Consensus development methods: Considerations for national and global frameworks and policy development

Background: key decisions have to be made in healthcare systems and policies often under uncertain conditions or without complete objective evidence. Decisions made on the health system and policy levels affect national and global population, which requires transparency and accountability to ensure the best impact to population's health. Consensus development methods assist complex process of the decision making combining existing evidence and expert opinions. Variety of challenges affect the selection, application and use of the consensus development methods, which requires careful consideration to keep rigour, validity and transparency. Objective: To identify and review studies which have used consensus development methods in order to develop national or international policy or framework in health field. Methods: A literature review was conducted searching the databases PubMed, EMBASE and PsycINFO. Studies using a consensus development approach to develop tools or frameworks for health system and policy enhancement were eligible for the review. Key elements of consensus development process were extracted and reported using content analysis and narrative synthesis. Results: The review included 26 studies in total either in national or international settings. Over 60% of studies extracted did not apply typical consensus development methods; however, stated as consensus meetings instead. Delphi technique was the most used method from the consensus development methods, which often combined with some face-to-face meeting features. Conclusions: This review summarised the use of consensus development methods in health system and policy development. The review identified a wide range of variations in the selection, use and application of the methods in studies. For better utilisation and application of the consensus development methods in the field, some standardisation of the methods and reporting would be warranted