Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries

Experiences of core outcome set developers on including stakeholders from low- and middle-income countries: An online survey

Core outcome set (COS) development and use enhances comparability of research findings. It may also enhance the translation of research into practice and reduce research waste. However, there is limited involvement of stakeholders from low- and middle-income countries (LMICs) in COS development and use. In this study, we explored the experiences of researchers in COS development projects who included stakeholders from LMICs. Online survey conducted in English of 70 COS developers from HICs who had included LMIC stakeholders in the process of developing a COS, published before the end of 2019. Respondents were identified from the COMET database and sent a link to the survey via a personalised email. Quantitative data were analysed using simple descriptive statistics. Qualitative data analysis was based on qualitative content analysis. There were 37 respondents yielding a 53% overall response rate. Analysis was limited to the responses related to 29 COS developed in the years 2015 to 2019, to reduce the potential for recall bias for earlier COS. Most respondents 20/29 (69%) were researchers. Determining 'what to measure' was reported as the most common stage of inclusion of LMIC stakeholders. Respondents cited (24/29, 83%) their ongoing collaborations with LMIC stakeholders such as clinicians or researchers as their main rationale for including LMICs stakeholders and reported that translation of the Delphi into languages other than English may be useful to enhance wider stakeholder participation. Involvement of LMIC stakeholders only in the later stages of COS development, lack of adequate resources to support their involvement, and lack of networks and contacts were thought to limit fuller participation of stakeholders from LMICs. To improve the involvement of LMIC stakeholders in COS development and use, COS developers need to raise awareness on the utility of COS. The need for and feasibility of translation into multiple languages warrants further discussion.

Working Towards Holistic Scar Assessment and Improved Shared Decision Making in Global Burn Care

Cutaneous burn scars impact various aspects of life. Scar treatment is mainly evaluated on scar characteristics. Consensus is needed on which other outcomes to capture, ensuring they are relevant to patients, clinicians, and researchers. The aim of this study was to identify, discuss and analyze outcomes related to cutaneous burn scarring, incorporating the voice of patients and views of healthcare professionals. For this, a Delphi process consisting of two survey rounds and a consensus meeting was initiated. Burn scar-related outcomes were identified from an existing comprehensive list of 100 outcomes by an international panel of patients, healthcare professionals and researchers. Fifty-nine outcomes were identified from the Delphi process as related to scarring (≥60% votes). Outcomes less impactful in relation to scar outcomes included psychosocial issues, sense of normality, understanding of treatment, costs and systemic issues. To represent a holistic assessment of outcomes related to cutaneous burn scarring, this Delphi process established a battery of outcomes currently included in scar quality assessment tools, and an expanded set of less frequently considered outcomes. Future work in this area must include the patient voice from developing countries. This is essential to identify globally applicable outcomes related to scarring.

A scoping review of burn care in Southeast Asia

BACKGROUND

Non-fatal burns are a major cause of morbidity, with incidents often occuring at home and at work. Almost all burn cases occur in the WHO region, precisely in African and Southeast Asian countries. Yet, the epidemiology of these injuries, especially in the WHO-defined Southeast Asian Region, has yet to be adequately defined.

METHOD

A scoping review of the literature was performed to identify epidemiology of thermal, chemical, and electrical burns in the WHO-defined Southeast Asian Region. The database search screened 1023 articles in total, of which 83 articles were assessed for eligibility at a full-text level, and 58 of these were excluded. Therefore, 25 full-text articles were included for data extraction and analysis.

RESULTS

Data analysed included demographics, injury details, burn mechanism, total body surface area burned, and in-hospital mortality.

CONCLUSION

Despite the steady increase on burns research, the Southeast Asian region is still limited in terms of burns data. This scoping review has shown that the largest set of articles on burns come from Southeast Asia, indicating the importance of reviewing data at a regional or local level, as global studies tend to be dominated by data from high-income countries.