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Quirke FA, Ariff S, Battin MR, Bernard C, Biesty L, Bloomfield FH, Daly M, Finucane E, Healy P, Haas DM, Kirkham JJ, Kibet V, Koskei S, Meher S, Molloy EJ, Niaz M, Bhraonáin EN, Okaronon CO, Parkes MJ, Tabassum F, Walker K, Webbe JWH, Devane D. COHESION: a core outcome set for the treatment of neonatal encephalopathy. Pediatr Res 2024; 95:922-930. [PMID: 38135724 PMCID: PMC10920183 DOI: 10.1038/s41390-023-02938-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Heterogeneity in outcomes reported in trials of interventions for the treatment of neonatal encephalopathy (NE) makes evaluating the effectiveness of treatments difficult. Developing a core outcome set for NE treatment would enable researchers to measure and report the same outcomes in future trials. This would minimise waste, ensure relevant outcomes are measured and enable evidence synthesis. Therefore, we aimed to develop a core outcome set for treating NE. METHODS Outcomes identified from a systematic review of the literature and interviews with parents were prioritised by stakeholders (n = 99 parents/caregivers, n = 101 healthcare providers, and n = 22 researchers/ academics) in online Delphi surveys. Agreement on the outcomes was achieved at online consensus meetings attended by n = 10 parents, n = 18 healthcare providers, and n = 13 researchers/ academics. RESULTS Seven outcomes were included in the final core outcome set: survival; brain injury on imaging; neurological status at discharge; cerebral palsy; general cognitive ability; quality of life of the child, and adverse events related to treatment. CONCLUSION We developed a core outcome set for the treatment of NE. This will allow future trials to measure and report the same outcomes and ensure results can be compared. Future work should identify how best to measure the COS. IMPACT We have identified seven outcomes that should be measured and reported in all studies for the treatment of neonatal encephalopathy. Previously, a core outcome set for neonatal encephalopathy treatments did not exist. This will help to reduce heterogeneity in outcomes reported in clinical trials and other studies, and help researchers identify the best treatments for neonatal encephalopathy.
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Affiliation(s)
- Fiona A Quirke
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland.
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland.
- School of Medicine, University of Limerick, Limerick, Ireland.
| | - Shabina Ariff
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Malcolm R Battin
- Department of Newborn Services, Auckland District Health Board, Auckland, New Zealand
| | - Caitlin Bernard
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, US
| | - Linda Biesty
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
| | - Frank H Bloomfield
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Mandy Daly
- Advocacy and Policymaking, Irish Neonatal Health Alliance, Wicklow, Ireland
| | - Elaine Finucane
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
| | - Patricia Healy
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, US
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Shireen Meher
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Eleanor J Molloy
- Health Research Board Neonatal Encephalopathy PhD Training Network (NEPTuNE), Dublin, Ireland
- Department of Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
- Department of Neonatology, Children's Hospital Ireland at Crumlin and Tallaght, Dublin, Ireland
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Maira Niaz
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | - Matthew J Parkes
- Centre for Statistics in Medicine; Nuffield Dept of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxfordshire, UK
| | - Farhana Tabassum
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Karen Walker
- Department of Newborn Care, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The George Institute for Global Health, Sydney, NSW, Australia
- Council of International Neonatal Nurses, Sydney, NSW, Australia
| | - James W H Webbe
- Academic Neonatal Medicine, Imperial College London, London, UK
| | - Declan Devane
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
- Cochrane Ireland, University of Galway, Galway, Ireland
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Venda Nova C, Ni Riordain R, Baker SR, Zakrzewska JM. An international Delphi survey and consensus meeting to define the core outcome set for trigeminal neuralgia clinical trials. Eur J Pain 2023; 27:86-98. [PMID: 36130737 PMCID: PMC10092666 DOI: 10.1002/ejp.2041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/17/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Trigeminal neuralgia (TN) is an excruciating unilateral facial pain, which negatively affects patient's quality of life. Historically, it has been difficult to compare treatment efficacy due to the lack of standardized outcomes. In addition, patients' perspective has seldomly been acknowledged. The aim of this study was to reach consensus on what outcomes of treatment are important to different TN stakeholders (patients, clinicians and researchers), to identify the TN Core Outcome Set (TRINCOS). METHODS A list of outcomes identified through a systematic review and focus group work was used to develop the survey questionnaire. A three-round Delphi was conducted. Participants were asked to score the outcomes on scale from 1 to 9 (1-3 not important;4-6 important but not critical;7-9 critical). Outcomes scored as critical by ≥70% and not important by <15% were retained, and those for which no consensus was reached were discussed at a consensus meeting. RESULTS Of the 70 participants who completed the Delphi, 26 were patients, 38 were clinicians and six were researchers. Of the 40 outcomes presented, 17 were scored as critical and no consensus was met for 23 outcomes. Agreement was reached during a consensus meeting on 10 outcomes across six domains (pain, side effects, social impact, quality of life, global improvement, and satisfaction with treatment). CONCLUSION Implementation of TRINCOS in future clinical trials will improve homogeneity of studies' results, reduce the redundancy in the outcome assessment and effectively allow comparison of different treatments to better inform researchers, clinicians and most importantly patients, about the efficacy of the different treatments. SIGNIFICANCE Implementation of a 10-item core outcome set in trigeminal neuralgia will improve comparability between studies allowing patients to have faster access to better treatments.
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Affiliation(s)
| | - Richeal Ni Riordain
- University College London, Eastman Dental Institute, London, UK.,Cork University Dental School and Hospital, Cork, Ireland
| | - Sarah R Baker
- School of Clinical Dentistry, Sheffield University, Sheffield, UK
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Katiri R, Hall DA, Hoare DJ, Fackrell K, Horobin A, Hogan N, Buggy N, Van de Heyning PH, Firszt JB, Bruce IA, Kitterick PT. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness. Trials 2022; 23:764. [PMID: 36076299 PMCID: PMC9454406 DOI: 10.1186/s13063-022-06702-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions. Methods A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting. Results The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set. Conclusions Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06702-1.
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Affiliation(s)
- Roulla Katiri
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK. .,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,Audiology Department, Mater Misericordiae University Hospital, North Circular Road, Dublin, D07 R2WY, Ireland.
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Derek J Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Kathryn Fackrell
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Wessex Institute, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Adele Horobin
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Nicholas Hogan
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Nóra Buggy
- National Institute for Health Research Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - Paul H Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), 2650, Edegem, Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Jill B Firszt
- Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110-1010, USA
| | - Iain A Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Pádraig T Kitterick
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Acoustic Laboratories, Australian Hearing Hub, Macquarie University, Sydney, NSW, 2109, Australia
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