Identifying research areas in peripheral artery disease treatment-a Delphi consensus approach.

BACKGROUND: The multitude of existing techniques for the endovascular treatment of peripheral artery disease (PAD), as well as newly emerging technologies combined with the diversity of patient profiles highlight the need for further research in this area. We conducted a Delphi consensus study, an established method utilising an iterative approach to reach consensus within a group of experts over several rounds, to identify gaps and new areas of research in the field of PAD. RESULTS: Using a four-round Delphi process, we started with 17 statements proposed by an expert panel to be rated on a 5-point Likert scale by EBIR-ES holders. We defined two consensus metrics to measure the agreement within the group: as > 75% concordance or > 60% certainty. Six statements that did not meet this threshold after round 1 underwent further rounds of expert feedback, discussion, and reassessment. Fifty-two EBIR-ES holders evaluated the initial statements and 36 contributed to the final consensus. While certainty was stable across all rounds, an increase in concordance was seen in 4 (67%) statements. As a supplement to the traditional Delphi method, we interpreted the decrease in concordance for 2 (33%) statements as areas in need of further research. CONCLUSIONS: The Delphi consensus method is an effective method for discovering potential research topics. Through iterative feedback, it encourages experts to refine their views and promotes a productive exchange of ideas. We identified the use of filter wires for atherectomy, as well as the comparison between atherectomy devices as key areas needing further research. Moreover, these findings underscore the value of developing formalised, multidisciplinary consensus guidelines to guide clinical practice.