The key elements and application of a master protocol in the development of the core outcome set

An international consensus study to identify "what" outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research

BACKGROUND

Development of a standardized set of topic-specific outcomes known as a Core Outcome Set (COS) is important to address issues of heterogeneity in reporting research findings in order to streamline evidence synthesis and clinical decision making.

AIM

The aim of the current international consensus study is to identify "what" outcomes to include in the Core Outcome Set for Endodontic Treatments (COSET). Outcomes of various endodontic treatments (non-surgical root canal treatment, surgical endodontics, vital pulp treatment and revitalization procedures) performed on permanent teeth were considered.

METHODS

A standard validated methodology for COS development and reporting was adopted. The process involved identification of existing outcomes through four published scoping reviews. This enabled creation of a list of outcomes to be prioritized via semi-structured patient interviews, e-Delphi process and a consensus meeting with a range of relevant global stakeholders. Outcomes were prioritized using a 1-9 Likert scale, with outcomes rated 7-9 considered critical, 4-6 are important and 1-3 are less important. Outcomes rated 7-9 by ≥70% and 1-3 by <15% of participants were considered to achieve consensus for inclusion in the COS. The outcomes that did not achieve consensus in the first round were considered for further prioritization in the second Delphi round and consensus meeting. Final decisions about the outcomes to include in COSET were made by voting during the consensus panel meeting using the Zoom Poll function.

RESULTS

A total of 95 participants including patients contributed to the COS development process. The consensus panel recommended, with strong consensus, eight outcomes shared across all treatment modalities for inclusion in COSET: pain; signs of infection (swelling, sinus tract); further intervention/exacerbation; tenderness to percussion/palpation; radiographic evidence of disease progression/healing; function; tooth survival; and patient satisfaction. Additional treatment specific outcomes were also recommended.

DISCUSSION

Many of the outcomes included in COSET are patient reported. All should be included in future outcomes studies.

CONCLUSION

COSET identified outcomes that are important for patients and clinicians and validated these using a rigorous methodology. Further work is ongoing to determine "how" and "when" these outcomes should be measured.

Development of a Core Outcome Set for Randomised Controlled Trials of Nursing Education: A Methodological Framework

Background. Nursing educational research is very important for the development of the nursing discipline. There have been many randomised controlled trials (RCTs) of nursing education, and the outcomes are highly heterogeneous and waste resources. The study aims to report the methodological framework to establish a core outcome set (COS) for RCTs of nursing education. Methods. The study will be conducted in the following five steps: (a) establish nursing education COS working groups; (b) develop an initial list of outcomes of nursing education by systematic review and semistructured interview; (c) Delphi survey with different stakeholders to reach a preliminary consensus on the core outcome of nursing education; (d) expert consultation to form the outcome pool; (e) expert consensus meeting to form the nursing education COS. Results. The goal is to develop a COS that includes stakeholders’ interest in nursing education to determine which outcomes should be reported and how they should be measured. Conclusions. By performing the study, the nursing education COS will be established, which will help to reduce reporting bias and resource waste, and provide enough results for nursing education systematic reviews.