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20110720_S3-LL Polytrauma DGU_final_eng_cleaned_mc_korrigiert

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<strong>S3</strong> Guideline on Treatment of Patients with Severe and Multiple Injuries<br />

B.2 Formulating the recommendation and finding consensus<br />

The medical societies involved each nominated at least one delegate who, as a representative of<br />

that subject discipline, participated in drawing up the guideline. Each medical society had a vote<br />

in the consensus process.<br />

The recommendations and the grades of recommendation were approved in 5 consensus<br />

conferences (April 18-19, 2009, June 30, 2009, September 8, 2009, November 26-27, 2009 and<br />

February 01, 2010):<br />

The course of action at these conferences, assisted by the TED (electronic voting) system, was in<br />

6 steps:<br />

� the opportunity to review the guideline manuscript before the conference and to compile<br />

notes on the proposed recommendations and grades;<br />

� presentation and explanation from each author responsible on the pre-formulated proposals<br />

for recommendations;<br />

� registration via moderators of participants’ opinions and alternative proposals on all<br />

recommendations, with speaker contributions solely for clarification;<br />

� voting on all recommendations and grades of recommendation and on the cited alternatives;<br />

� discussion of the points on which no “strong consensus” could be reached in the first round;<br />

� <strong>final</strong> voting.<br />

Most of the recommendations were approved with “strong consensus” (agreement of > 95% of<br />

participants). Areas in which no strong consensus could be reached are marked in the guideline<br />

and the various positions are expounded. In classifying the consensus str<strong>eng</strong>th, the following<br />

consensus grades were decided on in advance [9]:<br />

� strong consensus: > 95% of participants agreed<br />

� consensus: > 75-95% of participants agreed<br />

� majority consensus: > 50–75% of participants agreed<br />

� no consensus: < 50% of participants agreed<br />

The records of the meetings can be viewed at the Institute for Research in Operative Medicine<br />

(IFOM). The Delphi method was then applied to recommendations for which no consensus could<br />

be reached in the consensus conferences. A detailed methods report is available for viewing on<br />

the AWMF website and has been filed at the Institute for Research in Operative Medicine<br />

(IFOM).<br />

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