2.50
Hdl Handle:
http://hdl.handle.net/10755/211633
Type:
Research Study
Title:
MEASURING THE CONTENT VALIDITY OF GUTCHECK USING AN E-DELPHI
Abstract:
Purposes/Aims: The purpose of this study was to determine the level of agreement among experts about Necrotizing Enterocolitis (NEC) risk among premature infants and to measure the content validity of GutCheck, a neonatal NEC risk index. Rationale/Conceptual Basis/Background:  NEC is a deadly gastrointestinal disease that arises suddenly and requires extensive treatment in premature infants.  Costing an additional $100 000/case, it accounts for nearly 1/5 of Neonatal Intensive Care Unit costs in the US annually.  NEC survivors frequently experience long-term neurodevelopmental impairment, short gut syndrome, intestinal failure, catheter-associated sepsis and are among the most likely to stay in the NICU beyond 6 months.  Prematurity, low birthweight and aggressive formula feeding are the only risk factors consistently shown to independently predict NEC. Recent cohort studies have shown many risk factors contribute to the disease.  What is unknown is if combined risk increases the likelihood of NEC.  Consensus among neonatal clinicians and researchers about the validity of NEC risk is unclear. Methods: The E-Delphi (a consensus method consisting of multiple survey rounds using a study website, online survey, structured feedback and email) was used to determine agreement among experts.  Clinical and research experts were recruited using a purposive snowball sampling technique.  Experts rated the relevance of NEC risk factors on a 1-4 scale (1=not relevant, 2= unable to determine relevance without revision, 3= relevant with minor revision and 4= relevant without revision).  Recommended revisions were incorporated into round 2.   Items with a mean response > 3 or a percent-agreement of  > 70% were retained.  Items with a mean response < 2 or a percent-agreement of < 70% were deleted.  Stability, a change in mean response of < 15%, was calculated when consensus was not met. Results: Individual item content validity was calculated as the percentage of agreement among experts that rated the item a 3 or 4.  Individual CVI for retained items ranged from .63-.94.   In Round 1, 23 items were retained of 42 possible (CVI=.58 scale and .81 retained items).  In Round 2, 18 items were retained of 43 possible (CVI=.61 scale and .72 retained items). After two rounds, the total CVI for retained items in GutCheck was 0.77. Implications: Understanding NEC risk is imperative to improve NEC outcomes.  Although they did not initially agree, experts rated 41 risk factors for NEC as relevant after two rounds. More research is needed to reduce these to the most clinically useful and predictive to assist clinicians to make decisions in the best interest of infants at risk for NEC. 
Keywords:
Premature infants; Necrotizing Enterocolitis; NEC outcomes
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5596
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleMEASURING THE CONTENT VALIDITY OF GUTCHECK USING AN E-DELPHIen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211633-
dc.description.abstractPurposes/Aims: The purpose of this study was to determine the level of agreement among experts about Necrotizing Enterocolitis (NEC) risk among premature infants and to measure the content validity of GutCheck, a neonatal NEC risk index. Rationale/Conceptual Basis/Background:  NEC is a deadly gastrointestinal disease that arises suddenly and requires extensive treatment in premature infants.  Costing an additional $100 000/case, it accounts for nearly 1/5 of Neonatal Intensive Care Unit costs in the US annually.  NEC survivors frequently experience long-term neurodevelopmental impairment, short gut syndrome, intestinal failure, catheter-associated sepsis and are among the most likely to stay in the NICU beyond 6 months.  Prematurity, low birthweight and aggressive formula feeding are the only risk factors consistently shown to independently predict NEC. Recent cohort studies have shown many risk factors contribute to the disease.  What is unknown is if combined risk increases the likelihood of NEC.  Consensus among neonatal clinicians and researchers about the validity of NEC risk is unclear. Methods: The E-Delphi (a consensus method consisting of multiple survey rounds using a study website, online survey, structured feedback and email) was used to determine agreement among experts.  Clinical and research experts were recruited using a purposive snowball sampling technique.  Experts rated the relevance of NEC risk factors on a 1-4 scale (1=not relevant, 2= unable to determine relevance without revision, 3= relevant with minor revision and 4= relevant without revision).  Recommended revisions were incorporated into round 2.   Items with a mean response > 3 or a percent-agreement of  > 70% were retained.  Items with a mean response < 2 or a percent-agreement of < 70% were deleted.  Stability, a change in mean response of < 15%, was calculated when consensus was not met. Results: Individual item content validity was calculated as the percentage of agreement among experts that rated the item a 3 or 4.  Individual CVI for retained items ranged from .63-.94.   In Round 1, 23 items were retained of 42 possible (CVI=.58 scale and .81 retained items).  In Round 2, 18 items were retained of 43 possible (CVI=.61 scale and .72 retained items). After two rounds, the total CVI for retained items in GutCheck was 0.77. Implications: Understanding NEC risk is imperative to improve NEC outcomes.  Although they did not initially agree, experts rated 41 risk factors for NEC as relevant after two rounds. More research is needed to reduce these to the most clinically useful and predictive to assist clinicians to make decisions in the best interest of infants at risk for NEC. en_GB
dc.subjectPremature infantsen_GB
dc.subjectNecrotizing Enterocolitisen_GB
dc.subjectNEC outcomesen_GB
dc.date.available2012-02-20T12:05:19Z-
dc.date.issued2012-02-20T12:05:19Z-
dc.date.accessioned2012-02-20T12:05:19Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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