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Vidyasagaran AL, Ayesha R, Boehnke J, Kirkham J, Rose L, Hurst J, Miranda JJ, Rana RZ, Vedanthan R, Faisal M, Siddiqi N. Core outcome sets for trials of interventions to prevent and to treat multimorbidity in low- and middle-income countries: the COSMOS study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.29.24301589. [PMID: 38352562 PMCID: PMC10863036 DOI: 10.1101/2024.01.29.24301589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Introduction The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. A core outcome set (COS) appropriate for the study of multimorbidity in LMIC contexts does not presently exist. This is required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at the prevention and treatment of multimorbidity in LMICs. Methods To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups with representation from 33 countries (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals, and policy makers). Consensus meetings were used to reach agreement on the two final COS. Registration: https://www.comet-initiative.org/Studies/Details/1580. Results The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention, and six treatment outcomes were added from Delphi round one. Delphi round two surveys were completed by 95 of 132 round one participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) Adverse events, (2) Development of new comorbidity, (3) Health risk behaviour, and (4) Quality of life; and four for the treatment COS: (1) Adherence to treatment, (2) Adverse events, (3) Out-of-pocket expenditure, and (4) Quality of life. Conclusion Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs.
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Affiliation(s)
| | - Rubab Ayesha
- Rawalpindi Medical University; Foundation University School of Science and Technology
| | - Jan Boehnke
- University of Dundee, School of Health Sciences; University of York, Department of Health Sciences
| | - Jamie Kirkham
- The University of Manchester, Centre for Biostatistics; Manchester Academic Health Science Centre
| | - Louise Rose
- King's College London Florence Nightingale Faculty of Nursing Midwifery & Palliative Care
| | - John Hurst
- University College London, Department of Respiratory Medicine
| | - J Jaime Miranda
- Universidad Peruana Cayetano Heredia, CRONICAS Center of Excellence in Chronic Diseases; The George Institute for Global Health
| | | | - Rajesh Vedanthan
- NYU Grossman School of Medicine, Section for Global Health, Department of Population Health
| | | | - Najma Siddiqi
- University of York, Department of Health Sciences; Hull York Medical School
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Comans T, Nguyen K, Gray L, Flicker L, Williamson P, Dodd S, Kearney A, Cunningham C, Morris T, Nunn J, Trepel D, Almeida OP, Kenny D, Welch A, Lowthian JA, Quinn J, Petrie G, Dao-Tran TH, Manchha A, Kurrle SE. Measuring the success of programmes of care for people living with dementia: a protocol for consensus building with consumers to develop a set of Core Outcome Measures for Improving Care (COM-IC). BMJ Open 2023; 13:e073884. [PMID: 38072498 PMCID: PMC10729031 DOI: 10.1136/bmjopen-2023-073884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION The Core Outcome Measures for Improving Care (COM-IC) project aims to deliver practical recommendations on the selection and implementation of a suite of core outcomes to measure the effectiveness of interventions for dementia care. METHODS AND ANALYSIS COM-IC embeds a participatory action approach to using the Alignment-Harmonisation-Results framework for measuring dementia care in Australia. Using this framework, suitable core outcome measures will be identified, analysed, implemented and audited. The methods for analysing each stage will be codesigned with stakeholders, through the conduit of a Stakeholder Reference Group including people living with dementia, formal and informal carers, aged care industry representatives, researchers, clinicians and policy actors. The codesigned evaluation methods consider two key factors: feasibility and acceptability. These considerations will be tested during a 6-month feasibility study embedded in aged care industry partner organisations. ETHICS AND DISSEMINATION COM-IC has received ethical approval from The University of Queensland (HREC 2021/HE001932). Results will be disseminated through networks established over the project, and in accordance with both the publication schedule and requests from the Stakeholder Reference Group. Full access to publications and reports will be made available through UQ eSpace (https://espace.library.uq.edu.au/), an open access repository hosted by The University of Queensland.
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Affiliation(s)
- Tracy Comans
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kim Nguyen
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Len Gray
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Leon Flicker
- WA Centre for Health and Ageing, The University of Western Australia, Perth, Western Australia, Australia
| | - Paula Williamson
- Department of Health and Data Science, University of Liverpool, Liverpool, UK
| | - Susanna Dodd
- Department of Health and Data Science, University of Liverpool, Liverpool, UK
| | - Anna Kearney
- Department of Health and Data Science, University of Liverpool, Liverpool, UK
| | - Colm Cunningham
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- HammondCare International, London, UK
| | - Thomas Morris
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- HammondCare, Sydney, New South Wales, Australia
| | - Jack Nunn
- Science for All, Melbourne, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - Dominic Trepel
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Osvaldo P Almeida
- WA Centre for Health and Ageing, The University of Western Australia, Perth, Western Australia, Australia
| | - Danelle Kenny
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alyssa Welch
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Judy A Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Quinn
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Wynnum Manly Dementia Alliance, Brisbane, Queensland, Australia
| | - Glenys Petrie
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Wynnum Manly Dementia Alliance, Brisbane, Queensland, Australia
| | - Tiet-Hanh Dao-Tran
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Asmita Manchha
- Bolton Clarke Research Institute, Brisbane, Queensland, Australia
| | - Susan E Kurrle
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Karumbi J, Gorst S, Gathara D, Young B, Williamson P. Awareness and experiences on core outcome set development and use amongst stakeholders from low- and middle- income countries: An online survey. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002574. [PMID: 38051748 PMCID: PMC10697587 DOI: 10.1371/journal.pgph.0002574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/10/2023] [Indexed: 12/07/2023]
Abstract
Harmonization of outcomes to be measured in clinical trials can reduce research waste and enhance research translation. One of the ways to standardize measurement is through development and use of core outcome sets (COS). There is limited involvement of low- and middle-income country (LMIC) stakeholders in COS development and use. This study explores the level of awareness and experiences of LMIC stakeholders in the development and use of COS. We conducted an online survey of LMIC stakeholders. Three existing COS (pre-eclampsia, COVID-19, palliative care) were presented as case scenarios, and respondents asked to state (with reason(s)) if they would or would not use the COS if they were working in that area. Quantitative data were analyzed descriptively while qualitative data were analyzed thematically. Of 81 respondents, 26 had COS experience, 9 of whom had been involved in COS development. Personal research interests and prevalence of disease are key drivers for initiation/participation in a given COS project. Most respondents would use the COS for pre-eclampsia (18/26) and COVID-19 (19/26) since the development process included key stakeholders. More than half of the respondents were not sure or would not use the palliative care COS as they felt stakeholder engagement was limited and it was developed for a different resource setting. Respondents reported that use of COS can be limited by (i) feasibility of measuring the outcomes in the COS, (ii) knowledge on the usefulness and availability of COS and (iii) lack of wide stakeholder engagement in the COS development process including having patients and carers in the development process. To ensure the development and use of COS in LMICs, collaborations are essential in awareness raising on COS utility, training, and COS development. The COS also needs to be made accessible in locally understandable languages and feasible to measure in LMICs.
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Affiliation(s)
- Jamlick Karumbi
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Mvita, Kenya
| | - Sarah Gorst
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
| | - David Gathara
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Mvita, Kenya
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Paula Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
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Lee A, Higginbotham G, Davies P, Young A. Research priority setting in plastic and reconstructive surgery: A systematic review. J Plast Reconstr Aesthet Surg 2023; 76:148-159. [PMID: 36516507 DOI: 10.1016/j.bjps.2022.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/25/2022] [Accepted: 10/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The health research agenda has historically been led by researchers; however, their priorities may not necessarily align with those of patients, caregivers and clinicians. Research priority setting initiatives identify and prioritise topics which lack evidence. This is particularly important in plastic surgery, a speciality lacking high-quality evidence to definitively answer many common clinical questions. Research priorities direct research activity and funding, so their selection process must be representative and transparent. This review appraised all priority setting initiatives in plastic surgery using the reporting guideline for priority setting of health research (REPRISE). METHODS OVID Medline, EMBASE, CINAHL and the James Lind Alliance (JLA) repository were searched (inception - 11/06/21) using search terms for 'research priority setting' and 'plastic and reconstructive surgery'. Dual-author screening and data extraction were conducted, according to PRISMA. RESULTS Of 3899 de-duplicated citations, 17 were included. Most studies were conducted in national (14/17), high-income (16/17) settings. More priority setting initiatives focussed on burns (6/17) and hand surgery (4/17) than other subspecialties. The JLA (5/17) and qualitative (5/17) approaches were most used for prioritisation, followed by Delphi techniques (3/17), other surveys (3/17) and mixed methods (1/17). A minority included patient (8/17) or multi-disciplinary (8/17) stakeholders. Few reported strategies for implementing research priorities (6/17) or measuring their impact (2/17). CONCLUSIONS Stakeholders from lower-income countries are underrepresented in priority setting initiatives for plastic surgery, despite the global burden of disease. Future studies should recruit more patient and multidisciplinary stakeholders, to achieve meaningful consensus. Clear implementation strategies are needed to maximise impact.
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Affiliation(s)
- Alice Lee
- Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, United Kingdom; Department of Plastic Surgery, Stoke Mandeville Hospital, Aylesbury, HP21 8AL, United Kingdom.
| | - George Higginbotham
- School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, BS8 1TD, United Kingdom
| | - Philippa Davies
- Population Heath Sciences, Bristol Medical School and Bristol Biomedical Research Centre and Centre for Surgical Research, University of Bristol, BS8 2BN, United Kingdom
| | - Amber Young
- Population Heath Sciences, Bristol Medical School and Bristol Biomedical Research Centre and Centre for Surgical Research, University of Bristol, BS8 2BN, United Kingdom
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5
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Katiri R, Hall DA, Hoare DJ, Fackrell K, Horobin A, Hogan N, Buggy N, Van de Heyning PH, Firszt JB, Bruce IA, Kitterick PT. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness. Trials 2022; 23:764. [PMID: 36076299 PMCID: PMC9454406 DOI: 10.1186/s13063-022-06702-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions. Methods A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting. Results The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set. Conclusions Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06702-1.
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Affiliation(s)
- Roulla Katiri
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK. .,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,Audiology Department, Mater Misericordiae University Hospital, North Circular Road, Dublin, D07 R2WY, Ireland.
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Derek J Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Kathryn Fackrell
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Wessex Institute, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Adele Horobin
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Nicholas Hogan
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Nóra Buggy
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Paul H Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), 2650, Edegem, Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Jill B Firszt
- Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1010, USA
| | - Iain A Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Pádraig T Kitterick
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Acoustic Laboratories, Australian Hearing Hub, Macquarie University, Sydney, NSW, 2109, Australia
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The Management of Asymptomatic Congenital Pulmonary Airway Malformation: Results of a European Delphi Survey. CHILDREN 2022; 9:children9081153. [PMID: 36010044 PMCID: PMC9406306 DOI: 10.3390/children9081153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Consensus on the optimal management of asymptomatic congenital pulmonary airway malformation (CPAM) is lacking, and comparison between studies remains difficult due to a large variety in outcome measures. We aimed to define a core outcome set (COS) for pediatric patients with an asymptomatic CPAM. An online, three-round Delphi survey was conducted in two stakeholder groups of specialized caregivers (surgeons and non-surgeons) in various European centers. Proposed outcome parameters were scored according to level of importance, and the final COS was established through consensus. A total of 55 participants (33 surgeons, 22 non-surgeons) from 28 centers in 13 European countries completed the three rounds and rated 43 outcome parameters. The final COS comprises seven outcome parameters: respiratory insufficiency, surgical complications, mass effect/mediastinal shift (at three time-points) and multifocal disease (at two time-points). The seven outcome parameters included in the final COS reflect the diversity in priorities among this large group of European participants. However, we recommend the incorporation of these outcome parameters in the design of future studies, as they describe measurable and validated outcomes as well as the accepted age at measurement.
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Boehnke JR, Rana RZ, Kirkham JJ, Rose L, Agarwal G, Barbui C, Chase-Vilchez A, Churchill R, Flores-Flores O, Hurst JR, Levitt N, van Olmen J, Purgato M, Siddiqi K, Uphoff E, Vedanthan R, Wright J, Wright K, Zavala GA, Siddiqi N. Development of a core outcome set for multimorbidity trials in low/middle-income countries (COSMOS): study protocol. BMJ Open 2022; 12:e051810. [PMID: 35172996 PMCID: PMC8852662 DOI: 10.1136/bmjopen-2021-051810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION 'Multimorbidity' describes the presence of two or more long-term conditions, which can include communicable, non-communicable diseases, and mental disorders. The rising global burden from multimorbidity is well documented, but trial evidence for effective interventions in low-/middle-income countries (LMICs) is limited. Selection of appropriate outcomes is fundamental to trial design to ensure cross-study comparability, but there is currently no agreement on a core outcome set (COS) to include in trials investigating multimorbidity specifically in LMICs. Our aim is to develop international consensus on two COSs for trials of interventions to prevent and treat multimorbidity in LMIC settings. METHODS AND ANALYSIS Following methods recommended by the Core Outcome Measures in Effectiveness Trials initiative, the development of these two COSs will occur in parallel in three stages: (1) generation of a long list of potential outcomes for inclusion; (2) two-round online Delphi surveys and (3) consensus meetings. First, to generate an initial list of outcomes, we will conduct a systematic review of multimorbidity intervention and prevention trials and interviews with people living with multimorbidity and their caregivers in LMICs. Outcomes will be classified using an outcome taxonomy. Two-round Delphi surveys will be used to elicit importance scores for these outcomes from people living with multimorbidity, caregivers, healthcare professionals, policy makers and researchers in LMICs. Finally, consensus meetings including all of these stakeholders will be held to agree outcomes for inclusion in the two COSs. ETHICS AND DISSEMINATION The study has been approved by the Research Governance Committee of the Department of Health Sciences, University of York, UK (HSRGC/2020/409/D:COSMOS). Each participating country/research group will obtain local ethics board approval. Informed consent will be obtained from all participants. We will disseminate findings through peer-reviewed open access publications, and presentations at global conferences selected to reach a wide range of LMIC stakeholders. PROSPERO REGISTATION NUMBER CRD42020197293.
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Affiliation(s)
- Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
- Department of Health Sciences, University of York, York, UK
| | - Rusham Zahra Rana
- Institute of Psychiatry, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Centre for Reviews and Dissemination and Cochrane Common Mental Disorders, University of York, York, UK
| | - Oscar Flores-Flores
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad San Martin de Porres, Lima, Peru
- Asociación Benéfica PRISMA, Lima, Peru
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Naomi Levitt
- Chronic Disease Initiative for Africa and Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Josefien van Olmen
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
| | - Eleonora Uphoff
- Centre for Reviews and Dissemination and Cochrane Common Mental Disorders, University of York, York, UK
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
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8
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Musgrove E, Gasparini L, McBain K, Clifford SA, Carter SA, Teede H, Wake M. Synthesizing Core Outcome Sets for outcomes research in cohort studies: a systematic review. Pediatr Res 2022; 92:936-945. [PMID: 34921214 PMCID: PMC8678579 DOI: 10.1038/s41390-021-01801-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/10/2021] [Accepted: 10/09/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Life course studies are designed to "collect once, use multiple times" for observational and, increasingly, interventional research. Core Outcome Sets (COS) are minimum sets developed for clinical trials by multi-stakeholder consensus methodologies. We aimed to synthesize published COS that might guide outcomes selection for early life cohorts with an interventional focus. METHODS We searched PubMed, Medline, COMET, and CROWN for COS published before January 2021 relevant to four life stages (pregnancy, newborns, children <8 years, and parents (adults aged 18-50 years)). We synthesized core outcomes into overarching constructs. RESULTS From 46 COS we synthesized 414 core outcomes into 118 constructs. "Quality of life", "adverse events", "medication use", "hospitalization", and "mortality" were consistent across all stages. For pregnancy, common constructs included "preterm birth", "delivery mode", "pre-eclampsia", "gestational weight gain", "gestational diabetes", and "hemorrhage"; for newborns, "birthweight", "small for gestational age", "neurological damage", and "morbidity" and "infection/sepsis"; for pediatrics, "pain", "gastrointestinal morbidity", "growth/weight", "breastfeeding", "feeding problems", "hearing", "neurodevelopmental morbidity", and "social development"; and for adults, "disease burden", "mental health", "neurological function/stroke", and "cardiovascular health/morbidity". CONCLUSION This COS synthesis generated outcome constructs that are of high value to stakeholders (participants, health providers, services), relevant to life course research, and could position cohorts for trial capabilities. IMPACT We synthesized existing Core Outcome Sets as a transparent methodology that could prioritize outcomes for lifecourse cohorts with an interventional focus. "Quality of life", "adverse events", "medication use", "hospitalization", and "mortality" are important outcomes across pregnancy, newborns, childhood, and early-to-mid-adulthood (the age range relevant to parents). Other common outcomes (such as "birthweight", "cognitive function/ability", "psychological health") are also highly relevant to lifecourse research. This synthesis could assist new early life cohorts to pre-select outcomes that are of high value to stakeholders (participants, health providers, services), are relevant to lifecourse research, and could position them for future trials and interventional capability.
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Affiliation(s)
- Erica Musgrove
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville VIC, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia
| | - Loretta Gasparini
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville VIC, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia
| | - Katie McBain
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville VIC, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia
| | - Susan A. Clifford
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville VIC, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia
| | - Simon A. Carter
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville VIC, Australia ,grid.1013.30000 0004 1936 834XSydney School of Public Health, The University of Sydney, NSW, Australia
| | - Helena Teede
- grid.1002.30000 0004 1936 7857Monash Centre of Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC Australia ,grid.419789.a0000 0000 9295 3933Monash Endocrinology and Diabetes Units, Monash Health, Clayton, VIC Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, VIC, Australia. .,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia. .,Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand.
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Davies P, Davies AK, Kirkham JJ, Young AE. Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries. J Clin Epidemiol 2021; 144:56-71. [PMID: 34906674 PMCID: PMC9094759 DOI: 10.1016/j.jclinepi.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 11/08/2022]
Abstract
Objective To compare the views of participants from different income-status countries on outcome selection for a burn care Core Outcome Set (COS). Methods A retrospective analysis of data collected during a two round Delphi survey to prioritise the most important outcomes in burn care research. Results There was considerable agreement between participants from low- and middle-income countries (LMICs) and high-income countries (HICs) across outcomes. The groups agreed on 91% of 88 outcomes in round 1 and 92% of 100 in round 2. In cases of discordance, the consensus of participants from LMICs was to include the outcome and for participants from HICs to exclude. There was also considerable agreement between the groups for the top-ten ranking outcomes. Discordance in outcome prioritisation gives an insight into the different values clinicians from LMICs place on outcomes compared to those from HICs. Limitations of the study were that outcome rankings from international patients were not available. Healthcare professionals from LMICs were not involved in the final consensus meeting. Conclusion COS developers should consider the need for a COS to be global at protocol stage. Global COS should include equal representation from both LMICs and HICs at all stages of development.
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Affiliation(s)
- P Davies
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom
| | - A K Davies
- Centre for Academic Child Health, University of Bristol, United Kingdom
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - A E Young
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom.
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