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Exploring the acceptability of a ‘limited patient consent procedure’ for a proposed blood-borne virus screening programme: a Delphi consensus building technique
  1. Denise Crane1,
  2. Emily J Henderson2,
  3. David R Chadwick3
  1. 1School of Medicine Pharmacy and Health, Durham University, Durham, United Kingdom
  2. 2School of Medicine Pharmacy and Health, Durham University, Durham, United Kingdom
  3. 3Centre for Clinical Infection, The James Cook University Hospital, Middlesbrough, Cleveland, United Kingdom
  1. Correspondence to Dr Denise Crane; denise.crane{at}


Objective To identify components of a proposed blood-borne virus (BBV) population screening programme and its associated consent procedure that both the public and health practitioners (HPs) would find acceptable. The proposed BBV screening system would aim to reduce late diagnosis of BBVs and be used in patients undergoing routine blood tests, aided by risk stratification software to target individuals at higher risk of infection.

Design A Delphi technique was used to build consensus among two separate groups, public participants and HPs in England.

Methods A survey incorporating vignettes was developed, with input from an external panel of experts. Over three rounds, 46 public participants and 37 HPs completed the survey, rating statements on a four-point Likert scale. The survey covered issues around stigma and sensitivity, the use of risk stratification algorithms and ‘limited’ patient consent (ie, preinformed of the option to ‘opt-out’). Consensus was defined as >70% of participants agreeing or disagreeing with each statement.

Results Consensus was achieved among both groups in terms of acceptability of the screening programme. There was also consensus on using patient data to risk-stratify screening algorithms and the need to obtain some form of consent around the time of drawing blood.

Conclusions This study found that the special protected status of HIV in England is no longer deemed necessary today and hinders appropriate care. We propose that a novel ‘limited consent procedure’ could be implemented in future screening programmes.

  • HIV
  • hepatitis B
  • hepatitis C
  • screening
  • testing
  • consensus building
  • consent

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors DC, EJH and DRC were all responsible for the conception and design of this study, interpretation of the data, drafting, revising and approval of the final document.

    DC was responsible for recruitment of the participants, collection and analysis of the data.

  • Competing interests None declared.

  • Ethics approval Durham University School of Medicine, Pharmacy and Health’s Sub-Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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