Fig. 2

Workflow diagram of the modified Delphi study. The study was initiated in October 2022, concluded in November 2023, and consisted of three Delphi rounds. In Delphi round two, the level of agreement for each recommendation and the flowchart was calculated as the frequency of “agree” (3) and “strongly agree” (4) on a 4-point Likert-like scale and divided into three levels: (1) recommendations with strong consensus (≥ 85% agreement) underwent minor revisions and entered round three, (2) recommendations with moderate consensus (75–85% agreement) underwent major revisions and repeated round two, (3) recommendations with weak consensus (< 75% agreement) were excluded. In Delphi round 3, the level of consensus for each of the final recommendations and each of the routes in the flowchart was tested using the same procedure as in Delphi round 2. The consensus threshold was an agreement of ≥ 75% among the experts