Eliciting expert opinion using the Delphi technique: identifying performance indicators for cardiovascular disease

Combining opinion from expert panels is becoming a more common method of selecting criteria to define quality of health care. The Rand Corporation pioneered this method is the 1950s and 1960s in the context of forecasting technological events. Since then, numerous organizations have adopted the methodology to develop local and national policy. In the context of quality of care, opinion is typically elicited from a sample of experts regarding the appropriateness or importance of a medical treatment for several well-defined clinical cohorts. The information from the experts is then combined in order to create a standard or performance measure of care. This article describes how to use the panel process to elicit information from diverse panels of experts. 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.