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In round two, we sought to identify the reasons or rationale for why experts provided such a diverse range of answers to the same clinical problem. Specifically, experts received the collated response to the first round and a follow up questionnaire with 14 questions that addressed the specific areas of controversy identified in an effort to better understand the reasons for the range of diversity in clinical practice identified in the first round survey. The group's response was collected, collated and analysed. The first and second rounds served to identify clear areas of diverse practice; these specific topics became the focus of discussion for the third round. A convenience sample of five English speaking opinion leaders from geographically diverse areas (US, Canada, France, Australia and Colombia) participated SP600125 ic50 in a 1?h facilitated discussion related to discrete areas of controversy identified by find more our process. Participants�� responses were analysed independently by two members of the research team in order to identify patterns and categorise these ideas into thematic categories through the process of iterative analysis. Absolute and relative frequencies were measured for discrete variables. Proportions were evaluated using the ��2-test. In all statistical analyses, p?MAO 1). The first round consisted of a questionnaire with six clinical vignettes that addressed specific care aspects of the patient with splenic injuries (Appendix A). These areas included in-hospital management and follow up, definition of failure of NOMSI, angioembolisation, the role of NOMSI in the elderly or patients with concomitant traumatic brain injury, and the non-operative management of penetrating splenic trauma. Consensus was reached in only 6 out of 25 questions in round 1 (Table 2).