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Muhlestein WE, Wilson TJ. Analysis of outcome reporting in common peroneal neuropathy studies: a systematic review of the literature. Acta Neurochir (Wien) 2023; 165:2597-2604. [PMID: 37587319 DOI: 10.1007/s00701-023-05744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND There is a strong need for the development of core outcome sets (COS) across nerve surgery to allow for improved data synthesis, meta-analyses, and reporting consistency. Development of a core outcome set typically starts with assessing the literature for previously reported outcome measures. Common peroneal neuropathy (CPN) is the most common compressive mononeuropathy of the lower extremity and can result in pain, motor, and sensory deficits. A COS for COmmon PEroneal neuropathy (COS-COPE) is needed to improve future study design and comparison and synthesis of data. The goal of the current study was to assess the literature for outcomes reported in studies on CPN as the first step in the development of a COS. METHODS A systematic review of the literature from 2000 to 2023 was performed utilizing PubMed and Medical Subject Headings (MeSH). Identified articles were screened according to study inclusion/exclusion criteria. Outcome measures reported in each included study were recorded and categorized into motor, sensory, pain, composite foot/ankle score, electrodiagnostics, function/disability patient-reported outcome (PRO), psychological, or other outcomes. Descriptive statistics were performed. RESULTS A total of 31 articles met criteria for inclusion. A motor outcome was reported in 26 (83.9%) studies; 12 (38.7%) reported a sensory outcome; 8 (25.8%) reported a pain outcome; 4 (12.9%) reported a composite foot/ankle score; 3 (9.7%) reported electrodiagnostics; 1 (3.2%) reported a function/disability PRO; 1 (3.2%) reported a psychological outcome; 2 (6.5%) reported an imaging outcome; 3 (9.7%) reported other outcomes. Across the studies, 29 distinct outcome measures were reported. CONCLUSIONS The outcomes reported in studies on CPN are varied and inconsistent. It is likely that a combination of motor, sensory, pain, and functional outcomes will be needed in a COS to best study CPN. These data will serve as a baseline for the ultimate development of the COS-COPE.
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Affiliation(s)
| | - Thomas J Wilson
- Department of Neurosurgery, Stanford University, 453 Quarry Road, Palo Alto, CA, 94304-5327, USA.
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Zhang Y, Dai Z, Zhao T, Tian J, Xu J, Zhang J. Publication Trends and Hot Spots in Cauda Equina Syndrome: A Bibliometric Analysis and Visualization of Current Research. World Neurosurg 2023; 173:115-121. [PMID: 36754352 DOI: 10.1016/j.wneu.2023.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cauda Equina Syndrome (CES) is a relatively uncommon and complex disorder. Recently, there has been a surge in research on CES. Although the research directions are multifarious, the overall research trends are unclear at present. We aimed to identify the 100 most cited articles on CES and analyze the hot spots trends regarding CES related research by bibliometric analysis. METHODS Articles were obtained by conducting an English language search of the Web of Science Core Collection Databases with the keywords "cauda equina syndrome." The initial 390 articles returned from the search were analyzed by VOSviewer. Next, the top 100 most cited articles were further analyzed by title, authors, journal, year of publication, total citations, country of origin, institution, and keywords. RESULTS A total of 390 publications were identified. The top 100 most cited articles were listed in descending order of total citations (range: 196-11). These articles originated from 24 countries; among these countries, the United Kingdom contributed the most publications (n = 29). The most prolific journal was Spine (n = 27), and the University of Edinburgh was the most productive institution (n = 9). CONCLUSIONS The number of publications on CES increased steadily, with a stable rise in recent years. Some publications have been cited more than 100 times, indicating that these findings are widely accepted by relevant clinicians and contribute significantly to the knowledge of CES. This study represents the first bibliometric analysis and visualization of hot spots analysis and research trends on CES. We believe that this will aid clinical researchers in targeting future areas of research.
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Affiliation(s)
- Yaping Zhang
- General Office of the Administration, Zhejiang Provincial People's Hospital, Hangzhou, China; Department of Spine Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College People's Hospital, Hangzhou, Zhejiang, China
| | - Zhanqiu Dai
- Department of Spine Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College People's Hospital, Hangzhou, Zhejiang, China; Department of Orthopaedics, The Second Affiliated Hospital of Bengbu Medical College, Anhui, China; Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tingxiao Zhao
- Department of Spine Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College People's Hospital, Hangzhou, Zhejiang, China
| | - Jinlong Tian
- Department of Spine Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College People's Hospital, Hangzhou, Zhejiang, China; Department of Orthopaedics, The Second Affiliated Hospital of Bengbu Medical College, Anhui, China
| | - Jiongnan Xu
- Department of Spine Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College People's Hospital, Hangzhou, Zhejiang, China; The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China; Department of Orthopedics, Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, Guizhou, China.
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Quirke FA, Healy P, Bhraonáin EN, Daly M, Biesty L, Hurley T, Walker K, Meher S, Haas DM, Bloomfield FH, Kirkham JJ, Molloy EJ, Devane D. COHESION: core outcomes in neonatal encephalopathy (protocol). Trials 2021; 22:125. [PMID: 33557892 PMCID: PMC7871638 DOI: 10.1186/s13063-021-05030-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neonatal encephalopathy is a complex syndrome in infants that predominantly affects the brain and other organs. The leading cause is a lack of oxygen in the blood reaching the brain. Neonatal encephalopathy can result in mortality or complications later in life, including seizures, movement disorders and cerebral palsy. Treatment options for neonatal encephalopathy are limited mainly to therapeutic hypothermia, although other potential treatments are emerging. However, evaluations of the effectiveness of treatments are challenging because of heterogeneity and inconsistency in outcomes measured and reported between trials. In this paper, we detail how we will develop a core outcome set to standardise outcomes measured and reported upon for interventions for the treatment of neonatal encephalopathy. METHODS We will systematically review the literature to identify outcomes reported previously in randomised trials and systematic reviews of randomised trials. We will identify outcomes important to parents or caregivers of infants diagnosed with and who have received treatment for neonatal encephalopathy. We will do this by conducting in person or by video teleconferencing interviews with parents or caregivers in high-income and low- to middle-income countries. Stakeholders with expertise in neonatal encephalopathy (parents/caregivers, healthcare providers and researchers) will rate the importance of identified outcomes in an online Delphi survey using either a three-round Delphi survey or a "Real-Time" Delphi survey to which stakeholders will be allocated at random. Consensus meetings will take place by video conference to allow for an international group of stakeholder representatives to discuss and vote on the outcomes to include in the final core outcome set (COS). DISCUSSION More research is needed on treatments for neonatal encephalopathy. Standardising outcomes measured and reported in evaluations of the effectiveness of interventions for the treatment of neonatal encephalopathy will improve evidence synthesis and improve results reported in systematic reviews and meta-analysis in this area. Overall, this COS will allow for improved treatments to be identified, heterogeneity in research to be reduced, and overall patient care to be enhanced. TRIAL REGISTRATION This study is registered in the Core Outcome Measures for Effectiveness (COMET) database http://www.comet-initiative.org/Studies/Details/1270 .
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Affiliation(s)
- Fiona A. Quirke
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Galway, Ireland
- Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Patricia Healy
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | | | - Mandy Daly
- Advocacy and Policymaking, Irish Neonatal Health Alliance, Wicklow, Ireland
| | - Linda Biesty
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
- Qualitative Research in Trials Centre (QUESTS), National University of Ireland Galway, Galway, Ireland
| | - Tim Hurley
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Galway, Ireland
- Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
| | - Karen Walker
- RPA Newborn Care, Sydney Local Health District, Sydney, Australia
| | - Shireen Meher
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - David M. Haas
- Department of Obstetrics and Gynaecology, Indiana University School of Medicine, Indianapolis, USA
| | | | - Jamie J. Kirkham
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Eleanor J. Molloy
- Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
- Department of Neonatology, Children’s Hospital Ireland at Crumlin and Tallaght, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Declan Devane
- Health Research Board – Trials Methodology Research Network (HRB-TMRN), Galway, Ireland
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
- Cochrane Ireland, National University of Ireland Galway, Galway, Ireland
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Srikandarajah N, Noble A, Clark S, Wilby M, Freeman BJC, Fehlings MG, Williamson PR, Marson T. Cauda Equina Syndrome Core Outcome Set (CESCOS): An international patient and healthcare professional consensus for research studies. PLoS One 2020; 15:e0225907. [PMID: 31923259 PMCID: PMC6953762 DOI: 10.1371/journal.pone.0225907] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/14/2019] [Indexed: 01/17/2023] Open
Abstract
Background Cauda Equina Syndrome (CES) is an emergency condition that requires acute intervention and can lead to permanent neurological deficit in working age adults. A Core Outcome Set (COS) is the minimum set of outcomes that should be reported by a research study within a specific disease area. There is significant heterogeneity in outcome reporting for CES, which does not allow data synthesis between studies. The hypothesis is that a COS for CES can be developed for future research studies using patients and healthcare professionals (HCPs) as key stakeholders. Methods and findings Qualitative semi-structured interviews with CES patients were audio-recorded, transcribed and analysed using NVivo to identify the outcomes of importance. These were combined with the outcomes obtained from a published systematic literature review of CES patients. The outcomes were grouped into a list of 37, for rating through two rounds of an international Delphi survey according to pre-set criteria. The Delphi survey had an overall response rate of 63% and included 172 participants (104 patients, 68 HCPs) from 14 countries who completed both rounds. Thirteen outcomes reached consensus at the end of the Delphi survey and there was no attrition bias detected. The results were discussed at an international consensus meeting attended by 34 key stakeholders (16 patients and 18 HCPs) from 8 countries. A further three outcomes were agreed to be included. There was no selection bias detected at the consensus meeting. There are 16 outcomes in total in the CESCOS. Discussion This is the first study in the literature that has determined the core outcomes in CES using a transparent international consensus process involving healthcare professionals and CES patients as key stakeholders. This COS is recommended as the most important outcomes to be reported in any research study investigating CES outcomes and will allow evidence synthesis in CES.
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Affiliation(s)
- Nisaharan Srikandarajah
- Institute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, United Kingdom
- * E-mail:
| | - Adam Noble
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Simon Clark
- Department of Spinal Surgery, The Walton Centre NHS Foundation Trust, Liverpool, Merseyside, United Kingdom
| | - Martin Wilby
- Department of Spinal Surgery, The Walton Centre NHS Foundation Trust, Liverpool, Merseyside, United Kingdom
| | - Brian J. C. Freeman
- Department of Spinal Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia
| | - Michael G. Fehlings
- Division of Neurosurgery and Spine Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Paula R. Williamson
- MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Tony Marson
- Institute of Translational Medicine, University of Liverpool, Liverpool, Merseyside, United Kingdom
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Kaiser R, Stokes OM, Mehdian H. In Reply: Time Factor and Disc Herniation Size: Are They Really Predictive for Outcome of Urinary Dysfunction in Patients With Cauda Equina Syndrome? Neurosurgery 2020; 86:E96-E97. [PMID: 31628749 DOI: 10.1093/neuros/nyz436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Radek Kaiser
- The Centre for Spinal Studies and Surgery, QMC Nottingham University Hospitals NHS Trust Nottingham, United Kingdom.,Department of Neurosurgery and Neurooncology First Faculty of Medicine Charles University and Military University Hospital Prague, Czech Republic
| | - Oliver M Stokes
- Exeter Spine Unit Princess Elizabeth Orthopaedic Centre Royal Devon and Exeter NHS Foundation Trust Exeter, United Kingdom
| | - Hossein Mehdian
- The Centre for Spinal Studies and Surgery, QMC Nottingham University Hospitals NHS Trust Nottingham, United Kingdom
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Xue Z, Sun J, Li T, Huang Z, Chen W. How to evaluate the clinical outcome of joint-preserving treatment for osteonecrosis of the femoral head: development of a core outcome set. J Orthop Surg Res 2019; 14:317. [PMID: 31597557 PMCID: PMC6785903 DOI: 10.1186/s13018-019-1364-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/05/2019] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to develop a core outcome set (COS) for clinical trials of joint-preserving treatment for osteonecrosis of the femoral head (ONFH), that is, to define a minimal set of outcomes that should be reported in such trials. Methods A mixed research method was adopted in this study. First, clinical trials of hip preservation therapy were systematically researched and analyzed. Second, a three-round Delphi survey involving both doctors and patients was carried out to obtain the core outcome indicators. Round 1 was a modified Delphi questionnaire for doctors and patients to determine which outcomes are important to these stakeholders, round 2 determined what clinical evaluation core outcomes should be included for the joint-preserving treatment of ONFH, and round 3 determined how core outcomes should be measured. Finally, a consensus meeting was held to discuss and vote on the established COS. Results The results of the systematic review showed that 42 outcome indicators were classified according to common signs and symptoms, quality of life, long-term outcomes, radiological evaluation, blood biochemistry, and indexes of safety. The three rounds of Delphi surveys completed the selection of indicators for the COS and the determination of the corresponding measurements. A total of 73 orthopedic doctors and 103 patients participated in round 1, and the top 10 indicators selected were basically the same. In round 2, 32 experts identified the following indicators: pain, range of motion (ROM) of hip flexion, walking distance, and stable rating of X-ray images. In round 3, 35 experts defined the measurement of each indicator. Finally, the consensus meeting identified the four indicators aforementioned that constituted the COS. The scores for pain, ROM of hip flexion, and walking distance are from 0 to 10; 0 represents the best scores, while 10 represents the most serious impairment. The stable rating of X-ray images is determined by the morphology of the femoral head and the change in the density of the necrotic area. Conclusions We established a COS for hip-preserving treatment of ONFH that includes four indicators: pain, ROM of hip flexion, walking distance, and stable rating of X-ray images.
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Affiliation(s)
- Zhipeng Xue
- Department of Orthopaedics, China Academy of Chinese Medical Sciences, Wangjing Hospital, No. 6 Zhonghuannanlu, Chaoyang District, Beijing, 100102, China
| | - Jigao Sun
- Department of Orthopaedics, China Academy of Chinese Medical Sciences, Wangjing Hospital, No. 6 Zhonghuannanlu, Chaoyang District, Beijing, 100102, China
| | - Taixian Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zeqing Huang
- Department of Orthopaedics, China Academy of Chinese Medical Sciences, Wangjing Hospital, No. 6 Zhonghuannanlu, Chaoyang District, Beijing, 100102, China
| | - Weiheng Chen
- Department of Orthopaedics, China Academy of Chinese Medical Sciences, Wangjing Hospital, No. 6 Zhonghuannanlu, Chaoyang District, Beijing, 100102, China.
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