideas, making future predictions, and eliciting expert opinions on complex issues. The iterative process involves collecting individual responses, summarizing them, and feeding the aggregated group response back to participants, who then have the opportunity to revise their answers. This cycle continues until a satisfactory level of consensus is reached. While consensus is often a focus, it is not the sole purpose of the Delphi method; its flexibility allows it to address a wide range of research objectives.

Critiques of the Delphi method often center on its limitations in comparison to evidence-based approaches. Because expert judgments are shaped by subjective experiences and knowledge, they may overlook robust cause-effect relationships established through empirical research. Furthermore, the method lacks a specific theoretical paradigm, which means there are no universally accepted criteria for assessing its quality. Sociological critiques have also highlighted potential issues such as the reproduction of power dynamics, the risk of consensus reinforcing established norms rather than incorporating novel insights, and the possibility of overlooking diverse perspectives.

One of the strengths of the Delphi method is its emphasis on anonymity, which helps to reduce biases such as the dominance of certain individuals or the pressure to conform to group opinions. This anonymity, combined with structured feedback, fosters independent thought and minimizes the distortion of data by group dynamics. However, the process can be labor-intensive and requires significant time for multiple rounds of questionnaires, data analysis, and feedback. While some studies recommend limiting the process to two rounds to reduce the burden on participants, fewer rounds may compromise the depth and rigor of the findings.

The quality of a Delphi study depends heavily on the selection of experts. Experts are typically chosen based on their professional expertise, scientific knowledge, or practical experience. The composition of the panel can significantly impact the outcomes, as diverse perspectives are essential for robust and innovative discussions. Research suggests that "cognitive diversity" within the group is as important as the individual abilities of its members. However, small group sizes may limit the diversity of viewpoints, reducing reliability and risking the dominance of particular thought collectives.

In health sciences, the Delphi method has been applied to a range of objectives. It is used to identify the current state of knowledge, improve predictions of future scenarios, resolve controversies, develop guidelines, create measurement tools, and prioritize actions. The flexibility of the method makes it valuable in exploratory phases of research or when addressing theoretical and methodological issues. Despite its limitations, the Delphi technique continues to be a crucial tool for generating expert-based insights, particularly in areas where experimental methods are impractical or infeasible.

In conclusion, while the Delphi method has limitations, such as its reliance on subjective judgment and the potential for group biases, its strengths lie in its ability to synthesize diverse perspectives and generate consensus on complex issues. Its iterative design, structured feedback, and emphasis on anonymity make it a unique and effective approach in health sciences research. However, careful consideration of expert selection, panel size, and methodological rigor is essential to ensure the validity and reliability of its findings.