Eliciting patient-important outcomes through group brainstorming: when is saturation reached?

Abstract

Purpose: Group brainstorming is a technique for the elicitation of patient input that has many potential uses, however no data demonstrate concept saturation. In this study we explore concept saturation in group brainstorming performed in a single session as compared to two or three sessions.

Methods: Fifty-two predominately African American adults patients with moderately to poorly controlled Diabetes Mellitus participated in three separate group brainstorming sessions as part of a PCORI-funded group concept mapping study examining comparing methods for the elicitation of patient important outcomes (PIOs). Brainstorming was unstructured, in response to a prompt designed to elicit PIOs in diabetes care. We combined similar brainstormed responses from all three sessions into a 'master list' of unique PIOs, and then compared the proportion obtained at each individual session, as well as those obtained in combinations of 2 sessions, to the master list.

Results: Twenty-four participants generated 85 responses in session A, 14 participants generated 63 in session B, and 14 participants generated 47 in session C. Compared to the master list, the individual sessions contributed 87%, 76%, and 63% of PIOs. Session B added 3 unique PIOs not present in session A, and session C added 2 PIOs not present in either A or B. No single session achieved >90% saturation of the master list, but all 3 combinations of 2 sessions achieved > 90%.

Conclusions: Single sessions elicited only 63-87% of the patient-important outcomes obtained across all three sessions, however all combinations of two sessions elicited over 90% of the master list, suggesting that 2 sessions are sufficient for concept saturation.

Trial registration: NCT02792777 . Registered 2 June 2016.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by our Institutional Review Board and all participants provided written informed consent.

Consent for publication

All authors have approved the final version of this manuscript for publication, and no research participants are identifiable.

Competing interests

We declare no competing interests and the funder had no role in the design, conduct or analysis of the study.

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Figures

Fig. 1

Venn Diagram of PIO Generation from the 3 Brainstorming Sessions. Legend: Bolded numbers in the outer circles indicate total PIOs identified in that session. The intersection of all 3 sessions shows 16 PIOs were common across the sessions. Italicized numbers in the outer circles show unique PIOs identified in that session, and bolded numbers in the inner circles show PIOs present in that 2-session combination