Background: Methodologies used to gain consensus among healthcare professionals, including variations of the Delphi technique and the RAND/UCLA appropriateness method, all force a consensus, corrupting the original opinion through the consensus-generating process. Furthermore, none assess knowledge awareness of the experts prior to the consensus process. Methods: Four case studies about X-linked hypophosphatemia (XLH) are reported to demonstrate the principle of group ‘awareness’ of items, consensus and the concept of prompted agreement. The novel methodology consisted of two surveys: Round 1 was an item-generation round in which participants were asked an open-ended question. Responses to Round 1 were collated into themes and developed into mutually exclusive items. Item generating was also performed using systematic literature reviews when appropriate. Items generated were used to develop a structured questionnaire (Round 2) comprising statements for which each participant identified their level of agreement using a five-point Likert scale. All responses were analysed anonymously. Item awareness, observed agreement consensus and prompted agreement were objectively measured. Results: The free-text responses to the item-generation round tested the awareness of specific concepts or items regarding setting up a European registry for XLH, the limitations of empirical treatment for XLH in children and adults, and triggers for treatment of XLH in adults. The four case studies showed different levels of item awareness, observed consensus and various degrees of prompted agreement. All participants agreed or strongly agreed with statements based on the most frequent items listed in Round 1. Less frequent items generated during Round 1 had various degrees of prompted agreement consensus, and some did not reach the consensus threshold of >50% agreement by the participants. Conclusions: Observed proportional group awareness and consensus is a relatively quick process compared with the Delphi technique and its variants, providing objective assessment of expert knowledge and standardized categorization of items with regard to awareness, consensus and prompting. It offers the opportunity for tailored management of each item or concept in terms of educational need and further investigation.