Objective To construct a multi-dimensional evaluation system for physical function and functional rehabilitation of elderly patients with lung cancer during perioperative period based on the modified Delphi method.Methods From December 2024 to April 2025, based on literature search and group research, a multi-dimensional evaluation indicator system for perioperative physical function and functional rehabilitation of elderly patients with lung cancer was initially constructed, and 13 experts in the field of elderly lung cancer treatment and perioperative rehabilitation were selected. Based on the modified Delphi method, two rounds of consultation and in-depth communication were conducted with experts to objectively evaluate the importance of indicators at all levels and finally appropriate indicators were selected. Results Through two rounds of expert consultation, a multi-dimensional comprehensive evaluation system was established, including 6 primary indicators (general situation and disease characteristics; physical fitness; pulmonary function; respiratory muscle function; balance function; activities of daily living, quality of life and emotional and psychological conditions) and 24 secondary indicators. The response rate of the two rounds of consultation questionnaires reached 100%, the coefficient of expert authority was 0.93±0.05, and the Kendall’s coefficient of concordance of the primary and secondary indicators were 0.391 and 0.187, respectively (P<0.05).ConclusionsThe multi-dimensional perioperative evaluation system of elderly patients with lung cancer constructed based on the modified Delphi method has good rationality and scientificity, which is helpful to comprehensively and multi-dimensionally evaluate the perioperative risk and functional status of elderly patients with lung cancer, and provide guidance and reference for clinical practice.
Irreparable posterosuperior massive rotator cuff tears represent a common and challenging condition in shoulder surgery. Reconstruction procedures can effectively restore the anatomical structure and function of the shoulder joint and, as an important joint-preserving treatment option for irreparable posterosuperior massive rotator cuff tears, have garnered increasing attention and application among shoulder surgeons. However, a lack of consensus currently exists regarding its definition, diagnostic criteria, and treatment strategies, leading to inconveniences in clinical decision-making and academic communication. To standardize the indications, surgical option selection, and postoperative rehabilitation strategies for the reconstruction of irreparable posterosuperior massive rotator cuff tears, the Shoulder Joint Study Group of the Fifth Committee of the Chinese Society of Sports Medicine of Chinese Medical Association organized experts in the relevant field to develop a consensus using a modified Delphi method, which involved two rounds of questionnaire surveys and one online expert meeting. After reviewing domestic and foreign literature, the consensus drafting group compiled the initial draft and questionnaire items. Suitable topics were selected via the first round of expert voting, and the recognition level of responses to each consensus question was determined in the second round. Online expert discussions were subsequently held to refine wording and reconcile divergent views, yielding the final consensus. A consensus is confirmed with an approval rate of no less than 85%. It is classified into three tiers: high consensus (95.0%-100%), general consensus (90.0%-94.9%), and basic consensus (85.0%-89.9%). This consensus ultimately formulated 10 recommendations focusing on core issues, including the definition and diagnosis of irreparable posterosuperior massive rotator cuff tears, the indications and timing of reconstruction surgery, the selection and application principles of commonly used reconstruction techniques, perioperative management and phased rehabilitation protocols, and the prevention and treatment of postoperative complications. This consensus aims to provide a clinical decision-making reference for orthopedic surgeons, sports medicine physicians, and rehabilitation specialists, thereby promoting the standardization and individualization of reconstruction treatment for irreparable massive rotator cuff tears and improving patient functional outcomes.