Results
Six items reached consensus at the end of round 1. Some questions were amended for the second round in response to comments from panellists; for example, many panellists requested information on COVID status and endoscopy findings in order to make recommendations. Steroid rinses were identified as a missing treatment and added.
All panellists completed both rounds of the Delphi process.
After the second round, consensus had been achieved on most items. There was disagreement on the use of Vit A drops and therefore no recommendations have been made in the guideline.
In 4 areas consensus could not be achieved at the 70% threshold, but was met at 60%. Further discussion lead to consensus regarding imaging. The remaining items related to treatment using oral corticosteroids, steroid drops or rinses and omega 3 supplements. The mean score for these items was 5, and 60 – 67% considered these an option, and less than 15% would not recommend. They have been included as an option but the uncertainty regarding the balance of risk and benefit should be discussed with the patient, and a decision made on an individual basis.