Results from the ATTOM project: A Delphi consensus study Sarah Tonkin-Crine, Rishi Pruthi, Gabriel Oniscu, Gerry Leydon, Rommel Ravanan, Paul Roderick on behalf of the ATTOM group.

Background The ATTOM* study – stream 1 –There is variation between renal units in listing for kidney transplantation. –It is important to identify factors which influence decisions to list. The ATTOM national survey sought to assess this at unit level. The survey identified specific areas where there is variation. *Access to Transplant and Transplant Outcome Measures. 2

Aim and Method The Delphi Study –Aim: To assess levels of consensus between individual clinicians on factors which influence listing for transplantation. Method –modified Delphi method –two data collection rounds, web-based survey –all UK consultant nephrologists and surgeons (n=600). 3

Content of the Delphi Clinicians were asked about specific areas and their influence on listing for transplantation: –Written transplant protocol –BMI criteria for listing –Minimum cardiac work-up –Evaluation of lower limb peripheral vascular disease –Screening for malignancy –Patient compliance –Using an MDT approach to decide on listing 4

Web-based survey 5 Clinicians received s with a link to an online questionnaire. –Clinicians rated their agreement with 29 statements.

Procedure 6 Round 1: –Clinicians rated 29 statements. –Median agreement and IQR were calculated for each statement. –Agreement consensus was rated as 8 or more out of 9. Round 2: –Clinicians rated statements that did not reach consensus in Round 1. –Clinicians were reminded of their previous answer and were given the median of all answers to Round 1. –Agreement consensus was rated as 8 or more out of 9.