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Ducey J, Lansdale N, Gorst S, Bray L, Teunissen N, Cullis P, Faulkner J, Gray V, Gutierrez Gammino L, Slater G, Baird L, Adams A, Brendel J, Donne A, Folaranmi E, Hopwood L, Long AM, Losty PD, Benscoter D, de Vos C, King S, Kovesi T, Krishnan U, Nah SA, Ong LY, Rutter M, Teague WJ, Zorn AM, Hall NJ, Thursfield R. Developing a core outcome set for the health outcomes for children and adults with congenital oesophageal atresia and/or tracheo-oesophageal fistula: OCELOT task group study protocol. BMJ Paediatr Open 2024; 8:e002262. [PMID: 38316469 PMCID: PMC10860107 DOI: 10.1136/bmjpo-2023-002262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/03/2023] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Heterogeneity in reported outcomes of infants with oesophageal atresia (OA) with or without tracheo-oesophageal fistula (TOF) prevents effective data pooling. Core outcome sets (COS) have been developed for many conditions to standardise outcome reporting, facilitate meta-analysis and improve the relevance of research for patients and families. Our aim is to develop an internationally-agreed, comprehensive COS for OA-TOF, relevant from birth through to transition and adulthood. METHODS AND ANALYSIS A long list of outcomes will be generated using (1) a systematic review of existing studies on OA-TOF and (2) qualitative research with children (patients), adults (patients) and families involving focus groups, semistructured interviews and self-reported outcome activity packs. A two-phase Delphi survey will then be completed by four key stakeholder groups: (1) patients (paediatric and adult); (2) families; (3) healthcare professionals; and (4) researchers. Phase I will include stakeholders individually rating the importance and relevance of each long-listed outcome using a 9-point Likert scale, with the option to suggest additional outcomes not already included. During phase II, stakeholders will review summarised results from phase I relative to their own initial score and then will be asked to rescore the outcome based on this information. Responses from phase II will be summarised using descriptive statistics and a predefined definition of consensus for inclusion or exclusion of outcomes. Following the Delphi process, stakeholder experts will be invited to review data at a consensus meeting and agree on a COS for OA-TOF. ETHICS AND DISSEMINATION Ethical approval was sought through the Health Research Authority via the Integrated Research Application System, registration no. 297026. However, approval was deemed not to be required, so study sponsorship and oversight were provided by Alder Hey Children's NHS Foundation Trust. The study has been prospectively registered with the COMET Initiative. The study will be published in an open access forum.
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Affiliation(s)
- Jonathan Ducey
- Department of Paediatric and Neonatal Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Nick Lansdale
- Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester, UK
- Division of Developmental Biology and Medicine, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Sarah Gorst
- Department of Health Data Science, University of Liverpool, Liverpool, UK
- MRC/NIHR Trials Methodology Research Partnership, Liverpool, UK
| | - Lucy Bray
- Evidence-based Practice Research Centre, Edge Hill University, Ormskirk, UK
- Children's Nursing Research Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Nadine Teunissen
- Department of Pediatric Surgery, Erasmus MC Sophia Children Hospital, Rotterdam, Zuid-Holland, The Netherlands
| | - Paul Cullis
- Department of Paediatric and Neonatal Surgery, Royal Hospital for Children and Young People, Edinburgh, UK
| | - Julia Faulkner
- Department of Dietetics, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK
| | - Victoria Gray
- Department of Clinical Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | | | | | - Laura Baird
- Department of Speech and Language Therapy, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Alex Adams
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Julia Brendel
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Adam Donne
- Department of ENT Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Eniola Folaranmi
- Department of Paediatric, Cardiff and Vale University Health Board, Cardiff, UK
| | - Laura Hopwood
- Department of Physiotherapy, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Anna-May Long
- Department of Paediatric and Neonatal Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul D Losty
- Department of Paediatric Surgery, Mahidol University, Salaya, Thailand
| | - Dan Benscoter
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Corné de Vos
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sebastian King
- Paediatric Surgery, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tom Kovesi
- Pediatrics, Division of Respirology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Usha Krishnan
- Department of Pediatric Gastroenterology, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Shireen A Nah
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Lin Yin Ong
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore
| | - Mike Rutter
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Warwick J Teague
- Department of Paediatric Surgery, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Aaron M Zorn
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Nigel J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rebecca Thursfield
- Respiratory Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Teunissen N, Brendel J, Eaton S, Hall N, Thursfield R, van Heurn ELW, Ure B, Wijnen R. Variability in the Reporting of Baseline Characteristics, Treatment, and Outcomes in Esophageal Atresia Publications: A Systematic Review. Eur J Pediatr Surg 2023; 33:129-137. [PMID: 36796427 DOI: 10.1055/s-0042-1758828] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
INTRODUCTION As survival rates of infants born with esophageal atresia (EA) have improved considerably, research interests are shifting from viability to morbidity and longer-term outcomes. This review aims to identify all parameters studied in recent EA research and determine variability in their reporting, utilization, and definition. MATERIALS AND METHODS Following PRISMA guidelines, we performed a systematic review of literature regarding the main EA care process, published between 2015 and 2021, combining the search term "esophageal atresia" with "morbidity," "mortality," "survival," "outcome," or "complication." Described outcomes were extracted from included publications, along with study and baseline characteristics. RESULTS From 209 publications that met the inclusion criteria, 731 studied parameters were extracted and categorized into patient characteristics (n = 128), treatment and care process characteristics (n = 338), and outcomes (n = 265). Ninety-two of these were reported in more than 5% of included publications. Most frequently reported characteristics were sex (85%), EA type (74%), and repair type (60%). Most frequently reported outcomes were anastomotic stricture (72%), anastomotic leakage (68%), and mortality (66%). CONCLUSION This study demonstrates considerable heterogeneity of studied parameters in EA research, emphasizing the need for standardized reporting to compare results of EA research. Additionally, the identified items may help develop an informed, evidence-based consensus on outcome measurement in esophageal atresia research and standardized data collection in registries or clinical audits, thereby enabling benchmarking and comparing care between centers, regions, and countries.
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Affiliation(s)
- Nadine Teunissen
- Department of Pediatric Surgery and Pediatric Intensive Care Unit, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
- Dutch Institute for Clinical Auditing, European Pediatric Surgical Audit, Leiden, the Netherlands
| | - Julia Brendel
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Simon Eaton
- Department of Pediatric Surgery and Pediatric Intensive Care Unit, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
- Developmental Biology and Cancer Research and Teaching Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom of Great Britain and Northern Ireland
| | - Nigel Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Rebecca Thursfield
- Department of Pediatric Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Ernest L W van Heurn
- Department of Pediatric Surgery, Emma's Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Benno Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Rene Wijnen
- Department of Pediatric Surgery and Pediatric Intensive Care Unit, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
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