Andy Easton & Patrice Carter,
In the complex and ever-evolving field of healthcare, decision-makers often face significant uncertainty due to limited or ambiguous evidence. Expert elicitation, a process that synthesises expert opinions to inform judgements and predictions where empirical evidence is lacking, has emerged as a valuable tool in this context. By leveraging the knowledge of subject matter experts, expert elicitation aids in making informed decisions across research projects and health technology assessments (HTAs).
What is expert elicitation?
Approaches to obtaining expert judgements generally fall under two categories: unstructured or structured:
Unstructured
Unstructured methods involve the process of collecting qualitative information from experts. Generally appropriate for driving strategic planning and positioning, these approaches include advisory boards and interviews.
Structured
Structured expert elicitation involves collecting beliefs from experts in a quantitative or statistical form. Structured methods should adhere to existing protocols which attempt to minimise bias and provide measures of uncertainty.
Increasing awareness and application in healthcare decisions
Global trends in pushing for faster access to care and earlier treatment initiation in the course of disease have led to an increase in the interest of alternative methods to generate evidence for HTAs. Expert elicitation is a useful resource when existing evidence is limited. Accordingly, the number of research publications in the space is ever-increasing (Figure).
Number of publications relating to “Delphi” or “consensus”
NICE guidance on the use of expert elicitation and expert opinion in HTA submissions found here is limited. Structured methods are preferred, as they attempt to minimise biases and provide some indication of uncertainty. Additionally, clear reporting of the identification and selection of experts and the results including the consensus of opinions or data aggregation is required.
Expert elicitation at HEOR
At HEOR, our evidence review and synthesis team has extensive experience in conducting both structured and unstructured expert elicitation projects in a variety of disease areas. These projects utilise numerous methodologies including Delphi, nominal group technique, surveys, expert panels, consensus workshops, and interviews.
We are proud to highlight three recent publications that reflect our work in this field:
1. | Carter P, et al. European expert consensus recommendations on the primary care use of direct oral anticoagulants in patients with venous thromboembolism. BMC Prim Care. 2024;25(1):90. |
2. | Cohen AT, et al. A consensus viewpoint on the role of DOACs in the management of cancer-associated thrombosis in the UK. Current Medical Research and Opinion. 2023;39(3):483-495. |
3. | Zaman A, et al. An update on anti-thrombotic therapy following TAVI: expert cardiologist opinion from a UK and Ireland Delphi group. Interventional Cardiology: Reviews, Research, Resources. 2023;18:e13. |
Conclusion
Expert elicitation continues to grow in importance in healthcare decision-making, filling evidence gaps and complementing real-world evidence by adding valuable context to large-scale studies. Not to be viewed as a low-cost, low-effort substitute for rigorous research, expert elicitation builds upon the best available evidence and should be employed judiciously to support timely, informed assessments and decisions when empirical data alone is insufficient.
By continuously refining our methods and adhering to established guidelines, we ensure that the insights derived from expert elicitation are robust, reliable, and ultimately beneficial in advancing healthcare outcomes.