Overview of Delphi Consensus Papers, Systematic Review Articles, and Non-systematic Review Articles

by Douglas DiRuggiero, DMSc, MHS, PA-C; Cynthia Trickett, PA-C, MPAS; and Melissa Seal, PhD

Arcutis Corner is a column that will appear in every issue of JCAD NP+PA Perspectives in Dermatology in 2025. The column is supported by Arcutis Biotherapeutics.

“Arcutis is deeply committed to fostering a strong understanding of research fundamentals to enhance scholarly endeavors. As the Head of Scientific Communications, I aim to secure a prominent place for NPs and PAs in scientific discussions and the broader literature landscape. This empowers them to rigorously assess the validity, relevance, and applicability of research, ensuring that patient care is anchored in the highest-quality evidence available.” – Melissa Seal, PhD

In the realm of scholarly research, various methodologies exist for synthesizing information and developing consensus around a particular topic. Three notable approaches are the Delphi consensus method, systematic reviews, and non-systematic reviews. Here, we highlight distinctions among these methodologies, highlighting their purposes, processes, advantages, limitations, and implications for scientific inquiry of methodologies for evaluating and synthesizing existing literature. Having clarity in the type of review being conducted is essential for researchers, practitioners, and policymakers.

Delphi consensus paper

Definition. The Delphi consensus method is a structured communication technique that relies on a panel of experts to reach a consensus on a particular issue or topic. It is often used to summarize the literature on topics where there might be limited published evidence or an abundance of published information that has not yet been summarized or considered by other expert panels to generate expert opinions on a certain question or specific topic.

Methodology

Selection of experts: A panel of experts is carefully chosen based on their knowledge and experience related to the topic in question.

Round-based approach: The Delphi method typically consists of multiple rounds of questionnaires. In the initial round, experts provide their opinions independently. These experts can also be called upon to review a group of manuscripts, and based on the reviewed data, render an opinion or recommendation. This recommendation can be assigned with a “strength of the recommendation” (A, B, or C) based on quantity of supporting data and the type of evidence used to support the statement (ie, an “A” recommendation from an expert panel might mean that multiple randomized, controlled trials or systematic reviews support the recommendation and opinion of the group). The methodology of the literature review and strength of recommendation is typically defined in the publication.

Feedback and iteration: After each round, a summary of the responses is shared back with the panel. Experts can reassess their previous answers considering the group’s responses, which helps promote convergence of opinion.

Final consensus: The process continues until a consensus is reached, or the rounds are deemed sufficient. In modified Delphi methods, Steps 2 and 3 are limited in rounds of feedback.

Advantages and limitations. The Delphi method is advantageous for generating informed consensus in the absence of empirical data. However, while the use of anonymous information can reduce the effect of a dominant individual’s responses, their responses allow other panel members to rethink their input in subsequent rounds based on the responses of others.

Systematic Review Article

Definition. A systematic review article synthesizes quantitative or qualitative research studies following a rigorous and predetermined methodology. It aims to provide a comprehensive summary of the existing literature on a specific question or topic.

Methodology

Clearly defined research question: A precise research question or clearly stated set of objectives is formulated to guide the review process.

Comprehensive and reproducible literature search: Systematic reviews involve a thorough search of multiple databases to gather relevant studies, following predefined search criteria for inclusion and exclusion.

Quality assessment: Each study is appraised for quality based on established criteria, ensuring that only high-quality evidence contributes to the final analysis.

Presentation and synthesis: The data from included studies is systematically synthesized, either qualitatively or quantitatively. Statistically combining and analyzing the results of multiple studies within a systematic review is called a meta-analysis. While a systematic review can be conducted without a meta-analysis, all meta-analyses are part of systematic reviews, which ultimately render a statistical estimate of the overall effect of an intervention or exposure.

Advantages and limitations. Systematic reviews are valued for their methodological rigor and ability to minimize bias, offering reliable conclusions based on existing literature. However, they can be time-consuming and might be limited by the available data, especially if research is sparse, poorly conducted, or study sample sizes are small.

Non-Systematic Review Article

Definition. Non-systematic review articles, often referred to as narrative reviews, provide a general overview of a topic without adhering to the rigorous, predefined protocols of a systematic review. They summarize existing literature based on the author or group of authors’ perspective or expertise in the area(s) for which they are reviewing and are typically used to describe the state of knowledge on a topic, identify trends in the literature and provide context on a specific topic rather than answering a specific research question.

Methodology

Topic selection: The author(s) select a topic of interest, often driven by expertise or recent developments in the field.

Literature survey: The review is based on a subjective selection of articles, which can be comprehensive but not systematically curated.

Thematic organization: Information is organized in a narrative style, often by themes, trends, or significant studies, without standardized methods for assessing quality.

Advantages and limitations. Non-systematic reviews are useful for providing broad insights and identifying gaps in research. However, their lack of methodological rigor can be influenced by the author’s own views, bias, and experience which might make them less reliable and comprehensive than systematic reviews.

Conclusion

The distinctions among Delphi consensus papers, systematic reviews, and non-systematic reviews are significant in academic research. The Delphi method is ideal for achieving expert consensus in the absence of (or overabundance) robust empirical data, while systematic reviews provide rigorous evaluations of existing literature. In contrast, non-systematic reviews offer a broader perspective, albeit with less methodological precision. Understanding these differences is crucial for researchers and practitioners as they navigate the landscape of academic literature and seek evidence for decision-making.

References

  1. Dalkey NC, Helmer O. An experimental application of the Delphi method to the use of experts. Management Science.1963; 9(3):458–467.
  2. Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–1015.
  3. Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions. Available at: Cochrane Handbook. 2020.
  4. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses: the PRISMA Group. PLOS Med. 2009;6(7):e1000097.
  5. Green J, Squires N. Scoping and narrative reviews: a guide for researchers. J Res Nurs. 2017;22(2):138–152.
  6. Mays N, Roberts E, Popay J. Synthesizing research evidence. In: Ball C and Hughes D. (Eds.), Research Evidence in Healthcare: A Guide to Effective Decision-Making. London: Department of Health. 2001.
  7. Gough D, Oliver S, Thomas J. An Introduction to Systematic Reviews. SAGE Publications. 2017.
  8. Booth A, Sutton A, Papaioannou D. Systematic Approaches to a Successful Literature Review. SAGE Publications. 2016. 

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