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Sousa Filho LF, Farlie MK, Haines T, Borrelli B, Carroll C, Mathews C, Ribeiro DC, Fritz JM, Underwood M, Foster NE, Lamb SE, Sanchez ZM, Malliaras P. Developing an international consensus Reporting guideline for intervention Fidelity in Non-Drug, non-surgical trials: The ReFiND protocol. Contemp Clin Trials 2024; 142:107575. [PMID: 38750951 DOI: 10.1016/j.cct.2024.107575] [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: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/11/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Inadequate reporting of fidelity to interventions in trials limits the transparency and interpretation of trial findings. Despite this, most trials of non-drug, non-surgical interventions lack comprehensive reporting of fidelity. If fidelity is poorly reported, it is unclear which intervention components were tested or implemented within the trial, which also hinders research reproducibility. This protocol describes the development process of a reporting guideline for fidelity of non-drug, non-surgical interventions (ReFiND) in the context of trials. METHODS The ReFiND guideline will be developed in six stages. Stage one: a guideline development group has been formed to oversee the guideline methodology. Stage two: a scoping review will be conducted to identify and summarize existing guidance documents on the fidelity of non-drug, non-surgical interventions. Stage three: a Delphi study will be conducted to reach consensus on reporting items. Stage four: a consensus meeting will be held to consolidate the reporting items and discuss the wording and structure of the guideline. Stage five: a guidance statement, an elaboration and explanation document, and a reporting checklist will be developed. Stage six: different strategies will be used to disseminate and implement the ReFiND guideline. DISCUSSION The ReFiND guideline will provide a set of items developed through international consensus to improve the reporting of intervention fidelity in trials of non-drug, non-surgical interventions. This reporting guideline will enhance transparency and reproducibility in future non-drug, non-surgical intervention research.
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Affiliation(s)
| | - Melanie K Farlie
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
| | | | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Daniel C Ribeiro
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
| | - Julie M Fritz
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, UT, USA.
| | - Martin Underwood
- Warwick Clinical Trials Unit, University of Warwick, Warwick, UK.; University Hospitals of Coventry and Warwickshire, Coventry, UK.
| | - Nadine E Foster
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, Australia; School of Medicine, Keele University, Keele, UK.
| | - Sarah E Lamb
- University of Exeter, St Luke's Campus, Exeter, UK.
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Peter Malliaras
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
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Blazey P, Scott A, Ardern CL, Davis JC, Whittaker JL, Losciale JM, Khan KM. Consensus methods in patellofemoral pain: how rigorous are they? A scoping review. Br J Sports Med 2024:bjsports-2023-107552. [PMID: 38777386 DOI: 10.1136/bjsports-2023-107552] [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: 04/24/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Clinicians treating patients with patellofemoral pain (PFP) rely on consensus statements to make the best practice recommendations in the absence of definitive evidence on how to manage PFP. However, the methods used to generate and assess agreement for these recommendations have not been examined. Our objective was to map the methods used to generate consensus-based recommendations for PFP and apply four novel questions to assess the rigour of consensus development. DESIGN Scoping review. DATA SOURCES We searched Medline, SPORTDiscus, CINAHL and Embase from inception to May 2022 to identify consensus-derived statements or practice guidelines on PFP. The Joanna Briggs Institute Manual for Evidence Synthesis was followed to map the existing evidence. We measured the consensus methods based on four sets of questions addressing the panel composition, application of the consensus method chosen, agreement process and the use of evidence mapping. ELIGIBILITY CRITERIA All consensus statements or clinical guidelines on PFP were considered. RESULTS Twenty-two PFP consensus statements were identified. Panel composition: 3 of the 22 (14%) consensus groups reported the panellists' experience, 2 (9%) defined a desired level of expertise, 10 (45%) reported panellist sex and only 2 (9%) included a patient. Consensus method: 7 of 22 (32%) reported using an established method of consensus measurement/development. Agreement process: 10 of 22 (45%) reported their consensus threshold and 2 (9%) acknowledged dissenting opinions among the panel. Evidence mapping: 6 of 22 (27%) reported using systematic methods to identify relevant evidence gaps. CONCLUSIONS PFP consensus panels have lacked diversity and excluded key partners including patients. Consensus statements on PFP frequently fail to use recognised consensus methods, rarely describe how 'agreement' was defined or measured and often neglect to use systematic methods to identify evidence gaps.
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Affiliation(s)
- Paul Blazey
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Alex Scott
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Clare L Ardern
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer C Davis
- Applied Health Economics Laboratory, Faculty of Management, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Karim M Khan
- Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
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Metry D, Copp HL, Rialon KL, Iacobas I, Baselga E, Dobyns WB, Drolet B, Frieden IJ, Garzon M, Haggstrom A, Hanson D, Hollenbach L, Keppler-Noreuil KM, Maheshwari M, Siegel DH, Waseem S, Dias M. Delphi Consensus on Diagnostic Criteria for LUMBAR Syndrome. J Pediatr 2024:114101. [PMID: 38759778 DOI: 10.1016/j.jpeds.2024.114101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE To develop consensus on diagnostic criteria for LUMBAR syndrome, the association of segmental infantile hemangiomas that affect the Lower body with Urogenital anomalies, Ulceration, spinal cord Malformations, Bony defects, Anorectal malformations, Arterial anomalies and/or Renal anomalies. STUDY DESIGN These diagnostic criteria were developed by an expert multidisciplinary and multi-institutional team based on analysis of peer-reviewed data, followed by electronic-Delphi consensus of a panel of 61 international pediatric specialists. RESULTS After two Delphi rounds, a 92% or higher level of agreement was reached for each Delphi statement. 98% of panelists agreed with the diagnostic criteria, and 100% agreed the criteria would be useful in clinical practice. The diagnosis of LUMBAR requires the presence of a segmental, or patterned, infantile hemangioma of the lumbosacral, sacrococcygeal, or pelvic cutaneous regions plus one additional criterion of the urogenital, spinal, bony, anorectal, arterial, or renal organ systems. CONCLUSIONS These diagnostic criteria will enhance clinical care by improving screening, detection, and overall awareness of this poorly understood neurocutaneous disorder. The criteria can be utilized by a wide variety of pediatric subspecialists. In addition, formal criteria will improve phenotypic uniformity among LUMBAR syndrome cohorts and a patient registry, allowing investigators to assess clinical features, long-term outcomes, and results of genetic sequencing in a standardized manner. Finally, these criteria will serve as a starting point for prospective studies to establish formal screening and management guidelines.
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Affiliation(s)
- Denise Metry
- Dept of Dermatology, Texas Children's Hospital, Baylor College of Medicine.
| | | | - Kristy L Rialon
- Dept of Surgery, Division of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine
| | - Ionela Iacobas
- Dept of Pediatrics, Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine
| | - Eulalia Baselga
- Dept of Dermatology, Hospital San Joan de Deu, Barcelona, Spain
| | | | - Beth Drolet
- Dept of Dermatology, University of Wisconsin
| | - Ilona J Frieden
- Depts of Dermatology and Pediatrics, University of California, San Francisco
| | - Maria Garzon
- Depts of Dermatology and Pediatrics, Columbia University
| | | | - Darrell Hanson
- Dept of Orthopedics and Sports Medicine, Houston Methodist Hospital
| | | | | | | | | | - Shamaila Waseem
- Dept of Gastroenterology, Indiana University School of Medicine
| | - Mark Dias
- Dept of Neurosurgery, Pennsylvania State College of Medicine
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Logullo P, van Zuuren EJ, Winchester CC, Tovey D, Gattrell WT, Price A, Harrison N, Goldman K, Chisholm A, Walters K, Blazey P. ACcurate COnsensus Reporting Document (ACCORD) explanation and elaboration: Guidance and examples to support reporting consensus methods. PLoS Med 2024; 21:e1004390. [PMID: 38709851 DOI: 10.1371/journal.pmed.1004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND When research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus among interested stakeholders. In these processes, the knowledge, experience, and expertise of health professionals, researchers, policymakers, and the public are systematically collected and synthesised to reach agreed clinical recommendations and/or priorities. However, despite the influence of consensus exercises, the methods used to achieve agreement are often poorly reported. The ACCORD (ACcurate COnsensus Reporting Document) guideline was developed to help report any consensus methods used in biomedical research, regardless of the health field, techniques used, or application. This explanatory document facilitates the use of the ACCORD checklist. METHODS AND FINDINGS This paper was built collaboratively based on classic and contemporary literature on consensus methods and publications reporting their use. For each ACCORD checklist item, this explanation and elaboration document unpacks the pieces of information that should be reported and provides a rationale on why it is essential to describe them in detail. Furthermore, this document offers a glossary of terms used in consensus exercises to clarify the meaning of common terms used across consensus methods, to promote uniformity, and to support understanding for consumers who read consensus statements, position statements, or clinical practice guidelines (CPGs). The items are followed by examples of reporting items from the ACCORD guideline, in text, tables, and figures. CONCLUSIONS The ACCORD materials-including the reporting guideline and this explanation and elaboration document-can be used by anyone reporting a consensus exercise used in the context of health research. As a reporting guideline, ACCORD helps researchers to be transparent about the materials, resources (both human and financial), and procedures used in their investigations so readers can judge the trustworthiness and applicability of their results/recommendations.
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Affiliation(s)
- Patricia Logullo
- Centre for Statistics in Medicine, University of Oxford, and EQUATOR Network UK Centre, Oxford, United Kingdom
| | | | - Christopher C Winchester
- Oxford PharmaGenesis, Oxford, United Kingdom
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - David Tovey
- Journal of Clinical Epidemiology, London, United Kingdom
| | | | - Amy Price
- Dartmouth Institute for Health Policy & Clinical Practice (TDI), Geisel School of Medicine, Dartmouth College, Hanover, NH, USA, previously at Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Keith Goldman
- Global Medical Affairs, AbbVie, North Chicago, Illinois, United States of America
| | | | | | - Paul Blazey
- Department of Medicine, University of British Columbia, Vancouver, Canada
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Squires RA, Crawford C, Marcondes M, Whitley N. 2024 guidelines for the vaccination of dogs and cats - compiled by the Vaccination Guidelines Group (VGG) of the World Small Animal Veterinary Association (WSAVA). J Small Anim Pract 2024; 65:277-316. [PMID: 38568777 DOI: 10.1111/jsap.13718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/24/2024] [Accepted: 02/07/2024] [Indexed: 04/05/2024]
Affiliation(s)
- R A Squires
- Formerly, Discipline of Veterinary Science, James Cook University, Townsville, QLD, 4814, Australia
| | - C Crawford
- College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32608, USA
| | - M Marcondes
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University, Rua Sergipe 575, ap. 32, São Paulo, 01243-001, SP, Brazil
| | - N Whitley
- Internal Medicine, Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire, SG5 3HR, UK
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Granström AL, Irvine W, Hoel AT, Tabbers M, Kyrklund K, Leon FF, Fusaro F, Thapar N, Dariel A, Sloots CEJ, Miserez M, Lemli A, Alexander S, Lambe C, Crétolle C, Qvist N, Schukfeh N, Lacher M, Cavalieri D, van Heurn E, Sfeir R, Pakarinen MP, Bjørnland K, Wester T. Ernica Clinical Consensus Statements on Total Colonic and Intestinal Aganglionosis. J Pediatr Surg 2024:S0022-3468(24)00295-1. [PMID: 38763854 DOI: 10.1016/j.jpedsurg.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Hirschsprung disease is a congenital intestinal motility disorder characterized by an absence of enteric ganglion cells. Total colonic aganglionosis and near total or total intestinal aganglionosis, defined as absence of ganglion cells in the entire colon and with variable length of small bowel involved, are life-threatening conditions which affect less than 10 % of all patients with Hirschsprung disease. The aim of this project was to develop clinical consensus statements within ERNICA, the European Reference Network for rare congenital digestive diseases, on four major topics: Surgical treatment of total colonic aganglionosis, surgical treatment of total intestinal aganglionosis, management of poor bowel function in total colonic and/or intestinal aganglionosis and long-term management in total colonic and or intestinal aganglionosis. METHODS A multidisciplinary panel of representatives from ERNICA centers was invited to participate. Literature was searched, using specified search terms, in Medline (ALL), Embase and Google Scholar. Abstracts were screened and full text publications were selected. The panel was divided in four groups that extracted data from the full text publications and suggested draft statements for each of the major topics. A modified Delphi process was used to refine and agree on the statements. RESULTS The consensus statement was conducted by a multidisciplinary panel of 24 participants from 10 European countries, 45 statements reached consensus after 3 Delphi-rounds. The availability of high-quality clinical evidence was limited, and most statements were based on expert opinion. Another 25 statements did not reach consensus. CONCLUSIONS Total colonic and total intestinal aganglionosis are rare variants of Hirschsprung disease, with very limited availability of high-quality clinical evidence. This consensus statement provides statements on the surgical treatment, management of poor bowel function and long-term management for these rare patients. The expert panel agreed that patients benefit from multidisciplinary and personalized care, preferably in an expert center. TYPE OF STUDY Clinical consensus statement. LEVEL OF EVIDENCE 3a.
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Affiliation(s)
- Anna Löf Granström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Unit of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.
| | - Willemijn Irvine
- Department of Evidence Based Medicine and Methodology, Qualicura Healthcare Support Agency, Breda, the Netherlands
| | - Anders Telle Hoel
- Department of Pediatric Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Merit Tabbers
- Emma Children's Hospital - Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Kristiina Kyrklund
- Section of Pediatric Surgery, New Children's Hospital, University of Helsinki, Finland
| | - Francesco Fascetti Leon
- University of Padua, Department of Women's and Children's Health, Padua, Italy; University Hospital, Unit of Pediatric Surgery, Division of Women's and Children's Health, Padua, Italy
| | - Fabio Fusaro
- Neonatal Surgery Unit, Bambino Gesù Children's Research Hospital, Rome, Italy
| | - Nikhil Thapar
- Stem Cell and Regenerative Medicine, Gos Institute of Child Health, University College London, London, UK; Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Woolworths Centre for Child Nutrition Research, Queensland University of Technology, Brisbane, Australia
| | - Anne Dariel
- Department of Pediatric Surgery, Assistance Publique Des Hôpitaux De Marseille, Hôpital Timone Enfants, Marseille, France
| | - Cornelius E J Sloots
- Department of Pediatric Surgery, Erasmus Mc - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Marc Miserez
- Department of Abdominal Surgery, University Hospital Gasthuisberg, Ku Leuven, Belgium
| | - Annette Lemli
- Soma, The German Patient Support Organization for Anorectal Malformations and Hirschsprung Disease, Munich, Germany
| | - Sabine Alexander
- Soma, The German Patient Support Organization for Anorectal Malformations and Hirschsprung Disease, Munich, Germany
| | - Cecile Lambe
- Service De Gastro-Entérologie Et Nutrition Pédiatrique, Hôpital Necker-Enfants Malades, Université Paris Cité, Paris, France
| | - Célia Crétolle
- Pediatric Surgery Department, National Reference Center for Ano Rectal Malformations and Rare Pelvic Anomalies Marep, Assistance Publique-Hôpitaux De Paris, Université Paris Cité, Paris, France
| | - Niels Qvist
- Research Unit for Surgery, And Centre of Excellence in Gastrointestinal Diseases and Malformations in Infancy and Childhood (Gain), Odense University Hospital, Odense Denmark, University of Southern Denmark, Odense, Denmark
| | - Nagoud Schukfeh
- Hannover Medical School, Department of Pediatric Surgery, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Martin Lacher
- Department of Pediatric Surgery, University of Leipzig, Germany
| | - Duccio Cavalieri
- Department of Biology, University of Florence and Associazione Famiglie Pazienti Morbo Di Hirschprung (Amorhi), Italy
| | - Ernst van Heurn
- Department of Paediatric Surgery, Amsterdam University Medical Centres, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism Research Institute, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Rony Sfeir
- Department of Pediatric Surgery, Jeanne De Flandre Hospital, Lille, France
| | - Mikko P Pakarinen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Section of Pediatric Surgery, New Children's Hospital, University of Helsinki, Finland
| | - Kristin Bjørnland
- Department of Pediatric Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tomas Wester
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Unit of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
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Gianola S, Bargeri S, Castellini G, Cook C, Palese A, Pillastrini P, Salvalaggio S, Turolla A, Rossettini G. Performance of ChatGPT Compared to Clinical Practice Guidelines in Making Informed Decisions for Lumbosacral Radicular Pain: A Cross-sectional Study. J Orthop Sports Phys Ther 2024; 54:1-7. [PMID: 38284363 DOI: 10.2519/jospt.2024.12151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE: To compare the accuracy of an artificial intelligence chatbot to clinical practice guidelines (CPGs) recommendations for providing answers to complex clinical questions on lumbosacral radicular pain. DESIGN: Cross-sectional study. METHODS: We extracted recommendations from recent CPGs for diagnosing and treating lumbosacral radicular pain. Relative clinical questions were developed and queried to OpenAI's ChatGPT (GPT-3.5). We compared ChatGPT answers to CPGs recommendations by assessing the (1) internal consistency of ChatGPT answers by measuring the percentage of text wording similarity when a clinical question was posed 3 times, (2) reliability between 2 independent reviewers in grading ChatGPT answers, and (3) accuracy of ChatGPT answers compared to CPGs recommendations. Reliability was estimated using Fleiss' kappa (κ) coefficients, and accuracy by interobserver agreement as the frequency of the agreements among all judgments. RESULTS: We tested 9 clinical questions. The internal consistency of text ChatGPT answers was unacceptable across all 3 trials in all clinical questions (mean percentage of 49%, standard deviation of 15). Intrareliability (reviewer 1: κ = 0.90, standard error [SE] = 0.09; reviewer 2: κ = 0.90, SE = 0.10) and interreliability (κ = 0.85, SE = 0.15) between the 2 reviewers was "almost perfect." Accuracy between ChatGPT answers and CPGs recommendations was slight, demonstrating agreement in 33% of recommendations. CONCLUSION: ChatGPT performed poorly in internal consistency and accuracy of the indications generated compared to clinical practice guideline recommendations for lumbosacral radicular pain. J Orthop Sports Phys Ther 2024;54(3):1-7. Epub 29 January 2024. doi:10.2519/jospt.2024.12151.
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Likar R, Aroyo I, Bangert K, Degen B, Dziewas R, Galvan O, Grundschober MT, Köstenberger M, Muhle P, Schefold JC, Zuercher P. Management of swallowing disorders in ICU patients - A multinational expert opinion. J Crit Care 2024; 79:154447. [PMID: 37924574 DOI: 10.1016/j.jcrc.2023.154447] [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: 04/11/2023] [Revised: 09/19/2023] [Accepted: 10/10/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Dysphagia is common in intensive care unit (ICU) patients, yet it remains underrecognized and often unmanaged despite being associated with life-threatening complications, prolonged ICU stays and hospitalization. PURPOSE To propose an expert opinion for the diagnosis and management of dysphagia developed from evidence-based clinical recommendations and practitioner insights. METHODS A multinational group of dysphagia and critical care experts conducted a literature review using a modified ACCORD methodology. Based on a fusion of the available evidence and the panel's clinical experience, an expert opinion on best practice management was developed. RESULTS The panel recommends adopting clinical algorithms intended to promote standardized, high-quality care that triggers timely systematic dysphagia screening, assessment, and treatment of extubated and tracheostomized patients in the ICU. CONCLUSIONS Given the lack of robust scientific evidence, two clinical management algorithms are proposed for use by multidisciplinary teams to improve early systematic detection and effective management of dysphagia in ICU patients. Additionally, emerging therapeutic options such as neurostimulation have the potential to improve the quality of ICU dysphagia care.
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Affiliation(s)
- Rudolf Likar
- Department for Anaesthesiology and Intensive Medicine, Klinikum Klagenfurt am Wörthersee, Austria
| | - Ilia Aroyo
- Department of Neurology and Neurointensive Care Medicine, Klinikum Darmstadt, Germany
| | - Katrin Bangert
- Clinic for Intensive Care Medicine, University Hospital Hamburg, Germany
| | - Björn Degen
- Clinic for Intensive Medicine, Dysphagia Centre, Vienna, Austria
| | - Rainer Dziewas
- Department of Neurology and Neurological Rehabilitation, Klinikum Osnabrück, Osnabrück, Germany
| | - Oliver Galvan
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Markus Köstenberger
- Department for Anaesthesiology and Intensive Medicine, Klinikum Klagenfurt am Wörthersee, Austria; Department for Anaesthesiology and Intensive Care Medicine, Medical University Graz, Graz, Austria.
| | - Paul Muhle
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Germany
| | - Joerg C Schefold
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Patrick Zuercher
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Gattrell WT, Logullo P, van Zuuren EJ, Price A, Hughes EL, Blazey P, Winchester CC, Tovey D, Goldman K, Hungin AP, Harrison N. ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med 2024; 21:e1004326. [PMID: 38261576 PMCID: PMC10805282 DOI: 10.1371/journal.pmed.1004326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited, or absent. Even when research evidence is abundant, clinical recommendations, policy decisions, and priority-setting may still require agreement from multiple, sometimes ideologically opposed parties. Despite their prominence and influence on key decisions, consensus methods are often poorly reported. Our aim was to develop the first reporting guideline dedicated to and applicable to all consensus methods used in biomedical research regardless of the objective of the consensus process, called ACCORD (ACcurate COnsensus Reporting Document). METHODS AND FINDINGS We followed methodology recommended by the EQUATOR Network for the development of reporting guidelines: a systematic review was followed by a Delphi process and meetings to finalize the ACCORD checklist. The preliminary checklist was drawn from the systematic review of existing literature on the quality of reporting of consensus methods and suggestions from the Steering Committee. A Delphi panel (n = 72) was recruited with representation from 6 continents and a broad range of experience, including clinical, research, policy, and patient perspectives. The 3 rounds of the Delphi process were completed by 58, 54, and 51 panelists. The preliminary checklist of 56 items was refined to a final checklist of 35 items relating to the article title (n = 1), introduction (n = 3), methods (n = 21), results (n = 5), discussion (n = 2), and other information (n = 3). CONCLUSIONS The ACCORD checklist is the first reporting guideline applicable to all consensus-based studies. It will support authors in writing accurate, detailed manuscripts, thereby improving the completeness and transparency of reporting and providing readers with clarity regarding the methods used to reach agreement. Furthermore, the checklist will make the rigor of the consensus methods used to guide the recommendations clear for readers. Reporting consensus studies with greater clarity and transparency may enhance trust in the recommendations made by consensus panels.
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Affiliation(s)
| | - Patricia Logullo
- Centre for Statistics in Medicine, University of Oxford, and EQUATOR Network UK Centre, Oxford, United Kingdom
| | | | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Paul Blazey
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher C. Winchester
- Oxford PharmaGenesis, Oxford, United Kingdom
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - David Tovey
- Journal of Clinical Epidemiology, London, United Kingdom
| | - Keith Goldman
- Global Medical Affairs, AbbVie, North Chicago, Illinois, United States of America
| | - Amrit Pali Hungin
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
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Edwards JD, Wocial LD, Madrigal VN, Moon MM, Ramey-Hunt C, Walter JK, Baird JD, Leland BD. Continuity Strategies for Long-Stay PICU Patients: Consensus Statements From the Lucile Packard Foundation PICU Continuity Panel. Pediatr Crit Care Med 2023; 24:849-861. [PMID: 38415714 PMCID: PMC10540754 DOI: 10.1097/pcc.0000000000003308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVES To develop consensus statements on continuity strategies using primary intensivists, primary nurses, and recurring multidisciplinary team meetings for long-stay patients (LSPs) in PICUs. PARTICIPANTS The multidisciplinary Lucile Packard Foundation PICU Continuity Panel comprising parents of children who had prolonged PICU stays and experts in several specialties/professions that care for children with medical complexity in and out of PICUs. DESIGN/METHODS We used modified RAND Delphi methodology, with a comprehensive literature review, Delphi surveys, and a conference, to reach consensus. The literature review resulted in a synthesized bibliography, which was provided to panelists. We used an iterative process to generate draft statements following panelists' completion of four online surveys with open-ended questions on implementing and sustaining continuity strategies. Panelists were anonymous when they voted on revised draft statements. Agreement of 80% constituted consensus. At a 3-day virtual conference, we discussed, revised, and re-voted on statements not reaching or barely reaching consensus. We used Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of the evidence and rate the statements' strength. The Panel also generated outcome, process, and balancing metrics to evaluate continuity strategies. RESULTS The Panel endorsed 17 consensus statements in five focus areas of continuity strategies (Eligibility Criteria, Initiation, Standard Responsibilities, Resources Needed to Implement, Resources Needed to Sustain). The quality of evidence of the statements was low to very low, highlighting the limited evidence and the importance of panelists' experiences/expertise. The strength of the statements was conditional. An extensive list of potential evaluation metrics was generated. CONCLUSIONS These expert/parent-developed consensus statements provide PICUs with novel summaries on how to operationalize, implement, and sustain continuity strategies for LSP, a rapidly growing, vulnerable, resource-intensive population in PICUs.
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Affiliation(s)
- Jeffrey D Edwards
- Section of Critical Care, Department of Pediatrics, Columbia University Vagelos College of Physician and Surgeons, New York, NY
| | - Lucia D Wocial
- John J. Lynch, MD Center for Ethics, MedStar Washington Hospital Center, Washington, DC
- Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, IN
| | - Vanessa N Madrigal
- Division of Critical Care Medicine, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC
- Pediatric Ethics Program, Children's National Medical Center, Washington, DC
| | - Michelle M Moon
- Palliative Care and Symptom Management, Swedish Health Systems, Issaquah, Washington, DC
| | - Cheryl Ramey-Hunt
- Integrated Care Management, Case Management, and Social Work, Indiana University Health and Riley Hospital for Children, Indianapolis, IN
| | - Jennifer K Walter
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Pediatric Advanced Care Team, Justin Michael Ingerman Center for Palliative Care, The Children's Hospital of Philadelphia, Philadelphia, PA
- Center for Pediatric Clinical Effectiveness and PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jennifer D Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA
| | - Brian D Leland
- Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, IN
- Division of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
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11
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de Vries PJ, Heunis TM, Vanclooster S, Chambers N, Bissell S, Byars AW, Flinn J, Gipson TT, van Eeghen AM, Waltereit R, Capal JK, Cukier S, Davis PE, Smith C, Kingswood JC, Schoeters E, Srivastava S, Takei M, Gardner-Lubbe S, Kumm AJ, Krueger DA, Sahin M, De Waele L, Jansen AC. International consensus recommendations for the identification and treatment of tuberous sclerosis complex-associated neuropsychiatric disorders (TAND). J Neurodev Disord 2023; 15:32. [PMID: 37710171 PMCID: PMC10503032 DOI: 10.1186/s11689-023-09500-1] [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: 04/27/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is associated with a wide range of physical manifestations for which international clinical recommendations for diagnosis and management have been established. TSC is, however, also associated with a wide range of TSC-Associated Neuropsychiatric Disorders (TAND) that are typically under-identified and under-treated yet associated with a profound burden of disease. The contemporary evidence base for the identification and treatment of TAND is much more limited and, to date, consensus recommendations for the diagnosis and management of TAND have also been limited and non-specific. METHODS The TANDem project was launched with an international, interdisciplinary, and participatory consortium of 24 individuals, including TSC family representatives, from all World Health Organization (WHO) regions but one. One of the aims of the TANDem project was to generate consensus recommendations for the identification and treatment of TAND. At the time of this project, no internationally adopted standard methodology and methodological checklists existed for the generation of clinical practice recommendations. We therefore developed our own systematic procedure for evidence review and consensus-building to generate evidence-informed consensus recommendations of relevance to the global TSC community. RESULTS At the heart of the consensus recommendations are ten core principles surrounded by cluster-specific recommendations for each of the seven natural TAND clusters identified in the literature (autism-like, dysregulated behavior, eat/sleep, mood/anxiety, neuropsychological, overactive/impulsive, and scholastic) and a set of wraparound psychosocial cluster recommendations. The overarching recommendation is to "screen" for TAND at least annually, to "act" using appropriate next steps for evaluation and treatment, and to "repeat" the process to ensure early identification and early intervention with the most appropriate biological, psychological, and social evidence-informed approaches to support individuals with TSC and their families. CONCLUSIONS The consensus recommendations should provide a systematic framework to approach the identification and treatment of TAND for health, educational, social care teams and families who live with TSC. To ensure global dissemination and implementation of these recommendations, partnerships with the international TSC community will be important. One of these steps will include the generation of a "TAND toolkit" of "what to seek" and "what to do" when difficulties are identified in TAND clusters.
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Affiliation(s)
- Petrus J de Vries
- Division of Child and Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.
| | - Tosca-Marie Heunis
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nola Chambers
- Division of Child and Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa
| | - Stacey Bissell
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Anna W Byars
- TSC Clinic Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Neurology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Tanjala T Gipson
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
- Le Bonheur Children's Hospital and Boling Center for Developmental Disabilities, Memphis, TN, USA
| | - Agnies M van Eeghen
- Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, Netherlands
- TAND Expert Centre, 'S Heeren Loo, Hoofddorp, Netherlands
| | - Robert Waltereit
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Jamie K Capal
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sebastián Cukier
- Department of Psychopathology and Mental Health, Pedro de Elizalde Hospital, Buenos Aires, Argentina
| | - Peter E Davis
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - J Chris Kingswood
- Department of Clinical Genetics, St George's University Hospitals, London, UK
- Sussex Renal Unit, The Royal Sussex County Hospital, Brighton, UK
| | | | - Shoba Srivastava
- Division of Child and Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa
- Society of Parents of Children With Autistic Disorders (SOPAN), Mumbai, India
| | - Megumi Takei
- Japanese Society of Tuberous Sclerosis Complex, Family Network, Tokyo, Japan
| | - Sugnet Gardner-Lubbe
- MuViSU (Centre for Multi-Dimensional Data Visualisation), Department of Statistics and Actuarial Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Aubrey J Kumm
- Division of Child and Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa
| | - Darcy A Krueger
- TSC Clinic Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Neurology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Boston, MA, USA
| | - Liesbeth De Waele
- Department of Paediatric Neurology, University Hospitals Leuven, Louvain, Belgium
- Department of Development and Regeneration, KU Leuven, Louvain, Belgium
| | - Anna C Jansen
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Pediatrics, Koningin Mathilde Moeder-en Kindcentrum, Antwerp University Hospital, Antwerp, Belgium
- Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
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12
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Hansford HJ, Cashin AG, Jones MD, Swanson SA, Islam N, Dahabreh IJ, Dickerman BA, Egger M, Garcia-Albeniz X, Golub RM, Lodi S, Moreno-Betancur M, Pearson SA, Schneeweiss S, Sterne J, Sharp MK, Stuart EA, Hernan MA, Lee H, McAuley JH. Development of the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) guideline. BMJ Open 2023; 13:e074626. [PMID: 37699620 PMCID: PMC10503363 DOI: 10.1136/bmjopen-2023-074626] [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: 04/12/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Observational studies are increasingly used to inform health decision-making when randomised trials are not feasible, ethical or timely. The target trial approach provides a framework to help minimise common biases in observational studies that aim to estimate the causal effect of interventions. Incomplete reporting of studies using the target trial framework limits the ability for clinicians, researchers, patients and other decision-makers to appraise, synthesise and interpret findings to inform clinical and public health practice and policy. This paper describes the methods that we will use to develop the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) reporting guideline. METHODS/DESIGN The TARGET reporting guideline will be developed in five stages following recommended guidance. The first stage will identify target trial reporting practices by systematically reviewing published studies that explicitly emulated a target trial. The second stage will identify and refine items to be considered for inclusion in the TARGET guideline by consulting content experts using sequential online surveys. The third stage will prioritise and consolidate key items to be included in the TARGET guideline at an in-person consensus meeting of TARGET investigators. The fourth stage will produce and pilot-test both the TARGET guideline and explanation and elaboration document with relevant stakeholders. The fifth stage will disseminate the TARGET guideline and resources via journals, conferences and courses. ETHICS AND DISSEMINATION Ethical approval for the survey has been attained (HC220536). The TARGET guideline will be disseminated widely in partnership with stakeholders to maximise adoption and improve reporting of these studies.
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Affiliation(s)
- Harrison J Hansford
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Aidan G Cashin
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Matthew D Jones
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Sonja A Swanson
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nazrul Islam
- Oxford Population Health, Big Data Institute, University of Oxford, Oxford, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Issa J Dahabreh
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Barbra A Dickerman
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Matthias Egger
- Institute of Social & Preventive Medicine, University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology and Research, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Xavier Garcia-Albeniz
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- RTI Health Solutions Barcelona, Barcelona, Catalunya, Spain
| | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara Lodi
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Margarita Moreno-Betancur
- Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sallie-Anne Pearson
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sebastian Schneeweiss
- Division of Pharmacoepidemiology, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan Sterne
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Health Data Research UK South-West, Bristol, UK
| | - Melissa K Sharp
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Miguel A Hernan
- CAUSALab, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hopin Lee
- University of Exeter Medical School, Exeter, UK
- EMEA Methods and Evidence Generation, IQVIA London, London, UK
| | - James H McAuley
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
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13
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Piozzi GN, Khobragade K, Aliyev V, Asoglu O, Bianchi PP, Butiurca VO, Chen WTL, Cheong JY, Choi GS, Coratti A, Denost Q, Fukunaga Y, Gorgun E, Guerra F, Ito M, Khan JS, Kim HJ, Kim JC, Kinugasa Y, Konishi T, Kuo LJ, Kuzu MA, Lefevre JH, Liang JT, Marks J, Molnar C, Panis Y, Rouanet P, Rullier E, Saklani A, Spinelli A, Tsarkov P, Tsukamoto S, Weiser M, Kim SH. International standardization and optimization group for intersphincteric resection (ISOG-ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome. Colorectal Dis 2023; 25:1896-1909. [PMID: 37563772 DOI: 10.1111/codi.16704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/12/2023]
Abstract
AIM Intersphincteric resection (ISR) is an oncologically complex operation for very low-lying rectal cancers. Yet, definition, anatomical description, operative indications and operative approaches to ISR are not standardized. The aim of this study was to standardize the definition of ISR by reaching international consensus from the experts in the field. This standardization will allow meaningful comparison in the literature in the future. METHOD A modified Delphi approach with three rounds of questionnaire was adopted. A total of 29 international experts from 11 countries were recruited for this study. Six domains with a total of 37 statements were examined, including anatomical definition; definition of intersphincteric dissection, intersphincteric resection (ISR) and ultra-low anterior resection (uLAR); indication for ISR; surgical technique of ISR; specimen description of ISR; and functional outcome assessment protocol. RESULTS Three rounds of questionnaire were performed (response rate 100%, 89.6%, 89.6%). Agreement (≥80%) reached standardization on 36 statements. CONCLUSION This study provides an international expert consensus-based definition and standardization of ISR. This is the first study standardizing terminology and definition of deep pelvis/anal canal anatomy from a surgical point of view. Intersphincteric dissection, ISR and uLAR were specifically defined for precise surgical description. Indication for ISR was determined by the rectal tumour's maximal radial infiltration (T stage) below the levator ani. A new surgical definition of T3isp was reached by consensus to define T3 low rectal tumours infiltrating the intersphincteric plane. A practical flowchart for surgical indication for uLAR/ISR/abdominoperineal resection was developed. A standardized ISR surgical technique and functional outcome assessment protocol was defined.
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Affiliation(s)
| | | | - Vusal Aliyev
- Bogazici Academy for Clinical Sciences, Istanbul, Turkey
| | - Oktar Asoglu
- Bogazici Academy for Clinical Sciences, Istanbul, Turkey
| | | | - Vlad-Olimpiu Butiurca
- University of Medicine, Pharmacy Science, and Technology 'G.E. Palade', Târgu-Mureș, Romania
| | | | | | - Gyu-Seog Choi
- Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Andrea Coratti
- Azienda USL Toscana Sud Est-Misericordia Hospital, Grosseto, Italy
| | | | - Yosuke Fukunaga
- Cancer Institution Hospital, Japanese Foundation of Cancer Research, Tokyo, Japan
| | | | - Francesco Guerra
- Azienda USL Toscana Sud Est-Misericordia Hospital, Grosseto, Italy
| | - Masaaki Ito
- National Cancer Center Hospital East, Chiba, Japan
| | - Jim S Khan
- University of Portsmouth, Portsmouth, UK
| | - Hye Jin Kim
- Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Jin Cheon Kim
- University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | | | - Tsuyoshi Konishi
- M.D. Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Li-Jen Kuo
- Taipei Medical University Hospital, Taipei City, Taiwan
| | | | - Jeremie H Lefevre
- Department of Digestive Surgery, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France
| | - Jin-Tung Liang
- National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan
| | | | - Călin Molnar
- University of Medicine, Pharmacy Science, and Technology 'G.E. Palade', Târgu-Mureș, Romania
| | - Yves Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly, Seine, France
| | | | - Eric Rullier
- Bordeaux University Hospital, Haut-Leveque Hospital, Pessac, France
| | | | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Petr Tsarkov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Martin Weiser
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Seon Hahn Kim
- Korea University Anam Hospital, Seoul, Korea
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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14
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Gottlieb M, Caretta‐Weyer H, Chan TM, Humphrey‐Murto S. Educator's blueprint: A primer on consensus methods in medical education research. AEM EDUCATION AND TRAINING 2023; 7:e10891. [PMID: 37448627 PMCID: PMC10336022 DOI: 10.1002/aet2.10891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 07/15/2023]
Abstract
Consensus methods such as the Delphi and nominal group techniques are increasingly utilized within medical education research. This educator's blueprint paper provides practical strategies regarding five key steps for ensuring best practices when using consensus methods. These strategies include deciding which consensus method is best, developing the initial questionnaire, identifying the participants, determining the number of rounds and consensus threshold, and describing and justifying any modifications. These strategies will help guide education researchers on their next study using consensus methods.
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Affiliation(s)
- Michael Gottlieb
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Holly Caretta‐Weyer
- Department of Emergency MedicineStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Teresa M. Chan
- Department of Emergency Medicine, Department of Medicine; Division of Emergency Medicine and Division of Education & InnovationMcMaster UniversityHamiltonOntarioCanada
| | - Susan Humphrey‐Murto
- Department of Medicine and Department of Innovation in Medical EducationUniversity of OttawaOttawaOntarioCanada
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15
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Rommerskirch-Manietta M, Manietta C, Hoffmann AL, Rohra H, Gove D, Alpers B, Hung L, Geary CR, Abbott KM, Ren LH, Oberfeld S, Diaz A, Roes M. Participatory development of a framework to actively involve people living with dementia and those from their social network, and healthcare professionals in conducting a systematic review: the DECIDE-SR protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:52. [PMID: 37434210 PMCID: PMC10337195 DOI: 10.1186/s40900-023-00461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Systematic reviews summarize and evaluate relevant studies to contribute to evidence-based practice. Internationally, researchers have reached a consensus that the active involvement of the public leads to better research. Despite this agreement, there are many reviews of research concerning healthcare interventions intended to promote the care of people living with dementia and those from their social network (e.g., close contacts, both family and non-family members) primarily involve only healthcare professionals and other experts. Due to the lack of a dementia-sensitive framework to actively involve people living with dementia and those from their social network, and healthcare professionals as co-researchers in systematic reviews, it is important to develop a framework to inform practice. METHODS For this framework development process, we will recruit four people living with dementia and a total of four people from their social network, and three healthcare professionals working in acute or long-term care settings. We will conduct regular meetings with these groups of the public and healthcare professionals to include them in all stages of the systematic review. We will also identify and develop methods necessary to ensure meaningful involvement. The results will be documented and analyzed for the development of a framework. For the planning and preparation for these meetings, as well as the conduct of the meetings themselves, we will be guided by the principles of the INVOLVE approach. In addition, the ACTIVE framework will be used to guide the degree of involvement and the stage in the review process. DISCUSSION We assume that our transparent approach to the development of a framework to support the active involvement of people living with dementia and those from their social network, and healthcare professionals in systematic reviews will serve as an impetus for and provide guidance to other researchers with the goal of increasing researchers' focus on this topic and facilitating systematic reviews that apply participatory approaches. TRIAL REGISTRATION Trial registration is unnecessary as no intervention study will be conducted.
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Affiliation(s)
- Mike Rommerskirch-Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Christina Manietta
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Anna Louisa Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Helga Rohra
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Patient Advisory Board, Bonn, Germany
| | | | - Birgit Alpers
- Medical Center Hamburg Eppendorf (UKE), Hamburg, Germany
| | - Lillian Hung
- School of Nursing, The University of British Columbia, Vancouver, Canada
| | | | - Katherine M. Abbott
- Department of Sociology and Gerontology, Miami University, Oxford, USA
- Scripps Gerontology Center, Oxford, USA
| | - Lily Haopu Ren
- School of Nursing, The University of British Columbia, Vancouver, Canada
| | - Stefanie Oberfeld
- Department of Geriatric Psychiatry, St. Rochus-Hospital, Telgte, Germany
| | - Ana Diaz
- Alzheimer Europe, Luxembourg, Luxembourg
| | - Martina Roes
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, Germany
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
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16
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Cook CE, Bailliard A, Bent JA, Bialosky JE, Carlino E, Colloca L, Esteves JE, Newell D, Palese A, Reed WR, Vilardaga JP, Rossettini G. An international consensus definition for contextual factors: findings from a nominal group technique. Front Psychol 2023; 14:1178560. [PMID: 37465492 PMCID: PMC10351924 DOI: 10.3389/fpsyg.2023.1178560] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 07/20/2023] Open
Abstract
Objective Emerging literature suggests contextual factors are important components of therapeutic encounters and may substantially influence clinical outcomes of a treatment intervention. At present, a single consensus definition of contextual factors, which is universal across all health-related conditions is lacking. The objective of this study was to create a consensus definition of contextual factors to better refine this concept for clinicians and researchers. Design The study used a multi-stage virtual Nominal Group Technique (vNGT) to create and rank contextual factor definitions. Nominal group techniques are a form of consensus-based research, and are beneficial for identifying problems, exploring solutions and establishing priorities. Setting International. Main outcome measures The initial stages of the vNGT resulted in the creation of 14 independent contextual factor definitions. After a prolonged discussion period, the initial definitions were heavily modified, and 12 final definitions were rank ordered by the vNGT participants from first to last. Participants The 10 international vNGT participants had a variety of clinical backgrounds and research specializations and were all specialists in contextual factors research. Results A sixth round was used to identify a final consensus, which reflected the complexity of contextual factors and included three primary domains: (1) an overall definition; (2) qualifiers that serve as examples of the key areas of the definition; and (3) how contextual factors may influence clinical outcomes. Conclusion Our consensus definition of contextual factors seeks to improve the understanding and communication between clinicians and researchers. These are especially important in recognizing their potential role in moderating and/or mediating clinical outcomes.
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Affiliation(s)
- Chad E. Cook
- Department of Orthopaedics, Duke University, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
- Duke Clinical Research Institute, Duke University, Durham, NC, United States
| | - Antoine Bailliard
- Department of Orthopaedics, Duke University, Durham, NC, United States
- Occupational Therapy Doctorate Division, Duke University, Durham, NC, United States
| | - Jennifer A. Bent
- Department of Rehabilitation, Duke University Hospital System, Durham, NC, United States
| | - Joel E. Bialosky
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
- Brooks-PHHP Research Collaboration, Gainesville, FL, United States
| | - Elisa Carlino
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Luana Colloca
- Departement of Pain and Translational Symptom Science and the Placebo Beyond Opinions Center, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gżira, Malta
| | - Dave Newell
- Anglo-European College of Chiropractic University College, Bournemouth, United Kingdom
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
| | - William R. Reed
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
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Rios C, Maldonado G, Vargas S, González J, Vera C, Zuñiga A, Martínez J, Castillo M, Jervis R, Ventura R, Guevara S, Torres G, Uguña F, Messina OD, Neyro JL, Fernández D, Guerrero R, Moreno M. First Ecuadorian statement consensus for the evaluation and treatment of osteoporosis. Arch Osteoporos 2023; 18:81. [PMID: 37316765 DOI: 10.1007/s11657-023-01263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 05/09/2023] [Indexed: 06/16/2023]
Abstract
Osteoporosis management has become more relevant as the life expectancy increases. In Ecuador, approximately 19% of adults over 65 years of age have been diagnosed with osteoporosis. There is no national consensus for the management and prevention of the disease being this proposal the first Ecuadorian consensus. INTRODUCTION In Ecuador, it is estimated that around 19% of adults over 65 years of age have osteoporosis. Due to the increase in life expectancy in the world population, the evaluation and management of osteoporosis has become more relevant. Currently, there is no national consensus for the management and prevention of the disease. The Ecuadorian Society of Rheumatology presented the project for the elaboration of the first Ecuadorian consensus for the management and prevention of osteoporosis. METHODS A panel of experts in multiple areas and extensive experience was invited to participate. The consensus was carried out using the Delphi method. Six working dimensions were created: definition and epidemiology of osteoporosis, fracture risk prediction tools, non-pharmacological treatment, pharmacological treatment, calcium and vitamin D, and glucocorticoid-induced osteoporosis. RESULTS The first round was held in December 2021, followed by the second round in February 2022 and the third round in March 2022. The data was shared with the specialists at the end of each round. After three rounds of work, a consensus was reached for the management and prevention of osteoporosis. CONCLUSION This is the first Ecuadorian consensus for the management and treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Carlos Rios
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | | | - Sara Vargas
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | - José González
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | - Claudia Vera
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | - Andrés Zuñiga
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | - José Martínez
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | | | - Raúl Jervis
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | - Rosa Ventura
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
| | | | | | | | | | - José Luis Neyro
- Obstetrics and Gynecology Department, Cruces University Hospital, Vasco Country University EHU-UPV, Baracaldo Bizkaia, Spain
| | - Daniel Fernández
- Rheumatology Department, San Ignacio University Hospital, Bogota, Colombia
| | | | - Mario Moreno
- Ecuadorian Society of Rheumatology, Guayaquil, Ecuador
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Rabie AA, Elhazmi A, Azzam MH, Abdelbary A, Labib A, Combes A, Zakhary B, MacLaren G, Barbaro RP, Peek GJ, Antonini MV, Shekar K, Al-Fares A, Oza P, Mehta Y, Alfoudri H, Ramanathan K, Ogino M, Raman L, Paden M, Brodie D, Bartlett R. Expert consensus statement on venovenous extracorporeal membrane oxygenation ECMO for COVID-19 severe ARDS: an international Delphi study. Ann Intensive Care 2023; 13:36. [PMID: 37129771 PMCID: PMC10152433 DOI: 10.1186/s13613-023-01126-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/05/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND The high-quality evidence on managing COVID-19 patients requiring extracorporeal membrane oxygenation (ECMO) support is insufficient. Furthermore, there is little consensus on allocating ECMO resources when scarce. The paucity of evidence and the need for guidance on controversial topics required an international expert consensus statement to understand the role of ECMO in COVID-19 better. Twenty-two international ECMO experts worldwide work together to interpret the most recent findings of the evolving published research, statement formulation, and voting to achieve consensus. OBJECTIVES To guide the next generation of ECMO practitioners during future pandemics on tackling controversial topics pertaining to using ECMO for patients with COVID-19-related severe ARDS. METHODS The scientific committee was assembled of five chairpersons with more than 5 years of ECMO experience and a critical care background. Their roles were modifying and restructuring the panel's questions and, assisting with statement formulation in addition to expert composition and literature review. Experts are identified based on their clinical experience with ECMO (minimum of 5 years) and previous academic activity on a global scale, with a focus on diversity in gender, geography, area of expertise, and level of seniority. We used the modified Delphi technique rounds and the nominal group technique (NGT) through three face-to-face meetings and the voting on the statement was conducted anonymously. The entire process was planned to be carried out in five phases: identifying the gap of knowledge, validation, statement formulation, voting, and drafting, respectively. RESULTS In phase I, the scientific committee obtained 52 questions on controversial topics in ECMO for COVID-19, further reviewed for duplication and redundancy in phase II, resulting in nine domains with 32 questions with a validation rate exceeding 75% (Fig. 1). In phase III, 25 questions were used to formulate 14 statements, and six questions achieved no consensus on the statements. In phase IV, two voting rounds resulted in 14 statements that reached a consensus are included in four domains which are: patient selection, ECMO clinical management, operational and logistics management, and ethics. CONCLUSION Three years after the onset of COVID-19, our understanding of the role of ECMO has evolved. However, it is incomplete. Tota14 statements achieved consensus; included in four domains discussing patient selection, clinical ECMO management, operational and logistic ECMO management and ethics to guide next-generation ECMO providers during future pandemic situations.
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Affiliation(s)
- Ahmed A Rabie
- Critical Care Department-ECMO care Unit (ECU), Riyadh Region Cluster1, King Saud Medical City, Riyadh, Saudi Arabia.
| | - Alyaa Elhazmi
- Internal Medicine Department, King Faisal University, Riyadh, Saudi Arabia
| | - Mohamed H Azzam
- Adult Critical Care Department, Dr. Sulaiman Alhabib Medical Group, Jeddah, Saudi Arabia
| | | | - Ahmed Labib
- Hamad Medical Corporation, Weill Cornell Medical College, Doha, Qatar
| | - Alain Combes
- INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne Université, 75013, Paris, France
- Service de Médecine Intensive-Réanimation, Institut de Cardiologie, APHP Sorbonne Université Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | | | - Graeme MacLaren
- Cardiothoracic ICU, National University Hospital, Singapore, Singapore
| | - Ryan P Barbaro
- Division of Pediatric Critical Care and Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
| | - Giles J Peek
- Congenital Heart Center, University of Florida, Gainesville, FL, USA
| | | | - Kiran Shekar
- Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Abdulrahman Al-Fares
- Department of Anesthesia, Critical Care Medicine and Pain Medicine, Ministry of Health, Kuwait City, Kuwait
- Al-Amiri Hospital Center for Respiratory and Cardiac Failure, Kuwait Extracorporeal Life Support Program, Ministry of Health, Kuwait City, Kuwait
| | - Pranay Oza
- Riddhi Vinayak Multispecialty Hospital, Mumbai, India
| | - Yatin Mehta
- Medanta Institute of Critical Care and Anesthesiology, Medanta The Medicity, Sector-38, Gurgaon, 122001, Haryana, India
| | - Huda Alfoudri
- Department of Anaesthesia, Critical Care, and Pain Management, Al-Adan Hospital Ministry of Health, Hadiya, Kuwait
| | | | - Mark Ogino
- Chief Partnership Officer, Nemours Children's Health, Delaware Valley, USA
| | - Lakshmi Raman
- Division of Paediatric Critical Care, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Matthew Paden
- Division of Paediatric Critical Care, Emory University, Atlanta, GA, USA
| | - Daniel Brodie
- Department of Medicine, Columbia University College of Physicians & Surgeons, and Center for Acute Respiratory Failure, New York-Presbyterian/Columbia University Medical Center, New York, USA
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Ruple A, Sargeant JM, Selmic LE, O'Connor AM. The standards of reporting randomized trials in pets (PetSORT): Methods and development processes. Front Vet Sci 2023; 10:1137774. [PMID: 37065218 PMCID: PMC10103610 DOI: 10.3389/fvets.2023.1137774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/13/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundReporting of clinical trials conducted in client- and shelter-owned dog and cat populations is not optimal, which inhibits the ability to assess the reliability and validity of trial findings and precludes the ability to include some trials in evidence synthesis.ObjectiveTo develop a reporting guideline for parallel group and crossover trials that addresses the unique features and reporting requirements for trials conducted in client- and shelter-owned dog and cat populations.DesignConsensus statement.SettingVirtual.ParticipantsFifty-six experts from North America, the United Kingdom, Europe, and Australia working in academia, government (research and regulatory agencies), industry, and clinical veterinary practice.MethodsA steering committee created a draft checklist for reporting criteria based upon the CONSORT statement and the CONSORT extensions for reporting of abstracts and crossover trials. Each item was presented to the expert participants and was modified and presented again until >85% of participants were in agreement about the inclusion and wording of each item in the checklist.ResultsThe final PetSORT checklist consists of 25 main items with several sub-items. Most items were modifications of items contained in the CONSORT 2010 checklist or the CONSORT extension for crossover trials, but 1 sub-item pertaining to euthanasia was created de novo.ConclusionThe methods and processes used to develop this guideline represent a novel departure from those used to create other reporting guidelines, by using a virtual format. The use of the PetSORT statement should improve reporting of trials conducted in client- and shelter-owned dogs and cats and published in the veterinary research literature.
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Affiliation(s)
- Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
- *Correspondence: Audrey Ruple
| | - Jan M. Sargeant
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Laura E. Selmic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Annette M. O'Connor
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
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van Zuuren EJ, Logullo P, Price A, Fedorowicz Z, Hughes EL, Gattrell WT. Existing guidance on reporting of consensus methodology: a systematic review to inform ACCORD guideline development. BMJ Open 2022; 12:e065154. [PMID: 36201247 PMCID: PMC9462098 DOI: 10.1136/bmjopen-2022-065154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify evidence on the reporting quality of consensus methodology and to select potential checklist items for the ACcurate COnsensus Reporting Document (ACCORD) project to develop a consensus reporting guideline. DESIGN Systematic review. DATA SOURCES Embase, MEDLINE, Web of Science, PubMed, Cochrane Library, Emcare, Academic Search Premier and PsycINFO from inception until 7 January 2022. ELIGIBILITY CRITERIA Studies, reviews and published guidance addressing the reporting quality of consensus methodology for improvement of health outcomes in biomedicine or clinical practice. Reports of studies using or describing consensus methods but not commenting on their reporting quality were excluded. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Screening and data extraction of eligible studies were carried out independently by two authors. Reporting quality items addressed by the studies were synthesised narratively. RESULTS Eighteen studies were included: five systematic reviews, four narrative reviews, three research papers, three conference abstracts, two research guidance papers and one protocol. The majority of studies indicated that the quality of reporting of consensus methodology could be improved. Commonly addressed items were: consensus panel composition; definition of consensus and the threshold for achieving consensus. Items least addressed were: public patient involvement (PPI); the role of the steering committee, chair, cochair; conflict of interest of panellists and funding. Data extracted from included studies revealed additional items that were not captured in the data extraction form such as justification of deviation from the protocol or incentives to encourage panellist response. CONCLUSION The results of this systematic review confirmed the need for a reporting checklist for consensus methodology and provided a range of potential checklist items to report. The next step in the ACCORD project builds on this systematic review and focuses on reaching consensus on these items to develop the reporting guideline. PROTOCOL REGISTRATION https://osf.io/2rzm9.
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Affiliation(s)
- Esther J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Patricia Logullo
- Nuffield Department of Orthopaedics, Rheumatology and Muskuloskeletal Sciences, Centre for Statistics in Medicine, University of Oxford and EQUATOR Network UK Centre, Oxford, Oxfordshire, UK
| | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
- The BMJ, London, UK
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