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

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?
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.

Aim

The main objective of this study was to determine whether a rating or ranking approach would lead to different item prioritization in a Delphi study. The secondary objectives were to determine the effect of assessment mode on questionnaire completion times and ease of panelists with the assessment task.

Contributors

Claudio Del Grande & Janusz Kaczorowski

Publication

Journal: BMC Trials
Volume: 24
Issue: 543
Pages: -
Year: 2023
DOI: 10.1186/s13063-023-07442-6

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This work was supported by the Fonds de Recherche du Québec – Santé [award number 36266] and the Dr. Sadok Besrour Chair in Family Medicine.


Health Area

Disease Category: Other

Disease Name: N/A

Target Population

Age Range: Unknown

Sex:

Nature of Intervention: N/A

Stakeholders Involved

- Clinical experts
- Consumers (caregivers)
- Consumers (patients)

Study Type

- COS methods research

Method(s)

- Delphi process
- Other

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 Krippendorf’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.

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