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Sun YN, An Y, Weng ZW, Zhou YJ, Wang XY, Yu CH. Development of CORE-CM core outcome domain sets for trials of Chinese medicine for lumbar spinal stenosis. BMJ Open 2023; 13:e075856. [PMID: 37844991 PMCID: PMC10582923 DOI: 10.1136/bmjopen-2023-075856] [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: 05/20/2023] [Accepted: 09/22/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES Most Asian countries have employed Chinese medicine (CM) and Western medicine to treat lumbar spinal stenosis (LSS). Evidence synthesis and comparison of effectiveness are difficult since outcomes examined and presented through trials possess heterogeneity. This study aimed to solve the outcome problems for CM clinical trials in LSS by building a core outcome set (COS). METHODS To achieve an agreement on a set of core outcome domains, a four-phase study was carried out. First, we identified candidate outcome domains by systematically reviewing trials. In addition, we identified outcome domains associated with patients by conducting semistructured interviews with patients. Next, outcome domains were processed through a national two-round Delphi survey, in which 18 patients and 21 experts were recruited. Finally, the above domains were converted as a core outcome domain set based on a consensus meeting, in which 24 stakeholders were recruited. RESULTS Seventeen outcome subdomains were identified by the systematic review and interviews. The Delphi survey assigned a priority to four outcome domains in the first round and four outcomes additionally in the second round. The core outcome domains were determined through discussion and redefinition of outcomes in the consensus meeting: pain and discomfort, health-related quality of life, lumbar function, activities of daily living, measures of walking, patient global assessment, adverse events and CM-specific outcomes. CONCLUSION COS-CM-LSS is likely to enhance the consistency of outcomes reported in clinical trials. In-depth research should be conducted for the exploration of the best methods to examine the above outcomes.
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Affiliation(s)
- Ya-Nan Sun
- Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yi An
- First Clinical College, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
- Health Management Department, Aerospace Central Hospital, Beijing, China
| | - Zhi-Wen Weng
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yan-Ji Zhou
- First Clinical College, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
- Health Management Department, Aerospace Central Hospital, Beijing, China
| | - Xi-You Wang
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Chang-He Yu
- Tuina and Pain Management Department, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
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2
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Ali MS, Khattak M, Metcalfe D, Perry DC. Radiological hip shape and patient-reported outcome measures in healed Perthes' disease. Bone Joint J 2023; 105-B:711-716. [PMID: 37257855 DOI: 10.1302/0301-620x.105b6.bjj-2022-1421.r1] [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: 06/02/2023]
Abstract
Aims This study aimed to evaluate the relationship between hip shape and mid-term function in Perthes' disease. It also explored whether the modified three-group Stulberg classification can offer similar prognostic information to the five-group system. Methods A total of 136 individuals aged 12 years or older who had Perthes' disease in childhood completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility score (function), Nonarthritic Hip Score (NAHS) (function), EuroQol five-dimension five-level questionnaire (EQ-5D-5L) score (quality of life), and the numeric rating scale for pain (NRS). The Stulberg class of the participants' hip radiographs were evaluated by three fellowship-trained paediatric orthopaedic surgeons. Hip shape and Stulberg class were compared to PROM scores. Results A spherical hip was associated with the highest function and quality of life, and lowest pain. Conversely, aspherical hips exhibited the lowest functional scores and highest pain. The association between worsening Stulberg class (i.e. greater deviation from sphericity) and worse outcome persisted after adjustment for age and sex in relation to PROMIS (predicted mean difference -1.77 (95% confidence interval (CI) -2.70 to -0.83)), NAHS (-5.68 (95% CI -8.45 to -2.90)), and NRS (0.61 (95% CI 0.14 to 1.08)), but not EQ-5D-5L (-0.03 (95% CI -0.72 to 0.11)). Conclusion Patient-reported outcomes identify lower function, quality of life, and higher pain in aspherical hips. The magnitude of symptoms deteriorated with time. Hip sphericity (i.e. the modified three-group classification of spherical, oval, and aspherical) appeared to offer similar levels of detail to the five-group Stulberg classification.
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Affiliation(s)
- Mohammed S Ali
- Trauma and Orthopaedics Department, Aintree University Hospital, Liverpool, UK
- Department of Women's and Children's Health, Institute of Translational Medicine, Liverpool Women's Hospital, Liverpool, UK
| | - Mohammed Khattak
- Trauma and Orthopaedics Department, Alder Hey Children's Hospital, Liverpool, UK
| | - David Metcalfe
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Daniel C Perry
- Department of Women's and Children's Health, Institute of Translational Medicine, Liverpool Women's Hospital, Liverpool, UK
- Trauma and Orthopaedics Department, Alder Hey Children's Hospital, Liverpool, UK
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3
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Aquilina AL, Claireaux H, Aquilina CO, Tutton E, Fitzpatrick R, Costa ML, Griffin XL. The core outcomes for open lower limb fracture study. Bone Joint Res 2023; 12:352-361. [PMID: 37257859 DOI: 10.1302/2046-3758.126.bjr-2022-0280.r1] [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: 06/02/2023] Open
Abstract
Aims A core outcome set for adult, open lower limb fracture has been established consisting of 'Walking, gait and mobility', 'Being able to return to life roles', 'Pain or discomfort', and 'Quality of life'. This study aims to identify which outcome measurement instruments (OMIs) should be recommended to measure each core outcome. Methods A systematic review and quality assessment were conducted to identify existing instruments with evidence of good measurement properties in the open lower limb fracture population for each core outcome. Additionally, shortlisting criteria were developed to identify suitable instruments not validated in the target population. Candidate instruments were presented, discussed, and voted on at a consensus meeting of key stakeholders. Results The Wales Lower Limb Trauma Recovery scale was identified, demonstrating validation evidence in the target population. In addition, ten candidate OMIs met the shortlisting criteria. Six patients, eight healthcare professionals, and 11 research methodologists attended the consensus meeting. Consensus was achieved for the EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and the Lower Extremity Functional Scale (LEFS) to measure 'Quality of life' and 'Walking, gait and mobility' in future research trials, audit, and clinical assessment, respectively. No instrument met consensus criteria to measure 'Being able to return to life roles' and 'Pain or discomfort'. However, the EQ-5D-5L was found to demonstrate good face validity and could also be used pragmatically to measure these two outcomes, accepting limitations in sensitivity. Conclusion This study recommends the LEFS and EQ-5D-5L to measure the core outcome set for adult open lower limb fracture.
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Affiliation(s)
- Alexander L Aquilina
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Bristol, UK
| | - Harry Claireaux
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Elizabeth Tutton
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- University of Oxford Nuffield Department of Population Health, Oxford, UK
| | - Matthew L Costa
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Xavier L Griffin
- Barts Health NHS Trust, London, UK
- Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK
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Borton ZM, Oakley BJ, Clamp JA, Birch NC, Bateman AH. Cervical transforaminal epidural steroid injections for radicular pain : a systematic review. Bone Joint J 2022; 104-B:567-574. [PMID: 35491579 DOI: 10.1302/0301-620x.104b5.bjj-2021-1816.r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Cervical radiculopathy is a significant cause of pain and morbidity. For patients with severe and poorly controlled symptoms who may not be candidates for surgical management, treatment with transforaminal epidural steroid injections (CTFESI) has gained widespread acceptance. However, a paucity of high-quality evidence supporting their use balanced against perceived high risks of the procedure potentially undermines the confidence of clinicians who use the technique. We undertook a systematic review of the available literature regarding CTFESI to assess the clinical efficacy and complication rates of the procedure. METHODS OVID, MEDLINE, and Embase database searches were performed independently by two authors who subsequently completed title, abstract, and full-text screening for inclusion against set criteria. Clinical outcomes and complication data were extracted, and a narrative synthesis presented. RESULTS Six studies (three randomized controlled trials and three non-randomized observational studies; 443 patients) were included in the final review. The aggregate data support the efficacy of CTFESI in excess of the likely minimal clinically important difference. No major complications were described. CONCLUSION There is increasing evidence supporting the efficacy of CTFESI. Concerns regarding the occurrence of catastrophic complications, widely shared in the case report and anecdotal literature, were not found when reviewing the best available evidence. However, the strength of these findings remains limited by the lack of highly powered high-level studies and the heterogeneity of the studies available. Further high-quality studies are recommended to address the issues of efficacy and safety with CTFESI. Cite this article: Bone Joint J 2022;104-B(5):567-574.
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Leo DG, Green G, Eastwood DM, Bridgens A, Gelfer Y. Development of a core outcome set for the orthopaedic management of spinal dysraphism. Bone Jt Open 2022; 3:54-60. [PMID: 35043675 PMCID: PMC9047074 DOI: 10.1302/2633-1462.31.bjo-2021-0157.r1] [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] [Indexed: 11/21/2022] Open
Abstract
Aims The aim of this study is to define a core outcome set (COS) to allow consistency in outcome reporting amongst studies investigating the management of orthopaedic treatment in children with spinal dysraphism (SD). Methods Relevant outcomes will be identified in a four-stage process from both the literature and key stakeholders (patients, their families, and clinical professionals). Previous outcomes used in clinical studies will be identified through a systematic review of the literature, and each outcome will be assigned to one of the five core areas, defined by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). Additional possible outcomes will be identified through consultation with patients affected by SD and their families. Results Outcomes identified in these stages will be included in a two-round Delphi process that will involve key stakeholders in the management of SD. A final list including the identified outcomes will then be summarized in a consensus meeting attended by representatives of the key stakeholders groups. Conclusion The best approach to provision of orthopaedic care in patients with SD is yet to be decided. The reporting of different outcomes to define success among studies, often based on personal preferences and local culture, has made it difficult to compare the effect of treatments for this condition. The development of a COS for orthopaedic management in SD will enable meaningful reporting and facilitate comparisons in future clinical trials, thereby assisting complex decision-making in the clinical management of these children. Cite this article: Bone Jt Open 2022;3(1):54–60.
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Affiliation(s)
- Donato G. Leo
- St George’s Healthcare NHS Trust, London, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Gemma Green
- St George’s Healthcare NHS Trust, London, UK
| | - Deborah M. Eastwood
- Great Ormond Street Hospital, London, UK
- University College London, London, UK
| | | | - Yael Gelfer
- St George’s Healthcare NHS Trust, London, UK
- St George's University of London, London, UK
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6
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Luo W, Ali MS, Limb R, Cornforth C, Perry DC. Use of the PROMIS Mobility score in assessing function in adolescents and adults previously affected by childhood hip disease. Bone Jt Open 2021; 2:1089-1095. [PMID: 34931526 PMCID: PMC8711660 DOI: 10.1302/2633-1462.212.bjo-2021-0154.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aims The Patient-Reported Outcomes Measurement Information System (PROMIS) has demonstrated faster administration, lower burden of data capture and reduced floor and ceiling effects compared to traditional Patient Reported Outcomes Measurements (PROMs). We investigated the suitability of PROMIS Mobility score in assessing physical function in the sequelae of childhood hip disease. Methods In all, 266 adolscents (aged ≥ 12 years) and adults were identified with a prior diagnosis of childhood hip disease (either Perthes’ disease (n = 232 (87.2%)) or Slipped Capital Femoral Epiphysis (n = 34 (12.8%)) with a mean age of 27.73 years (SD 12.24). Participants completed the PROMIS Mobility Computer Adaptive Test, the Non-Arthritic Hip Score (NAHS), EuroQol five-dimension five-level questionnaire, and the Numeric Pain Rating Scale. We investigated the correlation between the PROMIS Mobility and other tools to assess use in this population and any clustering of outcome scores. Results There was a strong correlation between the PROMIS Mobility and other established PROMs; NAHS (rs = 0.79; p < 0.001). There was notable clustering in PROMIS at the upper end of the distribution score (42.5%), with less seen in the NAHS (20.3%). However, the clustering was broadly similar between PROMIS Mobility and the comparable domains of the NAHS; function (53.6%), and activity (35.0%). Conclusion PROMIS Mobility strongly correlated with other tools demonstrating convergent construct validity. There was clustering of physical function scores at the upper end of the distributions, which may reflect truncation of the data caused by participants having excellent outcomes. There were elements of disease not captured within PROMIS Mobility alone, and difficulties in differentiating those with the highest levels of function. Cite this article: Bone Jt Open 2021;2(12):1089–1095.
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Affiliation(s)
- Weisang Luo
- Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool, UK
| | - Mohammed S Ali
- Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK
| | - Richard Limb
- Trauma and Orthopaedics, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Christine Cornforth
- Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK
| | - Daniel C Perry
- Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool, UK.,Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK.,Trauma and Orthopaedics, University of Liverpool and Alder Hey Children's Hospital, Liverpool, UK
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7
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Pearson NA, Tutton E, Joeris A, Gwilym S, Grant R, Keene DJ, Haywood KL. Co-producing a multi-stakeholder Core Outcome Set for distal Tibia and Ankle fractures (COSTA): a study protocol. Trials 2021; 22:443. [PMID: 34247628 PMCID: PMC8273034 DOI: 10.1186/s13063-021-05415-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/01/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Ankle fracture is a common injury with a strong evidence base focused on effectiveness of treatments. However, there are no reporting guidelines on distal tibia and ankle fractures. This has led to heterogeneity in outcome reporting and consequently, restricted the contribution of evidence syntheses. Over the past decade, core outcome sets have been developed to address this issue and are available for several common fractures, including those of the hip, distal radius, and open tibial fractures. This protocol describes the process to co-produce-with patient partners and other key stakeholders-a multi-stakeholder derived Core Outcome Set for distal Tibia and Ankle fractures (COSTA). The scope of COSTA will be for clinical trials. METHODS The study will have five-stages which will include the following: (i) systematic reviews of existing qualitative studies and outcome reporting in randomised controlled trial studies to inform a developing list of potential outcome domains; (ii) qualitative interviews (including secondary data) and focus groups with patients and healthcare professionals to explore the impact of ankle fracture and the outcomes that really matter; (iii) generation of meaningful outcome statements with the study team, international advisory group and patient partners; (iv) a multi-round, international e-Delphi study to achieve consensus on the core domain set; and (v) an evidence-based consensus on a core measurement set will be achieved through a structured group consensus meeting, recommending best assessment approaches for each of the domains in the core domain set. DISCUSSION Development of COSTA will provide internationally endorsed outcome assessment guidance for clinical trials for distal tibia and ankle fractures. This will enhance comparative reviews of interventions, potentially reducing reporting bias and research waste.
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Affiliation(s)
- Nathan A. Pearson
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Elizabeth Tutton
- Oxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Trauma and Major Trauma Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | | | - Stephen Gwilym
- Oxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Richard Grant
- National Institute for Health Research, Applied Research Collaboration, Coventry, UK
- Warwick Medical School, User Teaching and Research Action Partnership, Coventry, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal sciences, Fragility Fracture Network, University of Oxford, Oxford, UK
| | - David J. Keene
- Oxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kirstie L. Haywood
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
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8
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Leo DG, Russell A, Bridgens A, Perry DC, Eastwood DM, Gelfer Y. Development of a core outcome set for idiopathic clubfoot management. Bone Jt Open 2021; 2:255-260. [PMID: 33882693 PMCID: PMC8085617 DOI: 10.1302/2633-1462.24.bjo-2020-0202.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims This study aims to define a set of core outcomes (COS) to allow consistent reporting in order to compare results and assist in treatment decisions for idiopathic clubfoot. Methods A list of outcomes will be obtained in a three-stage process from the literature and from key stakeholders (patients, parents, surgeons, and healthcare professionals). Important outcomes for patients and parents will be collected from a group of children with idiopathic clubfoot and their parents through questionnaires and interviews. The outcomes identified during this process will be combined with the list of outcomes previously obtained from a systematic review, with each outcome assigned to one of the five core areas defined by the Outcome Measures Recommended for use in Randomized Clinical Trials (OMERACT). This stage will be followed by a two round Delphi survey aimed at key stakeholders in the management of idiopathic clubfoot. The final outcomes list obtained will then be discussed in a consensus meeting of representative key stakeholders. Conclusion The inconsistency in outcomes reporting in studies investigating idiopathic clubfoot has made it difficult to define the success rate of treatments and to compare findings between studies. The development of a COS seeks to define a minimum standard set of outcomes to collect in all future clinical trials for this condition, to facilitate comparisons between studies and to aid decisions in treatment. Cite this article: Bone Jt Open 2021;2(4):255–260.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK.,St George's Healthcare NHS Trust, London, UK
| | | | | | - Daniel C Perry
- University of Liverpool, Liverpool, UK.,University of Oxford, Oxford, UK.,Institute in the Park, Alder Hey Hospital, Liverpool, UK
| | - Deborah M Eastwood
- Great Ormond Street Hospital, London, UK.,University College London, London, UK
| | - Yael Gelfer
- St George's Healthcare NHS Trust, London, UK.,St George's University of London, London, UK
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9
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Haddad FS. Unacceptable practice in our field. Bone Joint J 2020; 102-B:1429-1430. [PMID: 33135453 DOI: 10.1302/0301-620x.102b11.bjj-2020-1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Fares S Haddad
- The Bone & Joint Journal, London, UK.,University College London Hospitals NHS Foundation Trust, London, UK
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10
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Affiliation(s)
- Ahmed A. Magan
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Ricci Plastow
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Fares S. Haddad
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
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Abstract
AIMS To identify a suite of the key physical, emotional, and social outcomes to be employed in clinical practice and research concerning Perthes' disease in children. METHODS The study follows the guidelines of the COMET-Initiative (Core Outcome Measures in Effectiveness Trials). A systematic review of the literature was performed to identify a list of outcomes reported in previous studies, which was supplemented by a qualitative study exploring the experiences of families affected by Perthes' disease. Collectively, these outcomes formed the basis of a Delphi survey (two rounds), where 18 patients with Perthes' disease, 46 parents, and 36 orthopaedic surgeons rated each outcome for importance. The International Perthes Study Group (IPSG) (Dallas, Texas, USA (October 2018)) discussed outcomes that failed to reach any consensus (either 'in' or 'out') before a final consensus meeting with representatives of surgeons, patients, and parents. RESULTS In total, 23 different outcome domains were identified from the systematic review, and a further ten from qualitative interviews. After round one of the Delphi survey, participants suggested five further outcome domains. A total of 38 outcomes were scored in round two of the Delphi. Among these, 16 outcomes were scored over the prespecified 70% threshold for importance (divided into six main categories: adverse events; life impact; resource use; pathophysiological manifestations; death; and technical considerations). Following the final consensus meeting, 14 outcomes were included in the final Core Outcome Set (COS). CONCLUSION Core Outcome Sets (COSs) are important to improve standardization of outcomes in clinical research and to aid communication between patients, clinicians, and funding bodies. The results of this study should be a catalyst to develop high-quality clinical research in order to determine the optimal treatments for children with Perthes' disease. Cite this article: Bone Joint J 2020;102-B(5):611-617.
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Affiliation(s)
- Donato G Leo
- School of Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- School of Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rebecca Murphy
- School of Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Tina Gambling
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Andrew F Long
- School of Healthcare, University of Leeds, Leeds, UK
| | - Jennifer Laine
- Gillette Children's Specialty Healthcare, St Paul, Minneapolis, USA, Minnesota, USA.,Executive Committee Member of the International Perthes Study Group (IPSG), Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, USA
| | - Daniel C Perry
- University of Liverpool, Liverpool, UK.,University of Oxford, Oxford, UK.,Alder Hey Hospital,Institute in the Park, Liverpool, UK
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12
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Marson BA, Manning JC, James M, Craxford S, Deshmukh SR, Ollivere BJ. CORE-Kids: a protocol for the development of a core outcome set for childhood fractures. BMJ Open 2020; 10:e036224. [PMID: 32114480 PMCID: PMC7050303 DOI: 10.1136/bmjopen-2019-036224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Limb fractures in children are common yet there are few trials that compare treatments for these injuries. There is significant heterogeneity in the outcomes reported in the paediatric orthopaedic literature, which limits the ability to compare study results and draw firm conclusions. The aim of the CORE-Kids Study is to develop a core outcome set for use in research studies of childhood limb fractures. A core outcome set will provide a minimum set of outcomes to be measured in all trials to minimise the heterogeneity of outcomes reported and minimise reporting bias. A core outcome set ensures that outcomes are reported that are relevant to families as well as clinicians. The core outcome set will include additional upper and lower limb modules. METHODS The development of the core outcome set will require four phases to evaluate:What are the outcomes that are relevant to professionals?What are the outcomes that are relevant to families?What are the most important of these outcomes?Which outcomes should be included in the core outcome set?This will be completed through a systematic review of trials to identify the outcomes domains that are relevant to trialists. A series of semi-structured interviews will be completed with families to identify the outcome domains that are relevant to families. These outcome domains will be used in a three-round Delphi Study to analyse the importance of these outcome domains to a range of stakeholders including parents, clinicians and researchers. Following this, the core outcome set will be decided at a consensus meeting. ETHICS AND DISSEMINATION Ethical approval has been awarded HRA/REC IRAS number 262503. Date of approval 06/08/2019. Dissemination will be through scientific literature and international societies. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials Initiative, registration number: 1274. Date of registration 13/12/2018. PROSPERO REGISTRATION NUMBER CRD42018106605.
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Affiliation(s)
| | - Joseph C Manning
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Marilyn James
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Simon Craxford
- Trauma Outcomes Group, University of Nottingham, Nottingham, UK
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