What is the Delphi Method?

why did Queerists use it to establish paediatric clinical guidelines

The RAND Corporation developed the Delphi Method to study consensus building, ie how to get people to agree on complex topics, and to develop opinion technology. A 1969 paper details research underlying the Delphi Method, a new technique for the use of experts as advisors in decision-making, especially in areas of broad or long-range policy formulation. For the Air Force, the [method has wide ranging application] from long-term threat assessment to forecasts of technological and social development. The Delphi technique is a method of eliciting and refining group judgments. The rationale for the procedures is primarily the age-old adage "two heads are better than one," when the issue is one where exact knowledge is not available. Organizations today use the Delphi Method for policy planning and forecasting activities, including threat detection.

Figure 1: From 1969 Norman Dalkey via RAND Corporation for US Air Force :: Three types of info involved in decision making :: speculation, opinion, knowledge

The original paper lists the following three features of the Delphi Method :

1. Anonymous—response opinions of members of the group are obtained by formal questionnaire.

2. Iteration and controlled feedback—interaction is effected by a systematic exercise conducted in several iterations, with carefully controlled feedback between rounds.

3. Statistical group response—the group opinion is defined as an appropriate aggregate of individual opinions on the final round.

Originally, UCLA upper class and graduate students populated the early studies. The research questions involved group decision-making and examining the group process. When you look at Figure 1, you can see the desire to lend some kind of scientific methodology or legitimacy to the thought-craft of speculation driving the development of the Delphi Method. Dalkey notes that there is an irrepressible urge on the part of analysts to move the arena of action entirely into the knowledge area. Sometimes this is possible. In general, it is not. When an opinion is expressed, it is an inescapable fact of life that whatever is said, there is a reasonable probability of its being false. In other words, there is no means through which social scientists can turn opinion into solid undisputed fact. An aggregate of expert opinions does not necessarily or automatically become an established scientific fact.

Unfortunately, there is no practical, objective measure for the dimension of evidence sketched in Fig. 1. The best we have is an intuitive and rough feeling for the scale. The prototype of knowledge may be found in the systematized, experimentally confirmed propositions of the natural sciences. — Dalkey

This early study process on the formation of the group process and group opinions that fed the development of the Delphi Method—

1. found anonymity achieved more successful outcomes than person-to-person information solicitation, and

2. enabled the improvement of techniques to aggregate individual opinions into group aggregates that can then be representative of the expert consensus on a research question, ie expert evidence.

That’s a very initial and cursory explanation of the Delphi Method, the process used by WPATH in establishing its guidelines for care. Note some key phrases about the intended use for Delphi in the pull quote below. I have questions.

especially in areas of broad or long-range policy formulation … long-term threat assessment to forecasts of technological and social development … eliciting and refining group judgments

Ok. I have a few initial questions.

1. Does this sound like the kind of process that would suit the development of primary care guidelines and standards of care for paediatric clinical practise in an area with a DEARTH valid and reliable research to support any definitive clinical claims made?

2. Does it sound like a conflict of interest when clinicians who have publicly declared a strong radical opinion on the issue of Gender Affirmation as an approach to paediatric care conduct research trials and studies on the research questions related to the topic to prove the thing they radically assert as true in social media comma?

3. Does it make sense that Gender Affirmationists expect us to throw out decades of valid and reliable clinical evidence and decades of work conducted to add solid knowledge to the human development knowledge base?

4. What does a Delphi consensus of Gender Affirmationist Clinician-Activists mean? Seriously when did a consensus on how to facilitate child sex changes of people who think kids can have sex changes become acceptable clinical standards of care?

5. Does it become something parents and medical professionals must endorse when we call that Delphi consensus of activist clinicians who think children should have sex changes “standards of care” and frame them in a dystopian fictional medical narrative about distressed disenfranchised kids needing love?

The US Air Force developed this opinion technology — used it for threat detection and forecasting. Do you think the Air Force would use a Delphi Method of consensus to determine the best practices for fighter pilots in combat? Probably that’s not how best practices in combat are determined for military SOP, it’s similar to clinical practise, where material physical reality and evidence therein determine how things are done.

Example to demonstrate why progressive activist consensus such as Delphi doesn’t work for clinical practise — Harm Reductionists in the Vancouver DTES Poverty Pimp Industry have arrived at a consensus that insulin needles are appropriate paraphernalia to give IV drug users to help reduce harm. This does not change the material physical fact that an insulin needle is not large or long enough for venipuncture and its repeated use will increase the risk of complications such as cellulitis and even endocarditis (I saw and treated both as a nurse).

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The Delphi Method: An Experimental Study of Group Opinion. RAND Corporation, 1969. https://doi.org/10.7249/RM5888.