Guideline on Treatment of Patients with Severe and Multiple ... - AWMF

S3 <strong>Guideline</strong> on Treatment of Patients with Severe and Multiple Injuries
B.2 Formulating the recommendation and finding consensus
The medical societies involved each nominated at least one delegate who, as a representative of
that subject discipline, participated in drawing up the guideline. Each medical society had a vote
in the consensus process.
The recommendations and the grades of recommendation were approved in 5 consensus
conferences (April 18-19, 2009, June 30, 2009, September 8, 2009, November 26-27, 2009 and
February 01, 2010):
The course of action at these conferences, assisted by the TED (electronic voting) system, was in
6 steps:
� the opportunity to review the guideline manuscript before the conference and to compile
notes on the proposed recommendations and grades;
� presentation and explanation from each author responsible on the pre-formulated proposals
for recommendations;
� registration via moderators of participants’ opinions and alternative proposals on all
recommendations, with speaker contributions solely for clarification;
� voting on all recommendations and grades of recommendation and on the cited alternatives;
� discussion of the points on which no “strong consensus” could be reached in the first round;
� final voting.
Most of the recommendations were approved with “strong consensus” (agreement of > 95% of
participants). Areas in which no strong consensus could be reached are marked in the guideline
and the various positions are expounded. In classifying the consensus strength, the following
consensus grades were decided on in advance [9]:
� strong consensus: > 95% of participants agreed
� consensus: > 75-95% of participants agreed
� majority consensus: > 50–75% of participants agreed
� no consensus: < 50% of participants agreed
The records of the meetings can be viewed at the Institute for Research in Operative Medicine
(IFOM). The Delphi method was then applied to recommendations for which no consensus could
be reached in the consensus conferences. A detailed methods report is available for viewing on
the AWMF website and has been filed at the Institute for Research in Operative Medicine
(IFOM).
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