Dunja Dreesens

48 Methods General design This study, conducted in 2015/2016, combined a survey with the RAND-modified Delphi method (also known as RAND/UCLA Appropriateness Method) (150) to identify a core set of knowledge tools and to reach agreement on the definitions of these tool types. The survey was added ahead of the Delphi to limit the number of tool types to be assessed during the Delphi, as the experts were expected to answer three questions per tool type. The project group thought this would be too time consuming and might jeopardize their participation. A knowledge tool can be defined as a tool to assess and synthesise the highest-quality knowledge and research, aimed at healthcare professionals and/or patients, serving to translate knowledge and support (shared) decision-making (95). The definition of a knowledge tool consists of three parts: a description of the tool, its goal and its target user(s) (151). Participants and project group The participants were purposively sampled for this study. Eligible candidates were identified by the project group using the following characteristics: professional activity in health care, palliative care or long-term care; expertise, either academically or in practice, in developing, implementing or evaluating knowledge tools for professionals, patients, or both; expertise in (shared) decision-making, linguistics or terminology; active in the public, academic or private domain of health care in the Netherlands; and with understanding of the Dutch language. In addition, we aimed for diversity in affiliation, gender and age among the participants. The group of experts was complemented with members of a working group advising the National Health Care Institute on tool development and use. As these members were representatives of the main (health)care organisations in the Netherlands which develop and disseminate knowledge tools, their involvement and contribution was considered essential. The anonymity of participants was ensured at all levels. First, the experts did not know who participated. Furthermore, their responses in the Delphi rounds were submitted under code aliases. The list with code aliases was only known to the administrator of the Delphi platform. By agreeing to participate in the survey and Delphi process, the experts also gave consent to use their comments for publication. The participants were contacted via email by the first author explaining the nature and goal of the study and the consecutive steps of the study. The participants were informed of the outcomes after each round. None of the participants received any remuneration. The project group consisted of the authors and the secretary of the working group of the National Health Care Institute. Identification and selection of tools Starting point was a longlist of knowledge tool types (n=67) yielded by a scoping review of knowledge and decision support tool types (143), separately executed before this study. The scoping review looked at tool types – developed by national, non-commercial, organisations – that support knowledge translation and (shared) decision making and their definitions. The Chapter 3