scholarly journals Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review

2021 ◽  
pp. 175319342098371
Author(s):  
Sandeep Rajiv Deshmukh ◽  
Christos Mousoulis ◽  
Ben A. Marson ◽  
Douglas Grindlay ◽  
Alexia Karantana ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Core Outcome Set ◽  
World Health ◽  
International Classification Of Functioning ◽  
Power Calculation ◽  
Core Outcome ◽  
Joint Injuries ◽  
Hand Fractures ◽  
Outcome Set ◽  
Health Organization

This study identifies the treatment outcome domains used in recently published studies on the treatment of hand fractures and joint injuries with the aim to inform development of a core outcome set. Seven databases were searched from January 2014 to March 2019 for randomized and quasi-randomized studies and large prospective observational studies. We identified 1777 verbatim outcomes in 160 eligible studies. From the verbatim outcomes we distinguished 639 unique outcomes, which we categorized into 74 outcome domains based on the World Health Organization International Classification of Functioning, Disability, and Health framework. The primary outcome was appropriately identified in only 65% (72/110) of randomized and quasi-randomized controlled trials. Of the 72 studies with a primary outcome identified, 74% (53/72) had an appropriate power calculation. The vast heterogeneity in outcome selection across studies highlights the need for a core outcome set of what outcomes to measure in future clinical research on hand fractures and joint injuries.

The ICF, Relationship-Centred Care and Research Outcome Measurement: Carol Frattali's Impact on Aphasia Research

2015 ◽  
Vol 25 (3) ◽  
pp. 107-113 ◽  
Author(s):  
Linda Worrall ◽  
Sarah Wallace
Keyword(s):  
Outcome Measurement ◽  
Core Outcome Set ◽  
World Health ◽  
International Classification Of Functioning ◽  
International Consensus ◽  
Treatment Research ◽  
Aphasia Treatment ◽  
Health Organization ◽  
Qualitative Methodologies ◽  
Measurement Practices

Outcome measurement was a major focus of Carol Frattali's work. This article describes three aphasia research initiatives that have followed from her early publications. The first is the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) to aphasia. The Living with Aphasia: A Framework for Outcome Measurement (A-FROM) is a reinterpretation of the ICF specifically as it applies to aphasia. The Assessment for Living with Aphasia (ALA) is an assessment that is derived from the A-FROM. The second initiative is the program of research that has described aphasia and aphasia rehabilitation from the patient perspective. Using qualitative methodologies, this research has highlighted the need for relationship-centred care in aphasia services. Finally, a current project is described that seeks to gain international consensus on a core outcome set for aphasia treatment research. This will help researchers combine data in effectiveness studies. To achieve the best outcomes for people with aphasia, there is a need to realize Carol Frattali's vision and ensure the continued use of unifying frameworks, relationship-centered practice, consumer-focused research, and consistent outcome measurement practices.

Developing a Core Outcome Set for Cesarean Delivery Maternal Infectious Morbidity Outcomes

2019 ◽  
Vol 37 (04) ◽  
pp. 436-452 ◽  
Author(s):  
Kristin E. Briscoe ◽  
David M. Haas
Keyword(s):  
Maternal Mortality ◽  
Wound Infection ◽  
Primary Outcome ◽  
Core Outcome Set ◽  
Wound Complications ◽  
Core Outcome ◽  
Free Response ◽  
Infectious Morbidity ◽  
Outcome Set ◽  
Core Outcomes

Objective This study aimed to develop a core outcome set of primary outcomes for studies involving cesarean deliveries with infectious morbidity outcomes. Study Design Authors reported primary outcomes from 11 Cochrane systematic reviews (SRs), 12 other SRs, and 327 randomized controlled trials (RCTs). These outcomes were condensed into 20 primary outcome groups. Next, a modified Delphi technique was used to gain consensus on key outcomes. Authors from included SRs were sent a questionnaire consisting of a free response and multiple-choice questions. These data were used to propose a set of core outcomes. Results The most frequent outcomes in RCTs were composite “infectious outcomes” (24%) with the second most common being endometritis (12%). The most common reported SR outcomes were wound infection (21%) and endometritis (16%). For the Delphi survey free response portion, wound infection (88%) and endometritis (79%) were the most commonly endorsed outcomes. Chosen list outcomes were maternal mortality (83%), wound infection (83%), wound complications (86%), and postpartum endometritis (80%). The proposed final core outcome set for cesarean trials was endometritis (primary outcome), maternal mortality, wound infection, wound complications, febrile morbidity, and neonatal morbidity. Conclusion Utilizing defined core outcomes in all studies of cesarean section can harmonize trial reports and allow data synthesis for meta-analyses.

scholarly journals Developing a core outcome set for a congenital abnormalities surveillance programme in Rwanda – a Delphi consensus study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1037
Author(s):  
Annette Uwineza ◽  
Aline Muhorakeye ◽  
Janvier Hitayezu ◽  
Peter Thomas Cartledge
Keyword(s):  
Congenital Anomalies ◽  
Congenital Abnormality ◽  
Congenital Abnormalities ◽  
Core Outcome Set ◽  
World Health ◽  
Consensus Methods ◽  
Core Outcome ◽  
Delphi Consensus ◽  
Surveillance Programme ◽  
Outcome Set

Background: In 2015 it was reported that approximately 300,000 newborns die within four weeks of birth every year, worldwide, due to congenital anomalies.  This represents approximately 11% of neonatal deaths. This has led scientists, clinicians and public health authorities to establish congenital abnormality registries (CARs). There is currently no CAR in Rwanda. In establishing such a registry, it was determined that the first step was to identify the core outcome set (COS) (or minimal data-set) of variables and outcomes for the registry to ensure that the final results are meaningful and employable. This study aimed to use Delphi consensus methods to identify a methodologically robust COS for a congenital abnormalities surveillance programme in Rwanda. Methods: A three-round, modified Delphi study was undertaken between April and June 2017. Round 1 was a literature and internet search followed by an open and closed question round with experts in Rounds 2 and 3, respectively. Results: An initial draft COS of 136 outcomes was created from a review of 15 African studies and 14 international repository tools including the European Surveillance of Congenital Anomalies and the World Health Organization surveillance guidance. In total, 36 and 34 participants took part in Rounds 2 and 3, respectively. A total of 32 new outcomes were added by participants in Round 2. 103 outcomes met the pre-defined consensus criteria and made up the final COS in Round 3. Conclusions: This is the first core outcome set for a congenital abnormality surveillance programme in an African nation identified in the literature.  The next stage is to field-test the surveillance programme using passive case-finding in teaching hospitals in Rwanda.

Sixth Edition: the New Standard

2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
World Health ◽  
International Classification Of Functioning ◽  
Revision Process ◽  
Sixth Edition ◽  
Impairment Ratings ◽  
Health Organization ◽  
Impairment Severity

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.

The Historical Development of Burden of Treatment Compliance

2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter
Keyword(s):  
Internal Medicine ◽  
Treatment Compliance ◽  
World Health ◽  
International Classification Of Functioning ◽  
Sixth Edition ◽  
Burden Of Treatment ◽  
Specific Goal ◽  
Surrogate Measure ◽  
Health Organization

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

Sahnan K, Tozer PJ, Adegbola SO, et al (2019) Developing a Core Outcome Set for Fistulising Perianal Crohn’s Disease Gut 68:226–38

2020 ◽  
Vol 14 (2) ◽  
pp. 100-101
Author(s):  
D. Bouchard ◽  
L. Tracanelli ◽  
F. Pigot
Keyword(s):  
Crohn’S Disease ◽  
Qualité De Vie ◽  
Maladie De Crohn ◽  
Core Outcome Set ◽  
Core Outcome ◽  
Perianal Crohn’S Disease ◽  
Revue De La Littérature ◽  
Outcome Set ◽  
Maladies Inflammatoires Intestinales ◽  
Perianal Crohn's Disease

Objectif : L’absence de standardisation des objectifs à atteindre par les traitements des fistules anopérinéales (FAP) de la maladie de Crohn limite les possibilités d’analyse et de comparaison des données issues des études disponibles. L’élaboration d’une liste standardisée d’objectifs à atteindre permettrait de résoudre ces problèmes. Cette étude valide la liste d’objectifs cruciaux (core outcome set [COS]) à atteindre pour le Crohn fistulisant. Méthode : Les objectifs susceptibles d’être retenus ont été définis par une revue de la littérature et des interviews de patients. La sélection consensuelle a été établie à l’issue d’un processus Delphi en trois étapes en évaluant sur une échelle de Likert en neuf points, l’importance que ces objectifs avaient pour définir la réussite d’un traitement. Des représentants de chacun des trois groupes impliqués dans ces traitements ont été recrutés à l’échelle nationale (chirurgiens et radiologistes, gastroentérologues et infirmières spécialisées en maladies inflammatoires intestinales, et enfin patients). Chaque intervenant a noté les différents objectifs possibles, puis a corrigé ses notes après avoir pris connaissance des autres notes données par les membres de son groupe (au deuxième tour) puis encore une fois après avoir pris connaissance des notations données par tous les participants (au troisième tour). Résultats : Au total, 295 objectifs potentiels ont été identifiés à partir d’une revue de la littérature et d’interviews, ils ont été catégorisés en 92 domaines. Cent quatre-vingt-sept participants (taux de réponse : 78,5 %) ont accordé la priorité à 49 objectifs à l’issue d’une méthode Delphi à trois cycles. Une réunion de consensus finale de 41 experts et patients s’est accordée sur un COS comprenant huit catégories d’objectifs. Ce COS comprenait trois catégories d’objectifs importants pour le patient (qualité de vie, incontinence et score combiné des priorités du patient) et cinq catégories d’objectifs retenus par les praticiens (activité de la maladie périanale, développement d’un nouvel abcès périanal, fistule nouvelle/récidivante, chirurgie non planifiée et dérivation fécale). Conclusion : Un COS sur les FAP de laMC a été élaboré par tous les acteurs clés de cette maladie. L’utilisation du COS diminuera l’hétérogénéité dans l’expression des résultats des traitements, ce qui rendra plus pertinente la comparaison des traitements entre eux, la synthèse des données et, en fin de compte, les soins rendus aux patients.

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