Delphi study on the STRIDE algorithm for compression selection in upper-body lymphoedema

Abstract

Background:
The original STRIDE algorithm covered lower-limb lymphoedema but not the upper body.

Aims:
To update the STRIDE algorithm for compression selection to treat lymphoedema of the upper limb, breast and trunk by achieving consensus on the definitions and importance of its six aspects.

Method:
Using a modified Delphi framework, clinical experts in the field ranked agreement and gave open-ended feedback over two rounds of surveys, with a >70% threshold for agreement.

Results:
In the first round, participants represented five continents (n=36). Characteristics that met the threshold consensus of >70% agreement were then applied to the STRIDE algorithm, and the second survey was developed. In the second round (n=22), the definitions of all elements of the STRIDE algorithm had at least 70% agreement or strong agreement. Shape and issues were the elements most often considered first in compression selection, while refill was least often considered first in selection.

Conclusions:
This Delphi study achieved consensus on the descriptions of the elements of the revised STRIDE algorithm for compression in upper-limb, breast and trunk lymphoedema. The STRIDE algorithm can now be used to make clinical decisions on selecting compression garments for the upper body.