Treatment of Varicose Veins, International Consensus on Which Major Complications to Discuss With the Patient: A Delphi Study

Objective To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as “major” or “minor” on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration. Conclusion An international consensus was reached about what physicians consider to be major complications of varicose vein treatments. This consensus may assist in standardizing the information physicians discuss with patients prior to varicose vein treatment.

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Varikose: Welche Komplikationen im Aufklärungsgespräch genannt werden sollten

Karger Kompass Dermatologie ◽

10.1159/000506823 ◽

2020 ◽

Vol 8 (2) ◽

pp. 60-61

Author(s):

Markus Stücker

Keyword(s):

Varicose Vein ◽

Delphi Method ◽

Thermal Injury ◽

Varicose Veins ◽

Cochrane Review ◽

International Consensus ◽

Major Complications ◽

Consent Procedure ◽

Intravenous Antibiotics ◽

Ischemic Attack

Objective: To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods: Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as «major» or «minor» on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results: Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration. Conclusion: An international consensus was reached about what physicians consider to be major complications of varicose vein treatments. This consensus may assist in standardizing the information physicians discuss with patients prior to varicose vein treatment.

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International Consensus About Which Major Complications Following Abdominal Aortic Aneurysm Surgery to Discuss with Patients Prior to Surgery: A Delphi Study

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2019.06.1093 ◽

2019 ◽

Vol 58 (6) ◽

pp. e439-e440

Author(s):

Sylvana M.L. de Mik ◽

Fabienne E. Stubenrouch ◽

Dink A. Legemate ◽

Ron Balm ◽

Frank J. Veith ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Delphi Study ◽

Aneurysm Surgery ◽

International Consensus ◽

Major Complications ◽

Abdominal Aortic ◽

Aortic Aneurysm Surgery

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Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation

BMJ Open ◽

10.1136/bmjopen-2020-047235 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047235

Author(s):

Iona Pearson ◽

Sue Blackwell ◽

Rebecca Fish ◽

Sarah Daniels ◽

Malcolm West ◽

...

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Outcome Measures ◽

Delphi Study ◽

Public Involvement ◽

Healthcare Professionals ◽

Patient And Public Involvement ◽

International Consensus ◽

Elective Colorectal Surgery ◽

Patient Related Outcome

IntroductionPrehabilitation in colorectal surgery is evolving and may minimise postoperative morbidity and mortality. With many different healthcare professionals contributing to the prehabilitation literature, there is significant variation in reported primary endpoints that restricts comparison. In addition, there has been limited work on patient-related outcome measures suggesting that patients with colorectal cancer needs and issues are being overlooked. The Defining Standards in Colorectal Optimisation Study aims to achieve international consensus from all stakeholders on key standards to provide a framework for reporting future prehabilitation research.Methods and analysisA systematic review will identify key standards reported in trials of prehabilitation in colorectal surgery. Standards that are important to patients will be identified by a patient and public involvement (PPI) event. The longlist of standards generated from the systematic review and PPI event will be used to develop a three-round online Delphi process. This will engage all stakeholders (healthcare professionals and patients) both nationally and internationally. The results of the Delphi will be followed by a face-to-face interactive consensus meeting that will define the final standards for prehabilitation for elective colorectal surgery.Ethics and disseminationThe University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee has approved this protocol, which is registered as a study (200190120) with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of the standards developed by all stakeholders will increase the potential for comparative research that advances understanding of the clinical application of prehabilitation.PROSPERO registration numberCRD42019120381.

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