Our consensus process relied on evidence where available and, in the absence of evidence, consensus expert opinion when possible [7 (link)]. This combined approach has previously led to important practice guidelines that were widely adopted into clinical practice [8 (link)]. In contrast, expert opinion alone can ignore important evidence, whereas evidence-based reviews can be conceptually flawed without expert opinion [9 ]. We conducted the consensus process in three stages: preconference, conference and postconference.
Before the conference, we identified six topics relevant to the field of ARF: definition/classification system for ARF; clinical outcome measures for ARF studies; physiological end-points for ARF studies; animal models of ARF; techniques for assessing and achieving fluid balance in ARF; and information technology in acute dialysis. We selected these topics based on the level of possible clinical impact, the level of controversy, known or suspected variation in practice, potential importance for scientific outcome, potential for development of evidence-based medicine recommendations, and availability of evidence. For each topic we outlined a preliminary set of key questions. We then invited an international panel, predominantly from the fields of nephrology and intensive care, based on their expertise in the fields of analysis. Panelists were assigned to three-person workgroups, with each workgroup addressing one key topic. Each workgroup conducted literature searches related to their topic questions via Medline, PubMed, bibliography of review articles and participants' files. Searches were limited to English language articles. However, articles written in other languages were used when identified by workgroup members. During this stage, the scope of the conference was also more clearly defined.
We conducted a 2-day conference in May 2002 in Vicenza, Italy. We developed summary statements through a series of alternating breakout and plenary sessions. In each breakout session, the workgroup refined key questions, identified the supporting evidence, and generated recommendations and/or directions for future research as appropriate. We generated future research questions by identifying deficiencies in the literature and debating whether more evidence was necessary. Where possible, we also considered pertinent study design issues. Workgroup members presented their findings during plenary sessions, rotating responsibility for presenting to ensure full participation. The workgroup then revised their drafts as needed until a final version was agreed upon. When consensus was not achieved on any individual question by the conclusion of the meeting, deliberations continued by correspondence. When voting was required to settle an issue, a two-thirds majority was required to approve a proposal.
A writing committee assembled the individual reports from the workgroups and each report was edited to conform to a uniform style and for length. Finally, each report was submitted for comments to independent international experts. In this report we present a summary of the proceedings.
Before the conference, we identified six topics relevant to the field of ARF: definition/classification system for ARF; clinical outcome measures for ARF studies; physiological end-points for ARF studies; animal models of ARF; techniques for assessing and achieving fluid balance in ARF; and information technology in acute dialysis. We selected these topics based on the level of possible clinical impact, the level of controversy, known or suspected variation in practice, potential importance for scientific outcome, potential for development of evidence-based medicine recommendations, and availability of evidence. For each topic we outlined a preliminary set of key questions. We then invited an international panel, predominantly from the fields of nephrology and intensive care, based on their expertise in the fields of analysis. Panelists were assigned to three-person workgroups, with each workgroup addressing one key topic. Each workgroup conducted literature searches related to their topic questions via Medline, PubMed, bibliography of review articles and participants' files. Searches were limited to English language articles. However, articles written in other languages were used when identified by workgroup members. During this stage, the scope of the conference was also more clearly defined.
We conducted a 2-day conference in May 2002 in Vicenza, Italy. We developed summary statements through a series of alternating breakout and plenary sessions. In each breakout session, the workgroup refined key questions, identified the supporting evidence, and generated recommendations and/or directions for future research as appropriate. We generated future research questions by identifying deficiencies in the literature and debating whether more evidence was necessary. Where possible, we also considered pertinent study design issues. Workgroup members presented their findings during plenary sessions, rotating responsibility for presenting to ensure full participation. The workgroup then revised their drafts as needed until a final version was agreed upon. When consensus was not achieved on any individual question by the conclusion of the meeting, deliberations continued by correspondence. When voting was required to settle an issue, a two-thirds majority was required to approve a proposal.
A writing committee assembled the individual reports from the workgroups and each report was edited to conform to a uniform style and for length. Finally, each report was submitted for comments to independent international experts. In this report we present a summary of the proceedings.