Consensus on Hypotonia via Delphi Process

To generate consensus on the assessment of hypotonia in the pediatric population, more specifically with respect to the clinical characteristics and first line tests and methods to be used to assess these characteristics. Consensus methodology was used. A sample of experts was recruited based on specific inclusion criteria. A two-round Delphi process was conducted electronically, which was based on a prior literature appraisal and survey amongst a cohort of clinicians. An a priori threshold margin error of 70 ± 5 % was pre-determined, with Cronbach’s α measuring the level of internal consistency. The 2-round iteration was useful in establishing consensus on clinical characteristics and tests /methods in the assessment of low muscle tone in the pediatric population (2–5 y age band). Twenty-four clinical characteristics, organized into 11 clusters were determined as relevant for inclusion. For each characteristic, one test (as a first line assessment method) had been identified with consensus after two rounds. Additionally, consensus on the importance of collateral sources was determined. The ranking order of importance of characteristics however revealed variations. The results of this study have displayed that Delphi, if executed with available guidelines, may be a useful technique in moving towards consensus on issues that may be contentious and have assisted in providing initial data to move towards consensus on the assessment of hypotonia in children.