Consensus building: The

Delphi Method and the

Nominal Group Technique
January 19, 2015Market ResearchAdvisory Board, Consensus, Delphi, expert panels,Focus Group, life
sciences experts, Nominal Group Technique, Primary Research
By Aina Pi, M.A., Consultant at Insights in Life Sciences (ilS).

Two of the best known methodologies to achieve consensus of opinion in expert

panels or workshops are the Delphi Method and the Nominal Group Technique.

Both consensus techniques, widely used in the field of health, are a mean of
collecting experts opinions where limited or conflicting evidence exists, and an
approach of guiding health decision-making.

In practice, the Delphi method and the nominal group technique are frequently
implemented to reach agreement on the classification of diagnostic criteria, the
development of clinical guidelines, the identification of health professionals needs,
as well as to orientate research.

The methodological manual for the development of Clinical Practices guidelines of

the Spanish Ministry of Health1 states that these methods are particularly useful
 specifically if a general agreement on the formulation of recommendations is
required: when there is a lack of scientific evidence, existing evidence is disputed, or
when there is a little risk-benefit balance.

The Delphi method and the nominal group technique are described below:

Delphi method:

A Delphi study works as follow: An open-ended questionnaire about a particular

topic is shared for an initial round of independent opinions from isolated
respondents. The full range of opinions are summarized and distributed for several
rounds of independent opinion and ranking, until a high degree of consensus is
reached. Delphi studies usually consist of three to five rounds.
The Delphi method minimizes the influence of individuals and maximizes the
reliability of results
Since the exchange of information takes place via written documentation, no
interactive discussion occurs. Nevertheless, the Delphi method can be adjusted
for face-to-face meetings
The anonymity of the procedure allows to easily raise controversial issues
The Delphi method is very useful for international research since there is no need to
gather all experts in the same location
The Delphi method requires an exhaustive prepared questionnaire, adequate time
and high participant motivation since it involves a considerable workload for
participants

The following case study, allows to gain a better understanding of how the Delphi
method works:

Case study: Rationales behind the choice of administration form with fentanyl:
Delphi survey among Danish general practitioners (GPs)2

The objective was to describe the rationale behind the choice of fentanyl (often used
in the management of chronic pain) administration forms among Danish GPs.
An expert panel of 33 GPs collaborated in the study. In the first round, they wrote
the main reasons for prescribing and not prescribing fentanyl patches, oral
transmucosal systems, and nasal sprays. Their answers were summarized, and in
two additional rounds of consultation, they were required to rate the importance of
each reason.
As a result, a ranking of the most important rationales behind the choice of fentanyl
administration form was obtained.
 Nominal Group Technique:

The nominal group technique methodology works as follow: Participants meet in a

session and complete a first round of independent opinions in writing about a
particular topic along with its rationale. The results are summarized and distributed
to participants. With the support of a moderator, participants expose and discuss
their opinions for clarification and evaluation. Several rounds of independent
opinions and ranking may be conducted. When the final round of ratings is carried
out, the highest total positions are selected as the final decisions. Nominal Groups
studies usually consist of four to five rounds
The Nominal Groups technique maximizes the compilation of information
since all individuals inputs are considered, preventing people from
dominating the discussion and encouraging minority views to be shared
It is a particularly useful technique since it gathers all experts at the same time and
location, being a cost-effective and time efficient method
The Nominal Groups method requires an accurate pre-planning from the moderator
and experts, and availability from experts since they are assembled together in a
single session.

The following case study, allows to gain a better understanding of how the Nominal
Group Technique works:

Case study: Identifying areas to improve pain management in hospitalized

patients3

The objective was to identify the areas to prioritize interventions in the pain
management for inpatients in a hospital from the USA
A multidisciplinary group of 27 health professionals participated in study.
In the first round, 94 ideas were generated. General and context-specific priority
ideas were summarized and grouped into several categories. In the following
rounds, participants were required to rate the importance of each idea.
Consequently, a ranking of the main priorities to improve pain control among
hospitalized patients was set.

If you would like to gain further knowledge, you can explore the following case
studies:

Centre for Disease Control and Prevention. Gaining Consensus Among

Stakeholders Through the Nominal Group Technique Department of Health and
Human Services 7 (2006): 1-3.
 Davies et al., 2011S. Davies, P.S. Romano, E.M. Schmidt, E. Schultz, J.J. Geppert,
K.M. McDonald. Assessment of a Novel Hybrid Delphi and Nominal Groups
Technique to Evaluate Quality Indicators. Health Services Research, 46 (6pt1)
(2011). 20052018.
Van E, Pitchforth T, Bishop C, Russell E. Delphi method and nominal group
techniques in family planning and reproductive health research. J Family Planning
Reprod Health Care (2006);32:4:249-252.

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REFERENCES

Manual metodolgico de elaboracin de guas de prctica clnica en el Sistema

1

Nacional de Salud. MSPS, 2007. Link

2
Jacobsen R, Mldrup C, Christrup L. Rationales behind the choice of
administration form with fentanyl: Delphi survey among Danish general practitioners
Journal Opioid Management (2010);6(4):259-68.

Pea A, Estrada CA, Soniat D, Taylor B, Burton M. Nominal group technique: a

3

brainstorming tool for identifying areas to improve pain management in hospitalized

patients J Hosp Med. 2012;7(5):416-20.