How to develop and evaluate consensus documents: Methods and checklists

Abstract

Evidence-based medicine seeks the rigorous application of the best available scientific evidence to clinical decision-making. However, when the evidence is insufficient or inconsistent, consensus documents can guide clinical practice and reduce variability of care. These documents, developed by experts, require a structured approach to ensure their validity and applicability. A consensus document is a report produced by experts following a formalized process to answer a specific clinical question. The methodology used must be rigorous to minimize biases, such as dominance of certain experts or the panel not being representative. The most widely used formal consensus methods are the Delphi technique, the nominal group technique, the RAND/UCLA method, consensus conferences and other, less structured methods such as consensus meetings and focus groups. To ensure the quality of a consensus document, the use of standards such as the ACCORD guideline is essential. This guideline provides drafting criteria, ensuring the inclusion of detailed information regarding the materials, resources (both human and financial) and procedures used during the consensus process. The critical reading of these documents should take into account factors such as the representativeness of the panel, the clarity of the consensus criteria and potential conflicts of interest. In this sense, critical appraisal tools, such as those proposed by the Joanna Briggs Institute, facilitate the identification of biases and the evaluation of the validity of recommendations.