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Published in: Trials 1/2023

Open Access 01-12-2023 | Research

Rating versus ranking in a Delphi survey: a randomized controlled trial

Authors: Claudio Del Grande, Janusz Kaczorowski

Published in: Trials | Issue 1/2023

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Abstract

Background

The Delphi technique has steeply grown in popularity in health research as a structured approach to group communication process. Rating and ranking are two different procedures commonly used to quantify participants’ opinions in Delphi surveys. We explored the influence of using a rating or ranking approach on item prioritization (main outcome), questionnaire completion time, and evaluation of task difficulty in a Delphi survey aimed at identifying priorities for the organization of primary cardiovascular care.

Methods

A randomized controlled parallel group trial was embedded in a three-round online Delphi survey. After an “open” first round, primary care patients, trained patient partners, and primary care clinicians from seven primary care practices were allocated 1:1 to a rating or ranking assessment group for the remainder of the study by stratified permuted block randomization, with strata based on participants’ gender and status. Agreement on item prioritization between the experimental groups was measured by calculating Krippendorff’s alpha reliability coefficient on the aggregate rank order of items in each group after the final round. Self-reported ease or difficulty with the assessment task was measured with the Single Ease Question.

Results

Thirty-six panelists (13 clinic patients, 7 patient partners, 16 clinicians; 60% females) were randomized to the rating (n = 18) or ranking (n = 18) group, with 30 (83%) completing all rounds. Both groups identified the same highest priorities from a set of 41 items, but significant discrepancies were found as early as the seventh top item. There was moderately strong agreement between the priority ordering of top items common to both groups (Krippendorff’s alpha = 0.811, 95% CI = 0.669–0.920). A 9-min mean difference to complete the third-round questionnaire in favor of the rating group failed to achieve statistical significance (p = 0.053). Ranking was perceived as more difficult (p < 0.001).

Conclusions

A rating or ranking procedure led to modestly similar item prioritization in a Delphi survey, but ranking was more difficult. This study should be replicated with a larger number of participants and with variations in the ranking and rating procedures.

Trial registration

Not applicable.
Appendix
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Literature
1.
go back to reference Dalkey N, Helmer O. An experimental application of the Delphi method to the use of experts. Manage Sci. 1963;9:458–67. Dalkey N, Helmer O. An experimental application of the Delphi method to the use of experts. Manage Sci. 1963;9:458–67.
2.
go back to reference Dalkey N. An experimental study of group opinion. Futures. 1969;1:408–26. Dalkey N. An experimental study of group opinion. Futures. 1969;1:408–26.
4.
go back to reference Linstone HA, Turoff M, editors. The Delphi method: techniques and applications. Reading, MA: Addison-Wesley Publishing Company; 1975. Linstone HA, Turoff M, editors. The Delphi method: techniques and applications. Reading, MA: Addison-Wesley Publishing Company; 1975.
5.
go back to reference Vernon W. The Delphi technique: a review. Int J Ther Rehab. 2009;16:69–76. Vernon W. The Delphi technique: a review. Int J Ther Rehab. 2009;16:69–76.
6.
go back to reference Goodman CM. The Delphi technique: a critique. J Adv Nurs. 1987;12:729–34.PubMed Goodman CM. The Delphi technique: a critique. J Adv Nurs. 1987;12:729–34.PubMed
7.
go back to reference Crisp J, Pelletier D, Duffield C, Adams A, Nagy S. The Delphi method? Nurs Res. 1997;46:116–8.PubMed Crisp J, Pelletier D, Duffield C, Adams A, Nagy S. The Delphi method? Nurs Res. 1997;46:116–8.PubMed
8.
go back to reference Keeney S, Hasson F, McKenna HP. A critical review of the Delphi technique as a research methodology for nursing. Int J Nurs Stud. 2001;38:195–200.PubMed Keeney S, Hasson F, McKenna HP. A critical review of the Delphi technique as a research methodology for nursing. Int J Nurs Stud. 2001;38:195–200.PubMed
9.
go back to reference Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS ONE. 2011;6:e20476.PubMedPubMedCentral Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS ONE. 2011;6:e20476.PubMedPubMedCentral
10.
go back to reference Hasson F, Keeney S. Enhancing rigour in the Delphi technique research. Technol Forecast Soc Change. 2011;78:1695–704. Hasson F, Keeney S. Enhancing rigour in the Delphi technique research. Technol Forecast Soc Change. 2011;78:1695–704.
11.
go back to reference Paré G, Cameron A-F, Poba-Nzaou P, Templier M. A systematic assessment of rigor in information systems ranking-type Delphi studies. Inf Manag. 2013;50:207–17. Paré G, Cameron A-F, Poba-Nzaou P, Templier M. A systematic assessment of rigor in information systems ranking-type Delphi studies. Inf Manag. 2013;50:207–17.
12.
go back to reference Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67:401–9.PubMed Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67:401–9.PubMed
13.
go back to reference Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med. 2017;31:684–706.PubMed Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med. 2017;31:684–706.PubMed
14.
go back to reference Grant S, Booth M, Khodyakov D. Lack of preregistered analysis plans allows unacceptable data mining for and selective reporting of consensus in Delphi studies. J Clin Epidemiol. 2018;99:96–105.PubMed Grant S, Booth M, Khodyakov D. Lack of preregistered analysis plans allows unacceptable data mining for and selective reporting of consensus in Delphi studies. J Clin Epidemiol. 2018;99:96–105.PubMed
15.
go back to reference Belton I, MacDonald A, Wright G, Hamlin I. Improving the practical application of the Delphi method in group-based judgment: a six-step prescription for a well-founded and defensible process. Technol Forecast Soc Change. 2019;147:72–82. Belton I, MacDonald A, Wright G, Hamlin I. Improving the practical application of the Delphi method in group-based judgment: a six-step prescription for a well-founded and defensible process. Technol Forecast Soc Change. 2019;147:72–82.
16.
go back to reference Humphrey-Murto S, de Wit M. The Delphi method-more research please. J Clin Epidemiol. 2019;106:136–9.PubMed Humphrey-Murto S, de Wit M. The Delphi method-more research please. J Clin Epidemiol. 2019;106:136–9.PubMed
17.
go back to reference Brookes ST, Macefield RC, Williamson PR, McNair AG, Potter S, Blencowe NS, et al. Three nested randomized controlled trials of peer-only or multiple stakeholder group feedback within Delphi surveys during core outcome and information set development. Trials. 2016;17:409.PubMedPubMedCentral Brookes ST, Macefield RC, Williamson PR, McNair AG, Potter S, Blencowe NS, et al. Three nested randomized controlled trials of peer-only or multiple stakeholder group feedback within Delphi surveys during core outcome and information set development. Trials. 2016;17:409.PubMedPubMedCentral
18.
go back to reference MacLennan S, Kirkham J, Lam TBL, Williamson PR. A randomized trial comparing three Delphi feedback strategies found no evidence of a difference in a setting with high initial agreement. J Clin Epidemiol. 2018;93:1–8.PubMed MacLennan S, Kirkham J, Lam TBL, Williamson PR. A randomized trial comparing three Delphi feedback strategies found no evidence of a difference in a setting with high initial agreement. J Clin Epidemiol. 2018;93:1–8.PubMed
19.
go back to reference Brookes ST, Chalmers KA, Avery KNL, Coulman K, Blazeby JM, ROMIO study group. Impact of question order on prioritisation of outcomes in the development of a core outcome set: a randomised controlled trial. Trials. 2018;19:66.PubMedPubMedCentral Brookes ST, Chalmers KA, Avery KNL, Coulman K, Blazeby JM, ROMIO study group. Impact of question order on prioritisation of outcomes in the development of a core outcome set: a randomised controlled trial. Trials. 2018;19:66.PubMedPubMedCentral
20.
go back to reference Gargon E, Crew R, Burnside G, Williamson PR. Higher number of items associated with significantly lower response rates in COS Delphi surveys. J Clin Epidemiol. 2019;108:110–20.PubMedPubMedCentral Gargon E, Crew R, Burnside G, Williamson PR. Higher number of items associated with significantly lower response rates in COS Delphi surveys. J Clin Epidemiol. 2019;108:110–20.PubMedPubMedCentral
21.
go back to reference De Meyer D, Kottner J, Beele H, Schmitt J, Lange T, Van Hecke A, et al. Delphi procedure in core outcome set development: rating scale and consensus criteria determined outcome selection. J Clin Epidemiol. 2019;111:23–31.PubMed De Meyer D, Kottner J, Beele H, Schmitt J, Lange T, Van Hecke A, et al. Delphi procedure in core outcome set development: rating scale and consensus criteria determined outcome selection. J Clin Epidemiol. 2019;111:23–31.PubMed
22.
go back to reference Lange T, Kopkow C, Lützner J, Günther K-P, Gravius S, Scharf H-P, et al. Comparison of different rating scales for the use in Delphi studies: different scales lead to different consensus and show different test-retest reliability. BMC Med Res Methodol. 2020;20:28.PubMedPubMedCentral Lange T, Kopkow C, Lützner J, Günther K-P, Gravius S, Scharf H-P, et al. Comparison of different rating scales for the use in Delphi studies: different scales lead to different consensus and show different test-retest reliability. BMC Med Res Methodol. 2020;20:28.PubMedPubMedCentral
23.
go back to reference Boel A, Navarro-Compán V, Landewé R, van der Heijde D. Two different invitation approaches for consecutive rounds of a Delphi survey led to comparable final outcome. J Clin Epidemiol. 2021;129:31–9.PubMed Boel A, Navarro-Compán V, Landewé R, van der Heijde D. Two different invitation approaches for consecutive rounds of a Delphi survey led to comparable final outcome. J Clin Epidemiol. 2021;129:31–9.PubMed
24.
go back to reference Powell C. The Delphi technique: myths and realities. J Adv Nurs. 2003;41:376–82.PubMed Powell C. The Delphi technique: myths and realities. J Adv Nurs. 2003;41:376–82.PubMed
25.
go back to reference Schmidt RC. Managing Delphi surveys using nonparametric statistical techniques. Decis Sci. 1997;28:763–74. Schmidt RC. Managing Delphi surveys using nonparametric statistical techniques. Decis Sci. 1997;28:763–74.
26.
go back to reference Hicks LE. Some properties of ipsative, normative, and forced-choice normative measures. Psychol Bull US: American Psychological Association. 1970;74:167–84. Hicks LE. Some properties of ipsative, normative, and forced-choice normative measures. Psychol Bull US: American Psychological Association. 1970;74:167–84.
27.
go back to reference Feather NT. The measurement of values: Effects of different assessment procedures. Aust J Psychol. 1973;25:221–31 United Kingdom: Taylor & Francis. Feather NT. The measurement of values: Effects of different assessment procedures. Aust J Psychol. 1973;25:221–31 United Kingdom: Taylor & Francis.
28.
go back to reference Rankin WL, Grube JW. A comparison of ranking and rating procedures for value system measurement. Eur J Soc Psychol. 1980;10:233–46. Rankin WL, Grube JW. A comparison of ranking and rating procedures for value system measurement. Eur J Soc Psychol. 1980;10:233–46.
29.
go back to reference Alwin DF, Krosnick JA. The measurement of values in surveys: a comparison of ratings and rankings. Public Opin Q. 1985;49:535–52 United Kingdom: Oxford University Press. Alwin DF, Krosnick JA. The measurement of values in surveys: a comparison of ratings and rankings. Public Opin Q. 1985;49:535–52 United Kingdom: Oxford University Press.
30.
go back to reference Elwyn G, O’Connor A, Stacey D, Volk R, Edwards A, Coulter A, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333:417.PubMedPubMedCentral Elwyn G, O’Connor A, Stacey D, Volk R, Edwards A, Coulter A, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333:417.PubMedPubMedCentral
31.
go back to reference Ryan JC, Wiggins B, Edney S, Brinkworth GD, Luscombe-March ND, Carson-Chahhoud KV, et al. Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders. PLoS ONE. 2021;16:e0255625.PubMedPubMedCentral Ryan JC, Wiggins B, Edney S, Brinkworth GD, Luscombe-March ND, Carson-Chahhoud KV, et al. Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders. PLoS ONE. 2021;16:e0255625.PubMedPubMedCentral
32.
go back to reference de Chiusole D, Stefanutti L. Rating, ranking, or both? A joint application of two probabilistic models for the measurement of values. TPM - Test Psychom Methodol Appl Psychol. 2011;18:49–60. de Chiusole D, Stefanutti L. Rating, ranking, or both? A joint application of two probabilistic models for the measurement of values. TPM - Test Psychom Methodol Appl Psychol. 2011;18:49–60.
33.
go back to reference Moore M. Rating versus ranking in the Rokeach Value Survey: an Israeli comparison. Eur J Soc Psychol. 1975;5:405–8 US: John Wiley & Sons. Moore M. Rating versus ranking in the Rokeach Value Survey: an Israeli comparison. Eur J Soc Psychol. 1975;5:405–8 US: John Wiley & Sons.
34.
go back to reference van Herk H, van de Velden M. Insight into the relative merits of rating and ranking in a cross-national context using three-way correspondence analysis. Food Qual Prefer. 2007;18:1096–105. van Herk H, van de Velden M. Insight into the relative merits of rating and ranking in a cross-national context using three-way correspondence analysis. Food Qual Prefer. 2007;18:1096–105.
35.
go back to reference Moors G, Vriens I, Gelissen JPTM, Vermunt JK. Two of a kind. Similarities between ranking and rating data in measuring values. Surv Res Methods. 2016;10:15–33. Moors G, Vriens I, Gelissen JPTM, Vermunt JK. Two of a kind. Similarities between ranking and rating data in measuring values. Surv Res Methods. 2016;10:15–33.
36.
go back to reference Del Grande C, Kaczorowski J, Pomey M-P. What are the top priorities of patients and clinicians for the organization of primary cardiovascular care in Quebec? A modified e-Delphi study. PLoS One. 2023;18:e0280051.PubMedPubMedCentral Del Grande C, Kaczorowski J, Pomey M-P. What are the top priorities of patients and clinicians for the organization of primary cardiovascular care in Quebec? A modified e-Delphi study. PLoS One. 2023;18:e0280051.PubMedPubMedCentral
37.
go back to reference Karazivan P, Dumez V, Flora L, Pomey M-P, Del Grande C, Ghadiri DP, et al. The patient-as-partner approach in health care: a conceptual framework for a necessary transition. Acad Med. 2015;90:437–41.PubMed Karazivan P, Dumez V, Flora L, Pomey M-P, Del Grande C, Ghadiri DP, et al. The patient-as-partner approach in health care: a conceptual framework for a necessary transition. Acad Med. 2015;90:437–41.PubMed
38.
go back to reference Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32:1008–15.PubMed Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32:1008–15.PubMed
39.
go back to reference Belton I, Wright G, Sissons A, Bolger F, Crawford MM, Hamlin I, et al. Delphi with feedback of rationales: how large can a Delphi group be such that participants are not overloaded, de-motivated, or disengaged? Technol Forecast Soc Change. 2021;170:120897. Belton I, Wright G, Sissons A, Bolger F, Crawford MM, Hamlin I, et al. Delphi with feedback of rationales: how large can a Delphi group be such that participants are not overloaded, de-motivated, or disengaged? Technol Forecast Soc Change. 2021;170:120897.
40.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.
41.
go back to reference Rowe G, Wright G. Expert opinions in forecasting: the role of the Delphi technique. In: Armstrong JS, editor. Principles of Forecasting: A Handbook for Researchers and Practitioners. Boston, MA: Springer, US; 2001. p. 125–44. Rowe G, Wright G. Expert opinions in forecasting: the role of the Delphi technique. In: Armstrong JS, editor. Principles of Forecasting: A Handbook for Researchers and Practitioners. Boston, MA: Springer, US; 2001. p. 125–44.
42.
go back to reference Beckstead JW. On measurements and their quality. Paper 4: verbal anchors and the number of response options in rating scales. Int J Nurs Stud. 2014;51:807–14.PubMed Beckstead JW. On measurements and their quality. Paper 4: verbal anchors and the number of response options in rating scales. Int J Nurs Stud. 2014;51:807–14.PubMed
43.
go back to reference Toma C. Picioreanu I. The Delphi technique: methodological considerations and the need for reporting guidelines in medical journals. Int J Public Health Res. 2016;4:47–59 Open Science Publishers. Toma C. Picioreanu I. The Delphi technique: methodological considerations and the need for reporting guidelines in medical journals. Int J Public Health Res. 2016;4:47–59 Open Science Publishers.
44.
go back to reference Rowe G, Wright G, Bolger F. Delphi: a reevaluation of research and theory. Technol Forecast Soc Change. 1991;39:235–51. Rowe G, Wright G, Bolger F. Delphi: a reevaluation of research and theory. Technol Forecast Soc Change. 1991;39:235–51.
45.
go back to reference Krippendorff K. Reliability in content analysis: some common misconceptions and recommendations. Hum Commun Res. 2004;30:411–33. Krippendorff K. Reliability in content analysis: some common misconceptions and recommendations. Hum Commun Res. 2004;30:411–33.
46.
go back to reference Hayes AF, Krippendorff K. Answering the call for a standard reliability measure for coding data. Commun Methods Meas. 2007;1:77–89. Hayes AF, Krippendorff K. Answering the call for a standard reliability measure for coding data. Commun Methods Meas. 2007;1:77–89.
48.
go back to reference Dillman DA, Smyth JD, Christian LM. Internet, phone, mail, and mixed mode surveys: the tailored design method. 4th ed. Hoboken, NJ, US: John Wiley & Sons Inc; 2014. Dillman DA, Smyth JD, Christian LM. Internet, phone, mail, and mixed mode surveys: the tailored design method. 4th ed. Hoboken, NJ, US: John Wiley & Sons Inc; 2014.
49.
go back to reference Krosnick JA. Response strategies for coping with the cognitive demands of attitude measures in surveys. Appl Cogn Psychol. 1991;5:213–36 John Wiley & Sons. Krosnick JA. Response strategies for coping with the cognitive demands of attitude measures in surveys. Appl Cogn Psychol. 1991;5:213–36 John Wiley & Sons.
50.
go back to reference Knäuper B, Belli RF, Hill DH, Herzog AR. Question difficulty and respondents’ cognitive ability: the effect on data quality. JOS. 1997;13:181 Stockholm: Statistics Sweden (SCB). Knäuper B, Belli RF, Hill DH, Herzog AR. Question difficulty and respondents’ cognitive ability: the effect on data quality. JOS. 1997;13:181 Stockholm: Statistics Sweden (SCB).
51.
go back to reference Richards T, Montori VM, Godlee F, Lapsley P, Paul D. Let the patient revolution begin. BMJ. 2013;346:f2614.PubMed Richards T, Montori VM, Godlee F, Lapsley P, Paul D. Let the patient revolution begin. BMJ. 2013;346:f2614.PubMed
Metadata
Title
Rating versus ranking in a Delphi survey: a randomized controlled trial
Authors
Claudio Del Grande
Janusz Kaczorowski
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Trials / Issue 1/2023
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-023-07442-6

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