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Delphi is based on the principle that forecasts (or decisions) from a structured group of individuals are more accurate than those from unstructured groups.<ref name="rw2001">{{cite book | vauthors = Rowe G, Wright G | author-link2 = George Wright (psychologist) | date = 2001 | chapter = Expert Opinions in Forecasting: The Role of the Delphi Technique | veditors = Armstrong | title = Principles of Forecasting: A Handbook of Researchers and Practitioners | series = International Series in Operations Research & Management Science | volume = 30 | pages = 125–144 | ___location = Boston | publisher = Kluwer Academic Publishers | doi = 10.1007/978-0-306-47630-3_7 | isbn = 978-0-7923-7401-5 | chapter-url = https://www3.nd.edu/~busiforc/handouts/Other%20Articles/expertopinions.pdf }}</ref> The experts answer questionnaires in two or more rounds. After each round, a [[facilitator]] or change agent<ref>{{Cite journal | vauthors = McLaughlin MW |date=1990 |title=The Rand Change Agent Study Revisited: Macro Perspectives and Micro Realities |jstor =1176973 |journal=Educational Researcher |volume=19 |issue=9 |pages=11–16 |doi=10.3102/0013189X019009011 |issn=0013-189X}}</ref> provides an anonymised summary of the experts' forecasts from the previous round as well as the reasons they provided for their judgments. Thus, experts are encouraged to revise their earlier answers in light of the replies of other members of their panel. It is believed that during this process the range of the answers will decrease and the group will converge towards the "correct" answer. Finally, the process is stopped after a predefined stopping criterion (e.g., number of rounds, achievement of consensus, stability of results), and the [[mean]] or [[median]] scores of the final rounds determine the results.<ref name="rw1999">{{cite journal | vauthors = Rowe G, Wright G | title = The Delphi technique as a forecasting tool: issues and analysis. | journal = International Journal of Forecasting | date = October 1999 | volume = 15 | issue = 4 | pages = 353–375 | doi = 10.1016/S0169-2070(99)00018-7 | s2cid = 10745965 }}</ref>
 
Special attention has to be paid to the formulation of the Delphi theses and the definition and selection of the experts in order to avoid methodological weaknesses that severely threaten the validity and reliability of the results.<ref>{{cite journal | vauthors = Markmann C, Spickermann A, von der Gracht HA, Brem A | title = Improving the question formulation in Delphi-like surveys: Analysis of the effects of abstract language and amount of information on response behavior. | journal = Futures & Foresight Science | date = March 2021 | volume = 3 | issue = 1 | pagesarticle-number = e56 | doi = 10.1002/ffo2.56 | s2cid = 225273393 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Mauksch S, Heiko A, Gordon TJ | title = Who is an expert for foresight? A review of identification methods. | journal = Technological Forecasting and Social Change | date = May 2020 | volume = 154 | article-number = 119982 | doi = 10.1016/j.techfore.2020.119982 | s2cid = 216161197 }} </ref>
 
Ensuring that the participants have requisite expertise and that more domineering participants do not overwhelm weaker-willed participants, as the first group tends to be less inclined to change their minds and the second group is more motivated to fit in, can be a barrier to reaching true consensus. <ref>{{cite journal | vauthors = Shang, Zshida| title = Use of Delphi in health sciences research: A narrative review. | journal = Medicine (Baltimore)| date = Feb 2023 | volume = 102 | issue = 7 | pages = e32829 | doi = 10.1097/MD.0000000000032829 | pmid = 36800594| pmc = 9936053 }}</ref>
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==== Public health ====
 
Some examples of its application in [[public health]] contexts include [[metabolic dysfunction–associated steatotic liver disease|non-alcoholic fatty liver disease]],<ref>{{cite journal | vauthors = Lazarus JV, Mark HE, Anstee QM, Arab JP, Batterham RL, Castera L, Cortez-Pinto H, Crespo J, Cusi K, Dirac MA, Francque S, George J, Hagström H, Huang TT, Ismail MH, Kautz A, Sarin SK, Loomba R, Miller V, Newsome PN, Ninburg M, Ocama P, Ratziu V, Rinella M, Romero D, Romero-Gómez M, Schattenberg JM, Tsochatzis EA, Valenti L, Wong VW, Yilmaz Y, Younossi ZM, Zelber-Sagi S | display-authors = 6 | title = Advancing the global public health agenda for NAFLD: a consensus statement | journal = Nature Reviews. Gastroenterology & Hepatology | volume = 19 | issue = 1 | pages = 60–78 | date = January 2022 | pmid = 34707258 | doi = 10.1038/s41575-021-00523-4 | s2cid = 239891445 | doi-access = free | hdl = 11424/243850 | hdl-access = free }}</ref> iodine deficiency disorders,<ref>{{cite journal | vauthors = Schaffner M, Rochau U, Stojkov I, Qerimi Rushaj V, Völzke H, Marckmann G, Lazarus JH, Oberaigner W, Siebert U | display-authors = 6 | title = Barriers Against Prevention Programs for Iodine Deficiency Disorders in Europe: A Delphi Study | journal = Thyroid | volume = 31 | issue = 4 | pages = 649–657 | date = April 2021 | pmid = 32912084 | doi = 10.1089/thy.2020.0065 | s2cid = 221622474 }}</ref> building responsive health systems for communities affected by migration,<ref>{{cite journal | vauthors = Pottie K, Hui C, Rahman P, Ingleby D, Akl EA, Russell G, Ling L, Wickramage K, Mosca D, Brindis CD | display-authors = 6 | title = Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus | journal = International Journal of Environmental Research and Public Health | volume = 14 | issue = 2 | pages = 144 | date = February 2017 | pmid = 28165380 | pmc = 5334698 | doi = 10.3390/ijerph14020144 | doi-access = free }}</ref> the role of health systems in advancing well-being for those living with HIV,<ref>{{cite journal | vauthors = Lazarus JV, Safreed-Harmon K, Kamarulzaman A, Anderson J, Leite RB, Behrens G, Bekker LG, Bhagani S, Brown D, Brown G, Buchbinder S, Caceres C, Cahn PE, Carrieri P, Caswell G, Cooke GS, Monforte AD, Dedes N, Del Amo J, Elliott R, El-Sadr WM, Fuster-Ruiz de Apodaca MJ, Guaraldi G, Hallett T, Harding R, Hellard M, Jaffar S, Kall M, Klein M, Lewin SR, Mayer K, Pérez-Molina JA, Moraa D, Naniche D, Nash D, Noori T, Pozniak A, Rajasuriar R, Reiss P, Rizk N, Rockstroh J, Romero D, Sabin C, Serwadda D, Waters L | display-authors = 6 | title = Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV | journal = Nature Communications | volume = 12 | issue = 1 | article-number = 4450 | date = July 2021 | pmid = 34272399 | pmc = 8285468 | doi = 10.1038/s41467-021-24673-w | bibcode = 2021NatCo..12.4450L }}</ref> on policies and interventions to reduce harmful [[gambling]],<ref>{{cite journal |last1=Regan |first1=Marguerite |last2=Smolar |first2=Maria |last3=Burton |first3=Robyn |last4=Clarke |first4=Zoe |last5=Sharpe |first5=Casey |last6=Henn |first6=Clive |last7=Marsden |first7=John |date=August 2022 |title=Policies and interventions to reduce harmful gambling: an international Delphi consensus and implementation rating study |journal=[[Lancet Public Health]] |volume=7 |issue=8 |pages=e705–e717 |doi=10.1016/S2468-2667(22)00137-2 |doi-access=free |pmid=35907421 |hdl=1893/36145 |hdl-access=free }}</ref> on the regulation of [[electronic cigarettes]]<ref>{{cite journal |last1=Berlin |first1=Ivan |last2=Jacot-Sadowski |first2=Isabelle |last3=Humair |first3=Jean-Paul |last4=Cornuz |first4=Jacques |date=7 September 2021 |title=International expert consensus on electronic nicotine delivery systems and heated tobacco products: a Delphi survey |journal=[[BMJ Open]] |volume=11 |issue=9 |pages=e045724 |doi=10.1136/bmjopen-2020-045724 |doi-access=free |pmid=34493505 |pmc=8451280 }}</ref><ref>{{cite journal |last1=Velarde Crézé |first1=Camille |last2=Lebon |first2=Luc |last3=Duperrex |first3=Olivier |last4=Faivre |first4=Vincent |last5=Pasche |first5=Myriam |last6=Cornuz |first6=Jacques |date=1 February 2023 |title=New puff-like disposable electronic cigarettes: expert consensus on their regulation |url=https://www.revmed.ch/revue-medicale-suisse/2023/revue-medicale-suisse-812/nouvelles-cigarettes-electroniques-jetables-puffs-consensus-d-expert-e-s-sur-leur-reglementation |journal=[[Revue Médicale Suisse]] |volume=19 |issue=812 |pages=181–185 |doi=10.53738/REVMED.2023.19.812.181 |doi-access=free |pmid=36723643 |access-date=21 December 2024|url-access=subscription }}</ref><ref>{{cite journal |last1=Asfar |first1=Taghrid |last2=Schmidt |first2=Michael |last3=Oluwole |first3=Olusanya Joshua |last4=Casas |first4=Alejandra |last5=Friedman |first5=Lily |last6=Ferdous |first6=Tarana |last7=Noar |first7=Seth |last8=Eissenberg |first8=Thomas |last9=Maziak |first9=Wasim |date=2024 |title=Building consensus on a set of ENDS-specific pictorial health warnings: a Delphi study among a tobacco control expert panel |url=https://tobaccocontrol.bmj.com/content/early/2024/02/12/tc-2023-058384 |journal=[[Tobacco Control (journal)|Tobacco Control]] |volume=34 |issue=4 |pages=472–480 |doi=10.1136/tc-2023-058384 |pmid=38346872 |pmc=11317547 |pmc-embargo-date=August 12, 2025 |access-date=21 December 2024|url-access=subscription }}</ref> and on recommendations to end the [[COVID-19 pandemic]].<ref name=":0">{{cite journal | vauthors = Lazarus JV, Romero D, Kopka CJ, Karim SA, Abu-Raddad LJ, Almeida G, Baptista-Leite R, Barocas JA, Barreto ML, Bar-Yam Y, Bassat Q, Batista C, Bazilian M, Chiou ST, Del Rio C, Dore GJ, Gao GF, Gostin LO, Hellard M, Jimenez JL, Kang G, Lee N, Matičič M, McKee M, Nsanzimana S, Oliu-Barton M, Pradelski B, Pyzik O, Rabin K, Raina S, Rashid SF, Rathe M, Saenz R, Singh S, Trock-Hempler M, Villapol S, Yap P, Binagwaho A, Kamarulzaman A, El-Mohandes A | display-authors = 6 | title = A multinational Delphi consensus to end the COVID-19 public health threat | journal = Nature | volume = 611 | issue = 7935 | pages = 332–345 | date = November 2022 | pmid = 36329272 | pmc = 9646517 | doi = 10.1038/s41586-022-05398-2 | bibcode = 2022Natur.611..332L }}</ref>
 
==== Reporting guidelines====