Outcomes and measures of delirium interventional studies in palliative care to inform a core outcome set: A systematic review

Background: Trials of interventions for delirium in various patient populations report disparate outcomes and measures but little is known about those used in palliative care trials. A core outcome set promotes consistency of outcome selection and measurement. Aim: To inform core outcome set development by examining outcomes, their definitions, measures and time-points in published palliative care studies of delirium prevention or treatment delirium interventions. Design: Prospectively registered systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data sources: We searched six electronic databases (1980–November 2020) for original studies, three for relevant reviews and the International Clinical Trials Registry Platform for unpublished studies and ongoing trials. We included randomised, quasi-randomised and non-randomised intervention studies of pharmacological and non-pharmacological delirium prevention and/or treatment interventions. Results: From 13/3244 studies (2863 adult participants), we identified 9 delirium-specific and 13 non-delirium specific outcome domains within eight Core Outcome Measures in Effectiveness Trials (COMET) taxonomy categories. There were multiple and varied outcomes and time points in each domain. The commonest delirium specific outcome was delirium severity ( n = 7), commonly using the Memorial Delirium Assessment Scale (6/8 studies, 75%). Four studies reported delirium incidence. Non-delirium specific outcomes included mortality, agitation, adverse events, other symptoms and quality of life. Conclusion: The review identified few delirium interventions with heterogeneity in outcomes, their definition and measurement, highlighting the need for a uniform approach. Findings will inform the next stage to develop consensus for a core outcome set to inform delirium interventional palliative care research.

Download Full-text

Core outcomes in neonatology: development of a core outcome set for neonatal research

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-317501 ◽

2019 ◽

Vol 105 (4) ◽

pp. 425-431 ◽

Cited By ~ 8

Author(s):

James William Harrison Webbe ◽

James M N Duffy ◽

Elsa Afonso ◽

Iyad Al-Muzaffar ◽

Ginny Brunton ◽

...

Keyword(s):

Clinical Trials ◽

Core Outcome Set ◽

Neonatal Care ◽

Consensus Meeting ◽

High Income ◽

Core Outcome ◽

Outcome Set ◽

Outcome Selection ◽

Survey Results ◽

Meta Analyses

BackgroundNeonatal research evaluates many different outcomes using multiple measures. This can prevent synthesis of trial results in meta-analyses, and selected outcomes may not be relevant to former patients, parents and health professionals.ObjectiveTo define a core outcome set (COS) for research involving infants receiving neonatal care in a high-income setting.DesignOutcomes reported in neonatal trials and qualitative studies were systematically reviewed. Stakeholders were recruited for a three-round international Delphi survey. A consensus meeting was held to confirm the final COS, based on the survey results.ParticipantsFour hundred and fourteen former patients, parents, healthcare professionals and researchers took part in the eDelphi survey; 173 completed all three rounds. Sixteen stakeholders participated in the consensus meeting.ResultsThe literature reviews identified 104 outcomes; these were included in round 1. Participants proposed 10 additional outcomes; 114 outcomes were scored in rounds 2 and 3. Round 1 scores showed different stakeholder groups prioritised contrasting outcomes. Twelve outcomes were included in the final COS: survival, sepsis, necrotising enterocolitis, brain injury on imaging, general gross motor ability, general cognitive ability, quality of life, adverse events, visual impairment/blindness, hearing impairment/deafness, retinopathy of prematurity and chronic lung disease/bronchopulmonary dysplasia.Conclusions and relevanceA COS for clinical trials and other research studies involving infants receiving neonatal care in a high-income setting has been identified. This COS for neonatology will help standardise outcome selection in clinical trials and ensure these are relevant to those most affected by neonatal care.

Download Full-text

Outcome selection, measurement and reporting for new surgical procedures and devices: a systematic review of IDEAL/IDEAL‐D studies to inform development of a core outcome set

BJS Open ◽

10.1002/bjs5.50358 ◽

2020 ◽

Vol 4 (6) ◽

pp. 1072-1083

Author(s):

R. C. Macefield ◽

N. Wilson ◽

C. Hoffmann ◽

J. M. Blazeby ◽

A. G. K. McNair ◽

...

Keyword(s):

Systematic Review ◽

Surgical Procedures ◽

Core Outcome Set ◽

Core Outcome ◽

Outcome Set ◽

Outcome Selection

Download Full-text

Evaluating Outcomes Used in Cardiothoracic Surgery Intervention Based Research - A Systematic Review of Reviews to Develop a Core Outcome Set

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0035-1544432 ◽

2015 ◽

Vol 63 (S 01) ◽

Author(s):

C. Benstoem ◽

A. Moza ◽

A. Goetzenich ◽

C. Stoppe ◽

R. Autschbach

Keyword(s):

Systematic Review ◽

Core Outcome Set ◽

Cardiothoracic Surgery ◽

Core Outcome ◽

Outcome Set ◽

Review Of Reviews

Download Full-text

Faculty Opinions recommendation of Heterogeneity in definitions of endpoints for clinical trials of ulcerative colitis: A systematic review for development of a core outcome set.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729280962.793569711 ◽

2020 ◽

Author(s):

Jack Satsangi

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Clinical Trials ◽

Core Outcome Set ◽

Core Outcome ◽

Outcome Set

Download Full-text

The development of a faecal incontinence core outcome set: an international Delphi study protocol

International Journal of Colorectal Disease ◽

10.1007/s00384-021-03865-2 ◽

2021 ◽

Vol 36 (3) ◽

pp. 617-622

Author(s):

Sadé Assmann ◽

Daniel Keszthelyi ◽

Jos Kleijnen ◽

Merel Kimman ◽

Foteini Anastasiou ◽

...

Keyword(s):

Systematic Review ◽

Study Protocol ◽

Faecal Incontinence ◽

Delphi Study ◽

Evidence Synthesis ◽

Core Outcome Set ◽

Core Outcome ◽

Delphi Consensus ◽

Link Type ◽

Outcome Set

Abstract Purpose Faecal incontinence (FI) is estimated to affect around 7.7% of people. There is a lack of uniformity in outcome definitions, measurement and reporting in FI studies. Until now, there is no general consensus on which outcomes should be assessed and reported in FI research. This complicates comparison between studies and evidence synthesis, potentially leading to recommendations not evidence-based enough to guide physicians in selecting an FI therapy. A solution for this lack of uniformity in reporting of outcomes is the development of a Core Outcome Set (COS) for FI. This paper describes the protocol for the development of a European COS for FI. Methods Patient interviews and a systematic review of the literature will be performed to identify patient-, physician- and researcher-oriented outcomes. The outcomes will be categorised using the COMET taxonomy and put forward to a group of patients, physicians (i.e. colorectal surgeons, gastroenterologists and general practitioners) and researchers in a Delphi consensus exercise. This exercise will consist of up to three web-based rounds in which participants will prioritise and condense the list of outcomes, which is expected to result in consensus. A consensus meeting with participants from all stakeholder groups will take place to reach a final agreement on the COS. Discussion This study protocol describes the development of a European COS to improve reliability and consistency of outcome reporting in FI studies, thereby improving evidence synthesis and patient care. Trial registration This project has been registered in the COMET database on the 1st of April 2020, available at http://www.comet-initiative.org/Studies/Details/1554. The systematic review has been registered on the PROSPERO database on the 31st of August 2020, available at https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=202020&VersionID=1381336.

Download Full-text

Systematic Review on Pain-Related Outcome Domains After Sternotomy: A First Step Toward the Development of a Core Outcome Set

Value in Health ◽

10.1016/j.jval.2021.01.016 ◽

2021 ◽

Author(s):

T.V. Maeßen ◽

E. Austenfeld ◽

U. Kaiser ◽

S. Bigalke ◽

C.H. Meyer-Frießem ◽

...

Keyword(s):

Systematic Review ◽

Core Outcome Set ◽

Core Outcome ◽

Outcome Set

Download Full-text

The Core Outcome DEvelopment for Carrier Screening (CODECS) study: protocol for development of a core outcome set

Trials ◽

10.1186/s13063-021-05439-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ebony Richardson ◽

Alison McEwen ◽

Toby Newton-John ◽

Karine Manera ◽

Chris Jacobs

Keyword(s):

Systematic Review ◽

Genetic Testing ◽

Core Outcome Set ◽

Carrier Screening ◽

Core Outcome ◽

The Core ◽

Key Stakeholders ◽

Outcome Set ◽

Methods Of Measurement ◽

Genetic Carrier Screening

Abstract Background Reproductive genetic carrier screening is a type of genetic testing available to those planning a pregnancy, or during their first trimester, to understand their risk of having a child with a severe genetic condition. There is a lack of consensus for ‘what to measure’ in studies on this intervention, leading to heterogeneity in choice of outcomes and methods of measurement. Such outcome heterogeneity has implications for the quality and comparability of these studies and has led to a lack of robust research evidence in the literature to inform policy and decision-making around the offer of this screening. As reproductive genetic carrier screening becomes increasingly accessible within the general population, it is timely to investigate the outcomes of this intervention. Objectives The development of a core outcome set is an established methodology to address issues with outcome heterogeneity in research. We aim to develop a core outcome set for reproductive genetic carrier screening to clarify and standardise outcomes for research and practice. Methods In accordance with guidance from the COMET (Core Outcome Measures in Effectiveness Trials) Initiative, this study will consist of five steps: (i) a systematic review of quantitative studies, using narrative synthesis to identify previously reported outcomes, their definitions, and methods of measurement; (ii) a systematic review of qualitative studies using content analysis to identify excerpts related to patient experience and perspectives that can be interpreted as outcomes; (iii) semi-structured focus groups and interviews with patients who have undertaken reproductive genetic carrier screening to identify outcomes of importance to them; (iv) Delphi survey of key stakeholders, including patients, clinicians, and researchers, to refine and prioritise the list of outcomes generated from the previous steps; and (v) a virtual consensus meeting with a purposive sample of key stakeholders to finalise the core outcome set for reporting. Discussion This protocol outlines the core outcome set development process and its novel application in the setting of genetic testing. This core outcome set will support the standardisation of outcome reporting in reproductive carrier screening research and contribute to an evolving literature on outcomes to evaluate genetic testing and genetic counselling as health interventions. COMET core outcome set registration http://www.comet-initiative.org/Studies/Details/1381.

Download Full-text