Combining a Systematic Review With Consensus Methodology: Experiences From a Study to Consolidate the Principles of Screening

Abstract

This methods case provides insight on the use of systematic review and consensus methods. The main objective of this study was to assess and understand how screening principles have evolved since the seminal publication of 10 principles of screening by Wilson and Jungner in 1968. Their principles set out what should be known about a health problem, the natural progression of a disease/condition, available screening tests and follow-up treatments, and the cost-effectiveness of screening, before making a screening decision. This includes screening for cancers, rare diseases in newborns, and routine health concerns. Given the amount of time that had elapsed since Wilson and Jungner’s publication, and the ongoing and considerable attention directed to screening decisions, my colleagues and I were intrigued by why their principles still represented the de facto resource for screening decisions. We hypothesized that screening principles were evolving and expanding substantively to acknowledge a widening scope of issues for contemporary screening decisions and implementation contexts. Thus, we set out to review screening principles over a 50-year period to produce a consolidated list of screening principles that better reflects contemporary thinking on the topic. Our research design encompassed a systematic review of screening principles and a modified Delphi consensus process. After reviewing this methods case we hope that you will be able to assess and justify a broader range of research objectives where a systematic review is appropriate; understand the challenges, implications, and approaches for updating systematic reviews; and assess when to augment a systematic review with a consensus process.

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