Use of modified Delphi introduces the risk of chronological bias during clinical research interventions
Intended for healthcare professionals
Evidence and practice    

Use of modified Delphi introduces the risk of chronological bias during clinical research interventions

Kaylynn Armstrong Registered nurse, University of Texas Southwestern Medical Center, Dallas TX, US
Hend Nadim Research coordinator, University of Texas Southwestern Medical Center, Dallas TX, US
DaiWai Olson Professor, University of Texas Southwestern Medical Center, Dallas TX, US
Sonja Stutzman Project manager, Peter O’Donnell Jr Brain Institute, University of Texas Southwestern Medical Center, Dallas TX, US

Why you should read this article:
  • To gain insight into what chronological bias is and how it can affect the outcome of a study

  • To find out how to improve the design of your next study

  • To develop a thorough understanding of how to interpret research results that may be at risk of chronological bias, the ‘Hawthorne effect’ or performance bias

Background A study aimed at reducing the time spent on the phone obtaining insurance preauthorisation in a neurosurgical clinic was successfully completed. However, the researchers were unable to reject the null hypothesis because of a combination of chronological bias and the Hawthorne effect.

Aim To increase nurse researchers’ awareness of the potential to introduce a chronological bias as a confounder in clinical research and suggest potential alternative approaches to study design.

Discussion The researcher shared the study’s purpose, design and outcome measure with the participants before collecting the baseline data. This enabled the participants to alter their practice before the intervention was implemented (a chronological bias) and change their behaviour surrounding the outcome (the Hawthorne effect).

Conclusion The use of the Delphi method became a catalyst for change before the collection of baseline data, the combination of chronological bias and the Hawthorne effect affecting the study’s results.

Implications for practice Nurse researchers seeking to improve practice should collect baseline data before informing participants and consider the risks and benefits of blinding (concealment) surrounding the outcome.

Nurse Researcher. 29, 1, 9-13. doi: 10.7748/nr.2020.e1742

Correspondence

sonja.stutzman@utsouthwestern.edu

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Conflict of interest

None declared

Permission

To reuse this article or for information about reprints and permissions, please contact permissions@rcni.com

Write for us

For information about writing for RCNi journals, contact writeforus@rcni.com

For author guidelines, go to rcni.com/write-for-nurse-researcher

Want to read more?

RCNi-Plus
Already have access? Log in

or

3-month trial offer for £5.25/month

Subscribe today and save 50% on your first three months
RCNi Plus users have full access to the following benefits:
  • Unlimited access to all 10 RCNi Journals
  • RCNi Learning featuring over 175 modules to easily earn CPD time
  • NMC-compliant RCNi Revalidation Portfolio to stay on track with your progress
  • Personalised newsletters tailored to your interests
  • A customisable dashboard with over 200 topics
Subscribe

Alternatively, you can purchase access to this article for the next seven days. Buy now


Are you a student? Our student subscription has content especially for you.
Find out more