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Grycuk E, Eichenholtz E, Aarsland D, Betzhold S, Daly G, Fitzpatrick R, Folkerts AK, Kalbe E, Kane JPM, Kinchin I, Saldanha IJ, Smith V, Taylor JP, Thompson R, Leroi I. Developing a core outcome set (COS) for Dementia with Lewy bodies (DLB). HRB Open Res 2023; 5:57. [PMID: 36619176 PMCID: PMC9772580 DOI: 10.12688/hrbopenres.13590.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 10/13/2023] Open
Abstract
Background: Dementia with Lewy bodies (DLB) is an important cause of dementia with a range of clinical manifestations, including motor, neuropsychiatric, and autonomic symptoms. Compared with more common forms of dementia such as Alzheimer's disease, DLB has been the focus of significantly fewer treatment studies, often with diverse outcome measures, making comparison and clinical implementation difficult. A core outcome set (COS) can address this by ensuring that data are comparable, relevant, useful, and usable for making the best healthcare decisions. Methods: Using a multi-stage approach, development of the DLB-COS will include the following stages: (1) A systematic review, following PRISMA guidelines to create an initial long list of outcomes; (2) A two-round online Delphi including clinicians, scientists, policymakers, and individuals with lived experience of DLB and their representatives; (3) An online consensus meeting to agree on the final core list of outcomes (the final DLB-COS) for use in research and clinical practice; (4) A systematic review to identify appropriate measurement instruments for the DLB-COS outcomes; (5) A final consensus meeting of the professional stakeholders who attended the online consensus meeting to agree on the instruments that should be used to measure the outcomes in the DLB-COS; and (6) Global dissemination. Discussion: This is a multi-stage project to develop a COS to be used in treatment trials for DLB. A DLB-COS will ensure the selection of relevant outcomes and will identify the instruments to be used to measure DLB globally. Keywords: Dementia, Dementia with Lewy Bodies, Core Outcome Set, Delphi, Systematic Review, Ageing, Cognition, Memory.
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Affiliation(s)
- Emilia Grycuk
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland
| | - Emily Eichenholtz
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | | | - Gillian Daly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Rachel Fitzpatrick
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Joseph PM Kane
- Centre for Public Health, Queens University Belfast, Northern Ireland, UK
| | - Irina Kinchin
- Global Brain Health Institute, and Centre for Health Policy and Management, Trinity College, Dublin, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | | | - Iracema Leroi
- Global Brain Health Institute, and Department of Psychiatry, Trinity College Dublin, Ireland
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Grycuk E, Eichenholtz E, Aarsland D, Betzhold S, Daly G, Fitzpatrick R, Folkerts AK, Kalbe E, Kane JPM, Kinchin I, Saldanha IJ, Smith V, Taylor JP, Thompson R, Leroi I. Developing a core outcome set (COS) for Dementia with Lewy bodies (DLB). HRB Open Res 2022; 5:57. [PMID: 36619176 PMCID: PMC9772580 DOI: 10.12688/hrbopenres.13590.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Dementia with Lewy bodies (DLB) is an important cause of dementia with a range of clinical manifestations, including motor, neuropsychiatric, and autonomic symptoms. Compared with more common forms of dementia such as Alzheimer's disease, DLB has been the focus of significantly fewer treatment studies, often with diverse outcome measures, making comparison and clinical implementation difficult. A core outcome set (COS) can address this by ensuring that data are comparable, relevant, useful, and usable for making the best healthcare decisions. Methods: Using a multi-stage approach, development of the DLB-COS will include the following stages: (1) A systematic review, following PRISMA guidelines to create an initial long list of outcomes; (2) A two-round online Delphi including clinicians, scientists, policymakers, and individuals with lived experience of DLB and their representatives; (3) An online consensus meeting to agree on the final core list of outcomes (the final DLB-COS) for use in research and clinical practice; (4) A literature search to identify appropriate measurement instruments for the DLB-COS outcomes; (5) A final consensus meeting of the professional stakeholders who attended the online consensus meeting to agree on the instruments that should be used to measure the outcomes in the DLB-COS; and (6) Global dissemination. Discussion: This is a multi-stage project to develop a COS to be used in treatment trials for DLB. A DLB-COS will ensure the selection of relevant outcomes and will identify the instruments to be used to measure DLB globally.
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Affiliation(s)
- Emilia Grycuk
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland
| | - Emily Eichenholtz
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, UK
| | | | - Gillian Daly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Rachel Fitzpatrick
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Joseph PM Kane
- Centre for Public Health, Queens University Belfast, Northern Ireland, UK
| | - Irina Kinchin
- Global Brain Health Institute, and Centre for Health Policy and Management, Trinity College, Dublin, Ireland
| | | | - Valerie Smith
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, UK
| | | | - Iracema Leroi
- Global Brain Health Institute, and Department of Psychiatry, Trinity College Dublin, Ireland
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Ruiter ELM, Molleman GRM, Fransen GAJ, Wagenaar M, van der Velden K, Engels RCME. A set of pedagogical recommendations for improving the integrated approach to childhood overweight and obesity: A Delphi study. PLoS One 2020; 15:e0231245. [PMID: 32339183 PMCID: PMC7185684 DOI: 10.1371/journal.pone.0231245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 03/19/2020] [Indexed: 11/19/2022] Open
Abstract
Background Tackling the increasing global problem of childhood overweight and obesity requires an integrated approach. Studies increasingly emphasize the importance of the parents’ role in interventions designed to prevent overweight in children. The aim of this study was to develop a unified set of recommendations for healthy parenting practices that can be applied by all professionals who work with children age 4–13 years and can contribute to strengthening the integrated approach to childhood overweight. Methods A modified Delphi procedure was used to reach consensus regarding what these pedagogical recommendations should encompass. The 30 panelists were professionals and researchers who work with children age 4–13 in the domains of health care, overweight, parenting, education, nutrition, and/or sports. The procedure consisted of: i) extracting existing pedagogical recommendations from national guidelines and professional protocols, ii) appraising and prioritizing these recommendations in terms of relevance through two rounds of questionnaires, and iii) meeting to discuss and approve the set of recommendations. Results Consensus was reached for one set of eleven pedagogical theme-based recommendations designed to support and instruct parents how to stimulate healthy energy balance‒related behaviors in their child. Each recommendation contained information regarding: i) which behaviors in the child and/or parent are important, ii) why this is important, and iii) how parents can stimulate this behavior by applying parenting skills in daily life. The eleven themes were: modeling, positive parenting, breakfast, varied diet, sugar-sweetened beverages, snacks, physical activity, playing sports, quantity of screen time, screen time during meals, and sleep. Conclusion We developed a set of recommendations for healthy parenting that can be used by various professionals working with children age 4–13 and can contribute to creating an integrated approach to childhood overweight. We also developed a web-based app called “Recommendations for Healthy Parenting” as a convenient tool for following these recommendations.
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Affiliation(s)
- Emilie L. M. Ruiter
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
| | - Gerard R. M. Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gerdine A. J. Fransen
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlijn Wagenaar
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, Radboud University Medical Center, Nijmegen, the Netherlands
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Eubank BH, Mohtadi NG, Lafave MR, Wiley JP, Bois AJ, Boorman RS, Sheps DM. Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology. BMC Med Res Methodol 2016; 16:56. [PMID: 27206853 PMCID: PMC4875724 DOI: 10.1186/s12874-016-0165-8] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 05/14/2016] [Indexed: 01/06/2023] Open
Abstract
Background Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. Methods A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. Results In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. Conclusion This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0165-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Breda H Eubank
- Department of Health and Physical Education, Faculty of Health, Community, and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada.
| | - Nicholas G Mohtadi
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Orthopaedic Surgeon, Sport Medicine Centre, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Mark R Lafave
- Department of Health and Physical Education, Faculty of Health, Community, and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada
| | - J Preston Wiley
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Aaron J Bois
- Orthopaedic Surgeon, Sport Medicine Centre, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Richard S Boorman
- Orthopaedic Surgeon, Sport Medicine Centre, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - David M Sheps
- Division of Orthopaedics, Department of Surgery, University of Alberta, 116 St & 85 Ave., Edmonton, AB, T6G 2R3, Canada
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Validation of the Continuum of Care Conceptual Model for Athletic Therapy. JOURNAL OF SPORTS MEDICINE 2015; 2015:391459. [PMID: 26464897 PMCID: PMC4590912 DOI: 10.1155/2015/391459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/22/2015] [Accepted: 07/01/2015] [Indexed: 12/03/2022]
Abstract
Utilization of conceptual models in field-based emergency care currently borrows from existing standards of medical and paramedical professions. The purpose of this study was to develop and validate a comprehensive conceptual model that could account for injuries ranging from nonurgent to catastrophic events including events that do not follow traditional medical or prehospital care protocols. The conceptual model should represent the continuum of care from the time of initial injury spanning to an athlete's return to participation in their sport. Finally, the conceptual model should accommodate both novices and experts in the AT profession. This paper chronicles the content validation steps of the Continuum of Care Conceptual Model for Athletic Therapy (CCCM-AT). The stages of model development were domain and item generation, content expert validation using a three-stage modified Ebel procedure, and pilot testing. Only the final stage of the modified Ebel procedure reached a priori 80% consensus on three domains of interest: (1) heading descriptors; (2) the order of the model; (3) the conceptual model as a whole. Future research is required to test the use of the CCCM-AT in order to understand its efficacy in teaching and practice within the AT discipline.
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