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Saldanha IJ, Hughes KL, Dodd S, Lasserson T, Kirkham JJ, Wu Y, Lucas SW, Williamson PR. Study found increasing use of core outcome sets in Cochrane systematic reviews and identified facilitators and barriers. J Clin Epidemiol 2024; 169:111277. [PMID: 38428540 DOI: 10.1016/j.jclinepi.2024.111277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES In 2019, only 7% of Cochrane systematic reviews (SRs) cited a core outcome set (COS) in relation to choosing outcomes, even though a relevant COS existed but was not mentioned (or cited) for a further 29% of SRs. Our objectives for the current work were to (1) examine the extent to which authors are currently considering COS to inform outcome choice in Cochrane protocols and completed SRs, and (2) understand author facilitators and barriers to using COS. STUDY DESIGN AND SETTING We examined all completed Cochrane SRs published in the last 3 months of 2022 and all Cochrane protocols published in 2022 for the extent to which they: (a) cited a COS, (b) searched for COS, (c) used outcomes from existing COS, and (d) reported outcome inconsistency among included studies and/or noted the need for COS. One investigator extracted information; a second extractor verified all information, discussing discrepancies to achieve consensus. We then conducted an online survey of authors of the included SRs to assess awareness of COS and identify facilitators and barriers to using COS to inform outcome choice. RESULTS Objective 1: We included 294 SRs of interventions (84 completed SRs and 210 published SR protocols), of which 13% cited specific COS and 5% did not cite but mentioned searching for COS. A median of 83% of core outcomes from cited COS (interquartile range [IQR] 57%-100%) were included in the corresponding SR. We identified a relevant COS for 39% of SRs that did not cite a COS. A median of 50% of core outcomes from noncited COS (IQR 35%-72%) were included in the corresponding SR. Objective 2: Authors of 236 (80%) of the 294 eligible SRs completed our survey. Seventy-seven percent of authors noted being aware of COS before the survey. Fifty-five percent of authors who did not cite COS but were aware of them reported searching for a COS. The most reported facilitators of using COS were author awareness of the existence of COS (59%), author positive perceptions of COS (52%), and recommendation in the Cochrane Handbook regarding COS use (48%). The most reported barriers related to matching of the scope of the COS and the SR: the COS target population was too narrow/broad relative to the SR population (29%) or the COS target intervention was too narrow/broad relative to the SR intervention (21%). Most authors (87%) mentioned that they would consider incorporating missing core outcomes in the SR/update. CONCLUSION Since 2019, there is increasing consideration and awareness of COS when choosing outcomes for Cochrane SRs of interventions, but uptake remains low and can be improved further. Use of COS in SRs is important to improve outcome standardization, reduce research waste, and improve evidence syntheses of the relevant effects of interventions across health research.
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Affiliation(s)
- Ian J Saldanha
- Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Karen L Hughes
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Susanna Dodd
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Toby Lasserson
- Central Executive, The Cochrane Collaboration, London, UK
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Yuhui Wu
- Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Samuel W Lucas
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
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Holdsworth LM, Giannitrapani K, Gamboa RC, O'Hanlon C, Singh N, Walling A, Lindvall C, Lorenz K. Role matters in understanding 'quality' in palliative care: a qualitative analysis of patient, caregiver and practitioner perspectives. BMJ Open 2024; 14:e076768. [PMID: 38233055 PMCID: PMC10806673 DOI: 10.1136/bmjopen-2023-076768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES To compare the discussions from two panels on the concept of palliative care quality for patients with advanced cancer, exploring the priorities reflected in each group's perspectives. DESIGN We convened two RAND-UCLA appropriateness panel discussions on palliative care quality in advanced cancer. Discussions were audio-recorded and transcribed verbatim. Panel transcripts were analysed thematically using a matrix approach to examine perceptions and experiences of quality. SETTING Discussions were framed within the context of advanced cancer care and palliative care. PARTICIPANTS The patient-caregiver panel had 9 patients with current or a history of cancer and caregivers, and the practitioner panel had 10 expert practitioners representing fields of oncology, primary care, social work, palliative care, nursing, pain management and ethics. RESULTS Our analysis identified three thematic categories for understanding quality common across both groups and nine subthemes within those categories. At the highest level, quality was conceived as: (1) the patient and caregiver experience of care, (2) technical competence and (3) the structure of health system. Among the subthemes, four were present in only one of the two group's discussions: 'purpose and action' was specific to the patient-caregiver panel, whereas 'adhering to best medical practice', 'mitigating unintended consequences and side effects', and 'health system resources and costs' were specific to the practitioner panel. CONCLUSIONS While both panels aligned on the three key domains of quality, the particular dimensions through which they perceived quality varied in relation to their experience and role as a professional provider of care versus recipient of healthcare services. These differences suggest the importance of adopting a collaborative approach to quality measurement and improvement so that the values of all interested parties are represented in improvement efforts.
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Affiliation(s)
- Laura M Holdsworth
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Karleen Giannitrapani
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Raziel C Gamboa
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Claire O'Hanlon
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- RAND Corporation, Santa Monica, California, USA
| | - Nainwant Singh
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
| | - Anne Walling
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, California, USA
| | - Charlotta Lindvall
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Karl Lorenz
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California, USA
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Wu T, Yu Y, Huang Q, Chen X, Yang L, Liu S, Guo X. Current status and implementation strategies of patient education in core outcome set development. PATIENT EDUCATION AND COUNSELING 2024; 118:108027. [PMID: 37918218 DOI: 10.1016/j.pec.2023.108027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Patient participation is essential for Core Outcome Set (COS) development studies. Patient education during participation may help patients better express their views in COS studies. This study aimed to investigate the current status of patient participation and the specified educational information in COS studies. METHODS We conducted a systematic review of COS development studies. Information on patient participation in COS research, and especially details of patient education, was analyzed. RESULTS In total, 146 COS development studies were included in this review. Of these, 125 studies (85.6%) mentioned patient participation. Most studies did not provide explicit information on patient participation. Some studies mentioned recruiting patients, but ultimately, none of them responded. Six studies reported conducting patient education through workshops, creating patient forums, or providing videos and slides. However, these studies did not provide details on education. Twenty-three studies used the plain language to explain patient outcomes. CONCLUSION COS developers are increasingly focusing on patient participation. However, only a few COS studies have explicitly reported conducting measures related to patient education. Further patient education is necessary when they participate in the development of a new Core Outcome Set. PRACTICE IMPLICATION This article provides implementation strategies related to patient education for future COS development studies.
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Affiliation(s)
- Tongtong Wu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Yu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qian Huang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Xueyin Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Lihong Yang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Shaonan Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
| | - Xinfeng Guo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
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Goulão B, Morris TP, Blazeby J, Gamble C, Gillies K, Laidlaw L, Ramsay C, Soulsby I, Stewart D, Totton N. Involving patients and the public In sTatistIcal Analysis pLans (INITIAL): A delphi survey. PLoS One 2023; 18:e0292257. [PMID: 38096223 PMCID: PMC10721002 DOI: 10.1371/journal.pone.0292257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/17/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in trials aims to enhance research by improving its relevance and transparency. Planning for statistical analysis begins at the design stage of a trial within the protocol and is refined and detailed in a Statistical Analysis Plan (SAP). While PPI is common in design and protocol development it is less common within SAPs. This study aimed to reach consensus on the most important and relevant statistical analysis items within an SAP to involve patients and the public. METHODS We developed a UK-based, two-round Delphi survey through an iterative consultation with public partners, statisticians, and trialists. The consultation process started with 55 items from international guidance for statistical analysis plans. We aimed to recruit at least 20 participants per key stakeholder group for inclusion in the final analysis of the Delphi survey. Participants were asked to vote on each item using a Likert scale from 1 to 9, where a rating of 1 to 3 was labelled as having 'limited importance'; 4 to 6 as 'important but not critical' and 7 to 9 as 'critical' to involve patients and the public. Results from the second round determined consensus on critical items for PPI. RESULTS The consultation exercise led to the inclusion of 15 statistical items in the Delphi survey. We recruited 179 participants, of whom 72% (129: 36 statisticians, 29 patients or public partners, 25 clinical researchers or methodologists, 27 trial managers, and 12 PPI coordinators) completed both rounds. Participants were on average 48 years old, 60% were female, 84% were White, 64% were based in England and 84% had at least five years' experience in trials. Four items reached consensus regarding critical importance for patient and public involvement: presentation of results to trial participants; summary and presentation of harms; interpretation and presentation of findings in an academic setting; factors impacting how well a treatment works. No consensus was reached for the remaining 11 items. In general, the results were consistent across stakeholder groups. DISCUSSION We identified four critical items to involve patients and the public in statistical analysis plans. The remaining 11 items did not reach consensus and need to be considered in a case-by-case basis with most responders considering patient and public involvement important (but not critical). Our research provides a platform to enable focused future efforts to improve patient and public involvement in trials and enhance the relevance of statistical analyses to patients and the public.
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Affiliation(s)
- Beatriz Goulão
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Tim P. Morris
- MRC Clinical Trials Unit at UCL, London, United Kingdom
| | - Jane Blazeby
- Bristol NIHR Biomedical Research Centre, Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Carrol Gamble
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Lynn Laidlaw
- Public Partner Co-author, INITIAL Advisory Group, University of Aberdeen, Aberdeen, United Kingdom
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Irene Soulsby
- Public Partner Co-author, INITIAL Advisory Group, University of Aberdeen, Aberdeen, United Kingdom
| | - Derek Stewart
- Public Partner Co-author, INITIAL Advisory Group, University of Aberdeen, Aberdeen, United Kingdom
- University of Galway, Galway, Ireland
| | - Nikki Totton
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Evans K, Battersby C, Boardman JP, Boyle E, Carroll W, Dinwiddy K, Dorling J, Gallagher K, Hardy P, Johnston E, Mactier H, Marcroft C, Webbe JWH, Gale C. National priority setting partnership using a Delphi consensus process to develop neonatal research questions suitable for practice-changing randomised trials in the UK. Arch Dis Child Fetal Neonatal Ed 2023; 108:569-574. [PMID: 37094919 PMCID: PMC10646876 DOI: 10.1136/archdischild-2023-325504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The provision of neonatal care is variable and commonly lacks adequate evidence base; strategic development of methodologically robust clinical trials is needed to improve outcomes and maximise research resources. Historically, neonatal research topics have been selected by researchers; prioritisation processes involving wider stakeholder groups have generally identified research themes rather than specific questions amenable to interventional trials. OBJECTIVE To involve stakeholders including parents, healthcare professionals and researchers to identify and prioritise research questions suitable for answering in neonatal interventional trials in the UK. DESIGN Research questions were submitted by stakeholders in population, intervention, comparison, outcome format through an online platform. Questions were reviewed by a representative steering group; duplicates and previously answered questions were removed. Eligible questions were entered into a three-round online Delphi survey for prioritisation by all stakeholder groups. PARTICIPANTS One hundred and eight respondents submitted research questions for consideration; 144 participants completed round one of the Delphi survey, 106 completed all three rounds. RESULTS Two hundred and sixty-five research questions were submitted and after steering group review, 186 entered into the Delphi survey. The top five ranked research questions related to breast milk fortification, intact cord resuscitation, timing of surgical intervention in necrotising enterocolitis, therapeutic hypothermia for mild hypoxic ischaemic encephalopathy and non-invasive respiratory support. CONCLUSIONS We have identified and prioritised research questions suitable for practice-changing interventional trials in neonatal medicine in the UK at the present time. Trials targeting these uncertainties have potential to reduce research waste and improve neonatal care.
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Affiliation(s)
- Katie Evans
- School of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, London, UK
| | - Cheryl Battersby
- School of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, London, UK
| | - James P Boardman
- Neonatal Medicine, The University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK
| | - Elaine Boyle
- Neonatal Medicine, University of Leicester, Leicester, UK
- Neonatal Clinical Studies Group, National Institute for Health and Care Research, London, UK
| | | | - Kate Dinwiddy
- British Association of Perinatal Medicine, London, UK
| | - Jon Dorling
- Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Katie Gallagher
- EGA Institute for Women's Health, University College London, London, UK
| | - Pollyanna Hardy
- Policy Research Unit in Maternal Health & Care, National Perinatal Epidemiology Unit Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Emma Johnston
- Parents and Family Engagement Lead, Thames Valley and Wessex Operational Delivery Network, Thames Valley and Wessex, UK
| | - Helen Mactier
- Neonatal Medicine, University of Glasgow, Glasgow, UK
| | - Claire Marcroft
- Neonatal Physiotherapy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Chris Gale
- School of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, London, UK
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Kearney A, Gargon E, Mitchell JW, Callaghan S, Yameen F, Williamson PR, Dodd S. A systematic review of studies reporting the development of core outcome sets for use in routine care. J Clin Epidemiol 2023; 158:34-43. [PMID: 36948407 DOI: 10.1016/j.jclinepi.2023.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES Core outcome sets (COS) represent the minimum health outcomes to be measured for a given health condition. Interest is growing in using COS within routine care to support delivery of patient-focused care. This review aims to systematically map COS developed for routine care to understand their scope, stakeholder involvement, and development methods. METHODS Medline (Ovid), Scopus, and Web of Science Core collection were searched for studies reporting development of COS for routine care. Data on scope, methods, and stakeholder groups were analyzed in subgroups defined by setting. RESULTS Screening 25,301 records identified 262 COS: 164 for routine care only and 98 for routine care and research. Nearly half of the COS (112/254, 44%) were developed with patients, alongside input from experts in registries, insurance, legal, outcomes measurement, and performance management. Research publications were often searched to generate an initial list of outcomes (115/198, 58%) with few searching routine health records (47/198, 24%). CONCLUSION An increasing number of COS is being developed for routine care. Although involvement of patient stakeholders has increased in recent years, further improvements are needed. Methodology and scope are broadly similar to COS for research but implementation of the final set is a greater consideration during development.
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Affiliation(s)
- Anna Kearney
- Department of Health Data Science, University of Liverpool, Liverpool, UK.
| | - Elizabeth Gargon
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - James W Mitchell
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | | | - Farheen Yameen
- NIHR ARC NWC public advisor, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Susanna Dodd
- Department of Health Data Science, University of Liverpool, Liverpool, UK
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Raepsaet C, Alves P, Cullen B, Gefen A, Lázaro-Martínez JL, Lev-Tov H, Najafi B, Santamaria N, Sharpe A, Swanson T, Woo K, Beeckman D. The development of a core outcome set for clinical effectiveness studies of bordered foam dressings in the treatment of complex wounds. J Tissue Viability 2023:S0965-206X(23)00046-3. [PMID: 37127485 DOI: 10.1016/j.jtv.2023.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/05/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
AIM The aim of this project was to develop a core outcome set (COS) for clinical effectiveness studies of bordered foam dressings in the treatment of complex wounds. METHODS The research project followed the Core Outcome Measures in Effectiveness Trials (COMET) initiative and consisted of two phases. The first phase prepared the background and process, while the second phase had three steps: outcome list generation via systematic review and qualitative study, Delphi consensus study, and consensus meeting. The study has been registered in the Core Outcome Measures in Effectiveness Trials database. RESULTS The systematic review resulted in 82 outcomes and 20 additional outcomes were obtained during the interviews. After refinement, 111 panellists from 23 countries rated a list of 51 outcomes. In the following consensus meeting, six outcomes were prioritized to be included in the core outcome set. After the consensus meeting, a patient-reported outcome was added to the core outcome set. CONCLUSION The COS for evaluating the effectiveness of bordered foam dressings in treating complex wounds includes 7 outcomes: "ability to stay in place", "leakage", "pain", "dressing related periwound skin changes", "change in wound size over time", and "overall satisfaction". These identified outcomes are correlated with contemporary bioengineering testing and evaluation methods for dressing performance, which underpins the need for a close multidisciplinary collaboration to advance the field of wound dressings. The outcome 'overall satisfaction' reflects the impact of complex wounds and their treatment on a patient's daily life. The use of these outcomes is recommended to improve data synthesis and promote evidence-based practice. Future developments in COS development involve creating measurement instruments and relevant endpoints for these outcomes.
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Affiliation(s)
- Charlotte Raepsaet
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Paulo Alves
- Wounds Research Lab - Centre for Interdisciplinary Research in Health, Catholic University of Portugal, Porto, Portugal
| | | | - Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | | | - Hadar Lev-Tov
- University of Miami Hospital Miller School of Medicine, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, FL, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Nick Santamaria
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Sharpe
- Podiatry Department, Salford Royal NHS Foundation Trust, Salford Care Organisation, Salford, United Kingdom
| | | | - Kevin Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Swedish Centre for Skin and Wound Research, Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Odense, Denmark; School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
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8
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Labree B, Hoare DJ, Fackrell K, Hall DA, Gascoyne LE, Sereda M. Establishing a Core Domain Set for early-phase clinical trials of electrical stimulation interventions for tinnitus in adults: protocol for an online Delphi study. Trials 2022; 23:1039. [PMID: 36539777 PMCID: PMC9769048 DOI: 10.1186/s13063-022-07020-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Tinnitus is the awareness of a sound in the ear or head in the absence of an external source. It affects around 10-15% of people and current treatment options are limited. Experimental treatments include various forms of electrical stimulation of the brain. Currently, there is no consensus on the outcomes that should be measured when investigating the efficacy of this type of intervention for tinnitus. This study seeks to address this by establishing a Core Domain Set: a common standard of what specific tinnitus-related complaints are critical and important to assess in all clinical trials of electrical stimulation-based interventions for tinnitus. METHODS A two-round online survey will be conducted, followed by a stakeholder consensus meeting to identify a Core Domain Set. Participants will belong to one of two stakeholder groups: healthcare users with lived experience of tinnitus, and professionals with relevant clinical, commercial, or research experience. DISCUSSION This study will establish a Core Domain Set for the evaluation of electrical stimulation-based interventions for tinnitus via an e-Delphi study. The resulting Core Domain Set will act as a minimum standard for reporting in future clinical trials of electrical stimulation interventions for tinnitus. Standardisation will facilitate comparability of research findings.
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Affiliation(s)
- Bas Labree
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Derek J. Hoare
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Kathryn Fackrell
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK ,grid.5491.90000 0004 1936 9297Wessex Institute, University of Southampton, Southampton, UK
| | - Deborah A. Hall
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.472615.30000 0004 4684 7370Department of Psychology, School of Social Sciences, Heriot-Watt University, Putrajaya, Malaysia
| | - Lauren E. Gascoyne
- grid.4563.40000 0004 1936 8868Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Magdalena Sereda
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
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9
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León-Salas B, Álvarez-Pérez Y, Ramos-García V, Del Mar Trujillo-Martín M, de Pascual Y Medina AM, Esteva M, Brito-García N, González-Hernández N, Bohn-Sarmiento U, Biurrun-Martínez MC, Serrano-Aguilar P. Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives. Eur J Cancer Care (Engl) 2022; 31:e13730. [PMID: 36226900 DOI: 10.1111/ecc.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals. METHODS Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus. RESULTS The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors. CONCLUSIONS Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information. IMPLICATIONS FOR CANCER SURVIVORS Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.
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Affiliation(s)
- Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,University of La Laguna (ULL), Santa Cruz de Tenerife, Spain
| | - Mª Del Mar Trujillo-Martín
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | | | - Magdalena Esteva
- Research Unit, Majorca Primary Care Department, Palma de Mallorca, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Red de Investigación de Actividades Preventivas y Promoción de la Salud (RedIAPP), Madrid, Spain
| | | | - Nerea González-Hernández
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,Kronikgune Institute for Health Services Research, Bizkaia, Basque Country, Spain.,Research Unit, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
| | - Uriel Bohn-Sarmiento
- Medical Oncology Service, University Hospital of Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain
| | | | - Pedro Serrano-Aguilar
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.,Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
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Seery C, Wrigley M, O'Riordan F, Kilbride K, Bramham J. What adults with ADHD want to know: A Delphi consensus study on the psychoeducational needs of experts by experience. Health Expect 2022; 25:2593-2602. [PMID: 35999687 PMCID: PMC9615057 DOI: 10.1111/hex.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction A lack of knowledge about attention‐deficit/hyperactivity disorder (ADHD) can contribute to feelings of distress and difficulty in seeking and accepting an ADHD diagnosis. The present study uses a Delphi consensus design to investigate the psychoeducational needs of adults with ADHD and the information about ADHD they would like included in digital health interventions for adults with ADHD. Inclusion of perspectives of service users in developing such interventions ensures that they are evidence based and addresses the risks of engagement barriers. Methods The expert panel consisted of 43 adults with ADHD (age range: 23–67 years). Panel members were asked to rate the importance of the proposed topics and provide additional suggestions. Suggested topics and topics that did not achieve consensus were included for ranking in the second round. Results Interquartile ratings were used to determine consensus. A high consensus was achieved in both rounds, with an agreement on 94% of topics in the first round and 98% in the second round. Most topics were rated as important or essential. Conclusions The findings highlighted that adults with ADHD want to learn about many different aspects of ADHD and the importance of considering their perspectives when developing psychosocial interventions. Findings can be applied when creating psychoeducational content for adult ADHD. Patient or Public Contribution Adults with ADHD were recruited to the Delphi panel to use an experts‐by‐experience approach. In doing so, we are engaging service users in the development of a psychoeducational smartphone app. The evaluation of the app will involve interviews with app users. Additionally, the present study was developed and conducted with ADHD Ireland, a charity based in Ireland that advocates for people with ADHD.
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Affiliation(s)
- Christina Seery
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Margo Wrigley
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | - Fiona O'Riordan
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | | | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
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